Doctors Without Borders – Part Three

by Mark Lovett on February 13, 2009

This article on the nature of refugee camps is the third and final post highlighting the efforts of the international organization Doctors Without Borders/Médecins Sans Frontières (MSF).

(Please read Part One and Part Two for further background)

What would you do if armed conflict suddenly erupted around your town or within your neighborhood? Where would you go, what would take with you, and how would you find a supply of food or water? For those of us in the developed world it’s hard to imagine that this would ever happen, and if it did, we would most likely jump in our car and drive over to a friend or relative’s house.

But what if you lived in a remote area of the developing world and you had no car or safe place to go? This dilemma is a common occurrence in many parts of the world. In fact, there are currently 42 million people on this planet who have been forced to seek refuge, and quite often they must endure a long journey to find a refugee camp that will provide them with food, water, shelter and vitally needed medical attention.

Refugees Cross Into Tanzania

Photo by Martha Rial - December 1996

Before arriving in such a camp they may have slept in abandon buildings or old railway cars along the way without any sort of bedding, searching for food and water while constantly worried that they may once again encounter hostile forces and be forced to flee yet again.

These Internally Displaced Persons, or IDPs (26 million) and Refugees (16 million), are mainly located in Africa, the Middle East, Asia, Europe and South America. (The exhibit highlighted Sudan, Colombia, Iraq, DRC, Uganda, Somalia for IDPs and Somalia, Afghanistan, Iraq, Colombia, Sudan and Palestinian territories for Refugees)

Mongote Refugee Camp

The United Nations High Commissioner for Refugees (UNHCR) is responsible for ensuring respect for the rights of refugees, including:

  • The right to seek asylum;
  • The right to be protected from violence or forced repatriation
  • The right to receive assistance (food, water, shelter, medical care);
  • The right to a lasting solution, whether to return home when it is safe, to stay in the country of refuge, or to resettle in a third country.

But despite the fact that 147 countries have signed the 1951 Convention Relating to the Status of Refugees, millions still continue to encounter obstacles and discrimination while pursuing these basic rights. The plight of Internally Displaced Persons remains tenuous, as there is no official international agency with a mandate to protect them. It’s also sad to note that three-quarters of them are women and children.

Except for the volunteers from NGOs who serve the needs of these people, few have experienced the plight of refugees except from a distance; a picture of a dirt road filled with a long stream of refugees carrying what few belongings they have left wrapped in a sheet or stacked in a basket; a brief video clip of a straw hut city on the evening news.

Because so few of us have ever been on such a march or had to live inside one of those straw huts, MSF created a new program called A Refugee Camp in the Heart of the City. I was fortunate to visit this project when it arrived in San Diego and in the process gained a much better understanding of such living conditions.

Located outside on a grass lawn adjacent to Balboa Park, the camp was setup as a series of stations which demonstrated the variety of facilities and procedures that one might encounter while living in such a refugee camp. Guided tours were given every 15 minutes, with each station providing a very real representation of what your life would be like.

Your New Home

Typical Refugee Shelter

Living conditions within a refugee camp are sparse, to say the least. Using whatever local materials are available, living quarters are erected which often house an entire family in a space made for two. Cloth, straw, wood or cardboard may be used to build the structure, with a plastic tarp tied over the roof to keep the rain out.

Without the luxury of heating or air conditioning, refugees must endure extreme temperatures, along with a complete lack of privacy, furniture or any comforts of home.

Clean Water

Refugee Water Purification Equipment

Providing a supply of clean water is a critical issue for cooking, drinking and hygiene. Whereas most people in the U.S. will use in excess of 100 gallons of water per day, as a refugee that amount may be cut to as little as 1 gallon per person per day and up to 5 gallons per person per day. While a human’s need for water varies with conditions and temperatures, you can die in as little as 3 to 5 days without adequate water to drink.

Obtained from wells, rivers, streams and lakes, this water must often be purified before it’s safe to drink. And because the water supply must be kept a safe distance from where people live due to sanitation reasons, it is common for refugees to obtain water in plastic jugs and carry them back to their hut, some 300 yards (and in some cases much farther than this!) away, not an easy task for women or children.

Food to Eat

Typical Refugee Food Supply

Most refugees were self-sufficient in their towns or villages, raising animals or growing crops to provide food for their families, but as is often the case, their home may have been destroyed, their crops burned and animals killed or stolen during the fighting. If they were able to bring any food with them, it wouldn’t have been enough to last very long.

Governmental agencies, the United Nations or non-government agencies will attempt to deliver food during times of crisis, but immediate delivery is not assured. In some cases, food shipments are stolen by rebel forces for their own use. When aid does arrive, food distribution cards are handed out which entitle refugees to a ration of grains, beans or lentils, cooking oil, and perhaps some salt and sugar.

Stoves are sometimes provided, or cooking may occur in pots sitting on rocks with wood fires burning below. In such situations firewood must be gathered on a daily basis. This practice brings with it another threat, as children may be kidnapped and women raped if they stray too far from the protection of the camp.

Proper Sanitation

Refugee Sanitation Building

Until a camp is properly set up, “bathrooms” may consist of the outdoors, behind bushes or in an open area. As quickly as possible, MSF will build hygienic latrines with proper waste disposal practices to prevent the spread of disease. Because dysentery and cholera spread quickly, the latrines must be kept away from all drinking water sources. The ideal situation is to provide one latrine per 10 people, but that ratio can at times can range from 20 to as many as 200 people per facility.

Disease & Medical Treatment

Refugee Camp Medical Supplies

Even in the best of circumstances, where adequate facilities are built and people follow procedures, there exists the possibility of contracting a water-borne disease, such as hepatitis E or intestinal worms. In certain areas Cholera is also endemic and medical teams must react quickly to stem the spread.

Depending on the country and particular nature of the population, MSF staff members determine what medical supplies are required to treat the variety of maladies present. MSF has basic medicine and kits to treat basic medical problems. If there is a disease outbreak, MSF might need cholera kits or set up extra tents, etc. The prevalence of disease is exacerbated by lack of proper nutrition and severe stress that serves to weaken the immune system. Cholera, malaria, respiratory infections, acute diarrhea and measles are most problematic and can spread quickly in crowded conditions.

Issues of health also include mental problems. Those who were caught in the middle of fierce fighting may have nightmares or suffer from stress related problems. Many have had family members or close friends killed or wounded. One or more of their children may have been kidnapped and rape is a tragic problem of serious proportions for both women and young girls.

Time to Go Home

How long will refugees stay in such a camp? The answer varies widely, but it typically takes many months for an area of conflict to be stabilized to the point where people can return to their villages or towns. To site one extreme example, 2 million Afghans fled to Iran and Pakistan after the U.S. invasion began, some have been there for over 5 years.

Imagine yourself living in such conditions, how would you cope with such a dire situation?

{ 6 comments… read them below or add one }

Giovanna Garcia February 14, 2009 at 12:02 pm

I love your message of Global Patriot. We are all the same color on the inside. Everyone of us can do what we can to give back to our world. Medical people can help in groups such as doctors without borders, teachers can help to educate, writer like yourselves can help by writing and spread the message…People from all walks of life can do somthing about it. All it takes it everyone doing just a little bit.

Thank you for writing your blog post. Keep doing your work, you are making a difference.
Giovanna Garcia
Imperfect Action is better than No Action

Reply

Giovanna Garcia February 14, 2009 at 8:02 pm

I love your message of Global Patriot. We are all the same color on the inside. Everyone of us can do what we can to give back to our world. Medical people can help in groups such as doctors without borders, teachers can help to educate, writer like yourselves can help by writing and spread the message…People from all walks of life can do somthing about it. All it takes it everyone doing just a little bit.

Thank you for writing your blog post. Keep doing your work, you are making a difference.
Giovanna Garcia
Imperfect Action is better than No Action

Reply

Andrea Tannouri February 14, 2009 at 7:48 am

This is a sobering reality that many of us lucky Americans would do well to remember and be grateful for the opportunities and luxuries even the poorest of us enjoy, like clean drinking water.

My husband was a young teen when war erupted in his country of Lebanon, and as a member of the Lebanese Christian forces he was severely wounded twice. He is very lucky to be alive and saw his best friend die right next to him. As a sheltered American I cannot fathom the reality of having to flee your home or defend it and your family with your life.

I am grateful to God that there are people who are willing to work hard to bring the conditions of these refugees to light. Thank you for the work that you do.

Having known several Doctors who participate in the Doctors without Borders program, I also salute them for their dedication and selflessness.

God Bless you all.

Reply

Andrea Tannouri February 13, 2009 at 11:48 pm

This is a sobering reality that many of us lucky Americans would do well to remember and be grateful for the opportunities and luxuries even the poorest of us enjoy, like clean drinking water.

My husband was a young teen when war erupted in his country of Lebanon, and as a member of the Lebanese Christian forces he was severely wounded twice. He is very lucky to be alive and saw his best friend die right next to him. As a sheltered American I cannot fathom the reality of having to flee your home or defend it and your family with your life.

I am grateful to God that there are people who are willing to work hard to bring the conditions of these refugees to light. Thank you for the work that you do.

Having known several Doctors who participate in the Doctors without Borders program, I also salute them for their dedication and selflessness.

God Bless you all.

Reply

SCIENCE AND SOCIETY February 13, 2009 at 3:18 pm

This is an important, in-depth article on Doctors Without Borders, a global NGO providing much needed medical and related health services to people in the developing world. As Global Patriot notes, in the developed world, we have no conception of the desperate conditions that exist elsewhere. Displaced persons have need of many basic services, including clean water, sanitation, food, and medicine.

Poverty is a worldwide phenomenon. Tens of millions of childhood deaths could be prevented each year by providing clean water and sanitation in the developing world. The cost – approximately $50 billion per year – minimal, compared to the money governments are throwing around these days to prop-up a failed financial paradigm.

Reply

SCIENCE AND SOCIETY February 13, 2009 at 11:18 pm

This is an important, in-depth article on Doctors Without Borders, a global NGO providing much needed medical and related health services to people in the developing world. As Global Patriot notes, in the developed world, we have no conception of the desperate conditions that exist elsewhere. Displaced persons have need of many basic services, including clean water, sanitation, food, and medicine.

Poverty is a worldwide phenomenon. Tens of millions of childhood deaths could be prevented each year by providing clean water and sanitation in the developing world. The cost – approximately $50 billion per year – minimal, compared to the money governments are throwing around these days to prop-up a failed financial paradigm.

Reply

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