Doctors Without Borders
Intense Grief and Fear in Northern UgandaFor 18 years, people in northern Uganda have endured a brutal conflict with consequences that are nearly invisible to the outside world. More than 1.6 million people – 80 percent of northern Uganda’s entire population – have been displaced and now live in squalid conditions. Civilians have been attacked and killed by the Lord’s Resistance Army (LRA) in their villages, as well as in the camps where they have sought refuge. The LRA has abducted tens of thousands of children, forcing them into combat and sexual slavery...
No End in Sight to Devastating Conflict in DemocraticRepublic of Congo (DRC)
Civilians were once again besieged in the eastern DRC when fighting erupted in North Kivu this past December. Nearly 150,000 people fled for their lives from Kayna, Kanyabayonga, and Kirumba just a few weeks after thousands of others fled fighting in the Mitwaba region. These were just the latest chapters in a decade-long war that has cost an estimated three million people their lives and reduced an already impoverished country’s limited infrastructure to ruins...
Civilians Caught in Colombia's Crossfire
Forgotten by much of the world, Colombia’s enduring conflict continues to inflict great misery on civilians. More than three million people have been displaced within the country, usually to vast shantytowns on the outskirts of major cities, and violence is still the leading cause of death. While control over coca, oil, timber, and other resources fuels the decades-long conflict, half of Colombians live in poverty. In many areas, it is nearly impossible for people to stay outside the conflict, as both government and anti-government forces consider everyone a potential informer or collaborator. In areas where control changes hands, civilians caught in the middle can be threatened, attacked, or killed...
Tuberculosis Spiraling Out of Control
Tuberculosis (TB) kills one person every 15 seconds, thus claiming millions of lives every year even though it is a curable disease. While the risk of TB is relatively low in wealthy countries, the disease is making a comeback throughout the developing world: one-third of the world’s population is infected with the TB bacilli and eight million people annually develop active TB... The AIDS pandemic has lead to an explosion of HIV/TB co-infection, as TB is the most common opportunistic infection for those living with HIV/AIDS. This further increases TB’s appalling human toll. There is an urgent need for serious improvements in the way TB is tackled globally, from research and development of new medicines and diagnostic tests that detect all forms of TB in all patients, especially children and people living with HIV/AIDS...
Somalia Shattered By Anarchy and Chaos
Fourteen years of violence have dramatically affected Somalia’s population of nine million, with approximately two million people displaced or killed since civil war erupted in 1990 and close to five million people estimated to be without access to clean water or health care. The collapse of the health-care system, along with most other state services, have hit women and children particularly hard: one in sixteen women dies during childbirth; one in seven children dies before their first birthday; and one in five children dies before the age of five...
The Trauma of Ongoing War in Chechnya
A decade of intense conflict continues to devastate people in and around Chechnya. Despite repeated claims from officials that the situation is ‘normalizing,’ Chechnya is far from peaceful and stable. Even so, since 2003, Russian and Ingush authorities have put considerable pressure on internally displaced people (IDPs) in Ingushetia to return to the war-wreaked region. By the end of 2004, only 45,000 people who fled the conflict, out of an original 260,000, remain in Ingushetia and are living in terrible conditions, while those pressured to return to Chechnya have been placed in “Temporary Accommodation Centers,” where conditions are not much better...
User-Fee System Excludes Burundi's Poorest From BasicHealth Care
In Burundi, a country struggling to emerge from a decade-long civil war, a user-fee, or cost-recovery, system has become the cornerstone of health-care financing. As a result, the country’s most impoverished are paying a catastrophic price. A recent medical survey by MSF found mortality rates double the emergency threshold, and little or no health care for those who could not pay. In regions covered by the user-fee system, malaria deaths were twice as high as in areas adopting a low flat fee. One in five people interviewed said they didn’t visit health centers even when they are sick because they couldn’t afford it – not surprising in a country where nearly 99 percent of the people live on $1 a day and a staggering 85-90 percent survive on $1 a week...
North Koreans Endure Massive Deprivation and Repression
A man-made cataclysm continues to rage in North Korea, where people struggle against violent repression and massive deprivation in a country that is almost entirely sealed-off from the outside world. In the late 1990s, an estimated two to three million people starved, and recent stories from refugees reveal that the food and health situation is still dire. Even though huge amounts of international assistance pours into the country, there is no way of knowing if it reaches those most in need and many suspect that the bulk of aid is simply diverted by the military regime. Economic reforms, introduced in July 2002, have exacerbated problems, resulting in runaway inflation that undermines people’s ability to afford basic food items. For many desperate North Koreans, even fleeing the country does not end their anguish. Considered economic immigrants by Chinese authorities, most live in hiding because they fear arrest and forced repatriation to North Korea, where they are subject to imprisonment and brutal treatment...
Constant Threat of Hunger and Disease in Ethiopia
More than 10 percent of children do not survive their first year of life in Ethiopia. Scarce farmland in the overpopulated arid highlands leaves an estimated five million of Ethiopia’s 69 million people to face chronic food shortages. Severe droughts in 1999 and 2001 compounded the situation. While some recent rains have provided a little respite, the lack of substantial rainfall since early 2003 has led to the deaths of an estimated 50 percent of people’s livestock... Ethiopian doctors struggle with few resources to fight infectious diseases like HIV/AIDS, malaria, TB, and kala azar for which treatment is expensive and often inaccessible. Malaria has become particularly deadly because drug resistance has rendered the most common anti-malarial treatment practically useless...
The War is Over, But Liberians Still Live in Crisis
Intense fighting during the summer of 2003 in Liberia’s capital, Monrovia, cost more than 2,000 people their lives. More than a year after this debilitating 15-year civil war ended, though, Liberians are still living in a state of crisis. Little of the country’s demolished infrastructure remains, leaving most people without basic services like water and sanitation. More than 300,000 people are still displaced within the country while 300,000 refugees wait to return from neighboring countries. Health care, already scarce in the main cities, hardly exists at all in remote areas of the country. Today, there are only 30 Liberian physicians working in a country with more than three million people...
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