One of the MSF priorities when deciding whether to open or close a project is to be “needs-driven”. It is one of the reasons that I like working for MSF. This means designing projects, not because they are easy for MSF to access, but because there are real humanitarian medical needs that have been identified during an initial assessment.
Defining “needs” can sometimes be difficult, so we use terms like “vulnerability” to target certain groups who are those most in need of assistance. Some examples of vulnerable groups can be : displaced people, malnourished children, war-wounded, widows, orphans, victims of sexual violence, people living with HIV/AIDS.
On paper, these groups are quite easy to distinguish. In the field, it can be a bit more complicated. It is one of the reasons that our team is in Kitutu at the moment, to assess the level of vulnerability of the population.
I met a woman this week who is now a widow, living alone, after her husband and 7 children had all died over the last 5 years, either from illness or as casualties of the ongoing conflict. When she was displaced from her village a couple of months ago, she came to the village where we have since started our mobile clinic. As with other displaced people, she went first to the local chief of the village to ask for somewhere to stay. He found her an abandoned hut which she now lives in. It has a leaky roof, a broken bed and no door, but it will be her home until it is safe enough for her to go back to her village.
It looks pretty bleak. However, at least she is in a village where the community has really tried to help the newly displaced arrivals. Everyone has donated something, whether a bucket, a saucepan or a jerrycan, so that the displaced families in this village have the very basics they need to eat, drink and wash.
So would this woman be considered as “vulnerable” by MSF? Of course. But we have to be careful that we intervene in projects where the impact, especially medical, is clear. There are many people in South Kivu living in conditions like this woman. And our resources are not unlimited…
We are not only here to assess health needs though. We are also providing direct medical assistance through mobile clinics to some of the more remote parts of the health zone.
In the last 3 weeks, we have carried out more than 2,100 free medical consultations, most of which are for displaced people. That is more consultations in 3 weeks than the monthly total for the 22 health centres in the whole of the health zone of Kitutu!! We have screened 4,630 children under 5 years old for malnutrition , and have found that almost 300 are malnourished, of which 82 have severe malnutrition, who have started the necessary treatment.
When it comes to mobile clinics, there are not so many questions to ask yourself. You see the impact of MSF´s work every day.