Kabinda Hospital Center (CHK), Kinshasa. It is the only dedicated HIV/AIDS medical structure in the capital city of DRC. Originally from Boma, this 27 year old woman moved to her uncle’s to be cared for in Kinshasa. Her mother left the village to remain near her. After a first hospitalisation in Boma, she was recommended to go to Kinshasa. Without going through other intermediary structures, she went to the Kabinda Hospital Centre to be properly cared for. Today is her weekly appointment to get her ARVs. After receiving her drugs, she asked to see a doctor for abdominal pain. In her uncle’s family, he is the only one knowing her status. Her biggest fear is that her children learn about it as they would spread the noise around in the neighborhood and her uncle would have to send her away.

Kinshasa hospital (Centre Hospitalier de Kinshasa, CHK), the only medical structure dedicated to HIV/AIDS in the capital city of DRC.
Originally from Kassai Occidental, this 45 year old mother of 3 children all living with their father since their divorce 10 years ago (the divorce had nothing to do with her health status). After the divorce, she had a partner for 2 years, period during which she would have contracted the virus.
In June 2012, she quit the Kassai to reach Kinshasa in the hopes to get treated as her health reached a critical point. The move was made possible because her big sister lived here and could care for her. Her sister is the only person who knows her status. But due to lack of financial means, she was not brought to a health centre. It is a member of the RENOAC, an association of people living with HIV/AIDS who discovered her and brought her and referred her to the CHK on Nov. 25.
She was tested HIV and TB positive. She is leaving the hospital today and will be back next week to begin her ARV treatment, though she started on TB treatment. Before getting started on ARV , she will go through some information sessions which will allow her to understand the importance to carefully follow her treatment. This good understanding will increase her chances to adhere to the treatment and therefore, her chances of living positively.

G. has been on ARV treatment since the end of October 2012. Like many other people, G. doesn’t come to the hospital until late. This is for a number of reasons: lack of knowledge about the disease, belief in tradition medicines or witchcraft, not being able to pay for healthcare (healthcare is supposed to be free but, except for Kinshasa hospital, patients in the city’s health centres and hospitals still end up paying), stigmatisation.

G. first went to a health centre because of a wound that wouldn’t heal. She was referred to Kinshasa hospital and the wound turned out to be Kaposi’s sarcoma, an opportunistic infection that people with HIV develop at the fourth, and final, stage of the disease. G. was also diagnosed with tuberculosis.
G. has only told one aunt of her HIV status, although it was her oldest daughter who accompanied her to the hospital. G. has refused to tell her daughter, but suspects that other people visiting the hospital have talked about AIDS to her. She has seen her daughter grow more distant: She doesn’t share meals with her any more or help out with her medical care. “I can’t bring myself to say it to her in my own words”, says G. As long as it is other people who are telling her daughter that she has AIDS, G. can deny it, and her daughter will be uncertain. G. is scared of a violent reaction from her daughter, that she will reject her mother completely.
G. is from Katanga, southern DRC, where her parents and siblings still live. She moved to Kinshasa with her daughter in 2002 when she started a relationship with a soldier (G. is divorced). In 2011 the couple split up and G. found herself alone in the capital.

Ramatou, 21, stands next to the tent where she watches after her child who has been admitted to the hospital for severe fever and diarrhea. She has been here for three days and says she doesnt understand why her baby is sick.
MSF teams are on high alert during the rainy season between July and November because of the deadly combination of malnutrition and malaria. Since July, the MSF team in Guidan Roumji has to face a peak of malnutrition and malaria. The number of admissions to MSFs hospital has doubled over the last weeks and 80 per cent of the children admitted are now suffering from malaria. In Niger, MSF conducts medical and nutritional activities in Tahoua, Maradi, Zinder and Agadez. As of August 2012, more than 50,000 children suffering from acute malnutrition and 105.000 malaria cases have been treated in medical facilities run by MSF and its partners.

Fishing boats at Bunfi Port in Conakry, Guinea, Aug. 18, 2012.
Fishermen and vendors can touch fish contaminated with cholera and ingest it or spread it to others. Médecins Sans Frontières is responding to a cholera outbreak in Guinea, which is affecting coastal areas and inland. Two emergency MSF cholera treatment centers in Conakry are receiving around 60 new cases per day, and a third treatment center opened over the weekend.

Tegucigalpa, Honduras – July 2012
A homeless man is given a quick eye exam by a health worker from Médecins sans Frontières/Doctors Without Borders (MSF) on July 16, 2012.
Honduras now has the highest per capita murder rate in the world and its capital city, Tegucigalpa, is plagued by violence, poverty, homelessness and sexual assaults. With an estimated 80% of the cocaine entering the United States now being trans-shipped through Honduras, the violence on the streets is a spillover from the ramped rise in narco-trafficking.
MSF has set up a program in the capital that looks to provide medical and psychological care to the homeless population. Each day a team goes out into the streets to meet with vulnerable groups of homeless to assess their needs.

Jimale Mohamed, a MSF clinical officer, examines a young patient in the Out-patient Department of MSF’s field hospital in Doro refugee camp.

Doro is one of three Upper Nile camps sheltering at least 113,000 refugees who have crossed the border from Blue Nile state to escape fighting. Refugees arrive at the camp with harrowing stories of being bombed out of their homes, or having their villages burned. The camps into which they have poured are on a vast floodplain, leaving many tents flooded and refugees vulnerable to disease.

Jamam, South Sudan – July 2012
The wife of a man who died grieves as her husband is buried in a field July 19, 2012 in Jamam refugee camp.
About 100,000 refugees fleeing the fighting in the Sudanese state of Blue Nile have taken refuge in Maban county in South Sudan. They are weak and exhausted after their long trip.

Jamam refugee camp, Upper Nile State – March 2012
Refugees from Blue Nile State in Sudan fled to seek safety in the refugee camps at Doro and Jamam, in Maban County. More than 80,000 refugees have gathered in an inhospitable environment that cannot support this number of people, leaving them totally reliant on humanitarian assistance. These photos were taken in the dry season, with a window of opportunity to get everything ready prior to the rainy season closing fast.

Musina, South Africa – February 2012
Girls gather around the table to do their homework at the URC church where the girls shelter is.
In 2007, massive numbers of Zimbabweans started seeking refuge in South Africa, mostly illegally, due to the collapse of the economy and the political violence nationwide. MSF launched two projects providing humanitarian relief and medical assistance to the refugees at the end of 2007. In Musina, the northernmost town of the Limpopo province right across the border from Zimbabwe, MSF provides medical care for the new arrivals, collaborating with the public hospital to refer patients for secondary level care, chronic patient assessment and treatment of HIV and TB.

Upper Nile State, South Sudan – February 2012
Aziza with her son Tom in MSF’s in-patient department at Doro refugee camp.
Refugees from Blue Nile State in Sudan fled to seek safety in the refugee camps at Doro and Jamam, in Maban County, Upper Nile State, South Sudan. More than 80,000 refugees have gathered in an inhospitable environment that cannot support this number of people, leaving them totally reliant on humanitarian assistance. These photos were taken in the dry season, with a window of opportunity to get everything ready prior to the rainy season closing fast.

Helmand Province – December 2010
A young girl in the paediatric ward of the Médecins Sans Frontières hospital in Lashkar Gah. It is one of only two twenty-four hour and free hospitals in Southern Afghanistan and has 154 beds.

Kunduz, northern Afghanistan – December 2011
Ali*, 11, gazes through a window from inside outpatient clinic at the MSF trauma center in Kunduz, northern Afghanistan, December 3, 2011. He suffered severe facial and hand injuries when a discarded detonator he discovered in the street exploded. His brother was blinded in the explosion. The MSF hospital opened in August, 2011 and provides surgical care and physical therapy. It is the only trauma center of its kind in the region.

*Name has been changed

Liben Region – December 2011
After they have been to the reception centre, refugees coming from Somalia are moved to a transit camp where they are supposed to stay for a week. Approximately 8000 people are now living in transit camps and the majority has been there for over 2 months, the poor living condition attributes to the deteriorating health status of these refugees. In the only health centre in the camp MSF provides primary health care, psycho social care, runs a nutrition program, and an out Patient Department.

Kinshasa – January 2011
Patrick and Selly examining Nadine (28), a patient at the Centre Hospitalier de Kabinda (CHK) in Kinshasa. The conditions surrounding access to care for people living with HIV/AIDS in DRC are horrific. At the Centre Hospitalier de Kabinda, MSF has observed an excessively high number of patients arriving with serious complications resulting from lack of treatment. Their advanced illness creates unacceptable suffering.

Jonglei State, South Sudan – January 2012
Lekwongole, a village north of Pibor town where MSF runs a clinic, scarcely exists now. In the State of Jonglei in South Sudan, civilians continue to bear the brunt of inter-communal fighting. Wounded patients are still arriving at the Médecins Sans Frontières (MSF) hospital in Pibor, three weeks after the violent attack on the town and outlying villages in Pibor County. Many were injured in the bush, where thousands have remained, afraid to come out of hiding. MSF medical teams are now treating serious wound infections, some several weeks old.

Port-au-Prince, Haiti – June 2011
Chantale (name changed) was assaulted and raped while walking in her neighborhood, not far from her house. She was attacked in a vacant lot on her way home. Her attackers were never arrested. She is portrayed here with her MSF psychologist.
Sexual Violence in Haiti Sexual violence in Haiti is a true problem. Women are consistently made victims of sexual violence and they have little or no recourse either through their family or the law. Rapes, domestic violence are an accepted fact of life in the country and especially in the slums. Médecins Sans Frontières (MSF) offers psychological treatment and medical diagnoses to help treat the victims wounds.

Dollo Ado, Ethiopia – October, 2011
In the “Kobe” medical center for severely malnourished children, Hawa Nur Ibrahim sits with her 3 year old son Ali Adan. Her daughter Legla (2 years ) died recently of severe illness and she fears the same could happen to her son. Admitted for more than ten days already, his body is still very fragile and he is still not able to drink or eat himself.

January 2012
After a recent typhoon caused severe, and in some cases fatal, flooding on the southern Philippine island of Mindanao, a Médecins Sans Frontières (MSF) team began providing emergency medical assistance to people whose houses were destroyed and who are now living in evacuation centres.

Khanda Faraj Mohammed, 27 years old, mother of three and pregnant with her fourth child was severely burned in a car bomb explosion while shopping in the market of Kirkuk. She is being treated in a program run by Medécins Sans Frontières (MSF) that cares for Iraqi victims of violence whose injuries can not be treated inside Iraq. The program is now beginning to receive patients from Yemen, Syria, Egypt and Libya in addition to Iraqis. Amman, Jordan.