Treating refugees in Tanzania: Teamwork - it's a beautiful thing

Saschveen has recently returned from assignment with Médecins Sans Frontières / Doctors Without Borders (MSF) in Nduta, Tanzania, where she was providing vital healthcare to the many Burundian refugees there. She shares her diary from the time...

Something that inspires me and keeps me going every day, is how in the chaos that is a refugee camp, and with all the limitations and restrictions, there is this incredible sense of teamwork that permeates our activities at our hospital and in the community health posts.

Tens of women wash their babies in plastic tubs

A baby washing session run by the MSF health promotion team. Photo: MSF.

The big MSF machine

The work of the more than 600 staff on the ground with MSF here at Nduta Camp is no mean feat, and it never ceases to amaze me how it somehow all comes together each day and keeps an incredible momentum, charged with the collective energies of the people here.

I had heard, before I started working here, people talking about the “big MSF machine” where all of MSF’s key priorities come together in one combined effort.

The Nduta project really epitomises this: all of our departments are inextricably linked, and no one department could exist or function without the support of another.

Not just doctors…

Many people are of the misconception that Médecins Sans Frontières (which translates as “Doctors without Borders”) is comprised only of doctors and nurses.

A member of the MSF health promotion team smiles with his guitar

The health promotion team use songs to help communicate important tips for staying in good health. Photo: MSF

However, the reality is that the medical teams would have no way of reaching the population or administering care without the support of a huge number of other professionals making it happen.

Not a single vaccination can take place without a complex network of supply and pharmacy experts. They ensure that vaccines reach their target patients and work their magic, preventing devastating infections.

(The whole ‘cold chain’ process of transporting vaccines at a constant stable cold temperature to prevent the immunisations spoiling is one of the biggest logistical hurdles in public health in this setting.)

Every role is vital

Similarly, no medical interventions would even be possible if there is no shelter or essential equipment or electricity onsite.

No patient could improve and survive without access to clean water for drinking, hand-washing and surgical procedures, or without access to latrines and safe sewerage management.

No health care facility could continue to provide a safe and clean environment without the intensive labour of the hygiene officers, cleaners and sterilising teams at all hours of the day.

No infectious disease could be quickly identified, tracked, treated, monitored, nor prevented in its spread to others, without the intensive community surveillance and education by our health promotion team.

No life saving blood transfusions could occur without the support of laboratory personnel and the refugees that offer to be blood donors.

No patient’s malnutrition would be treated without the hard work of our nutrition assistants and the hospital kitchen.

No patient could have their complaints and concerns understood without the dutiful assistance of our medical interpreters.

No hospital or health service would be able to function without the incredible input (for everything from recruitment and payment of staff, and the timetabling, the purchasing and the coordination) from the Human resources and finance teams.

No patient could even be reached without the assistance of our transport, ambulance and mechanic teams on the ground.

Priority list

MSF’s essential priorities in any humanitarian emergency include:

  • assessments to prioritise the needs of the patients
  • the provision of measles vaccines and lifesaving essential childhood vaccinations
  • assisting in monitoring of water and sanitation activities
  • assessing and treating nutrition issues
  • advocating for shelter and site planning
  • the provision of essential healthcare services
  • programs to control communicable diseases
  • implementing public health surveillance measures to identify illnesses and health risks early
  • and finally ensuring Human Resources management & staff training.

Since my time here, I can confidently say that I now understand this term, the “big machine,” as I see this all of these key priorities in action every single day, and it still takes my breath away.