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In this series of photos, we will follow the MSF team based in Kayna, in a hilly region near Lake Edouard, in North Kivu, and see what they actually do operate on patients injured during clashes or victims of violence, respond to epidemics of cholera and measles, provide support to health centers and, every day, take care of medical emergencies. Les populations fuient Гgalement au Niger. Entre le 11 et le 15 mars dernier, 1 309 personnes se sont rГfugiГes Г Dirkou, et MSF leur fournit des soins mГdicaux lorsquelles arrivent Г Agadez. LвhygiГЁne et lвaccГЁs Г lвeau potable sont aussi des dГfis majeurs dans la zone.

Il nвy a aucune source dвeau potable et le niveau dвhygiГЁne - surtout sur elipa sites de regroupement prГcaires oГ vit une partie de la population rГfugiГe - est trГЁs bas. La population puise leau directement dans le fleuve, ce qui risque de favoriser la propagation de maladies dвorigine hydrique. "Dans de telles conditions, la propagation des maladies est quasiment inГvitable. La semaine passГe, il y a eu un cas suspect de fiГЁvre typhoГde sur lвun des sites de rГfugiГs. Il sвagissait dвun garГon ГgГ de 12 ans. La famille a enterrГ le corps juste Г cГtГ de leur hutte" relate Nathalie Gielen. Bitoye is approximately 10 km from the Central African border.

There, the mango trees were transformed into makeshift shelters with branches, loincloths and a cal-antagon jute bags as protection. A single food distribution over more than a week is not enough to supplement the little that local communities can offer to new arrivals. The city normally has a little over 10,000 inhabitants. Today, there are more than 15,000, an increase of 50 of the population. There are no latrines and despite the presence of three boreholes, access to drinking water remains largely insufficient. вIn three days of consultations, our medical team has already received 19 children suffering from severe acute malnutrition and the main pathologies are malaria, diarrhea and respiratory infections,в notes Anthony. On the road, people are so crowded in trucks that some fall and break their limbs. I saw a man arrive with an open fracture of the tibia that had been hastily sewn up and whose bone protruded 4 or 5 centimeters.

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Gulatun, a patient at the MSF maternity ward, is due to give birth in two months, but the placenta is blocking her uterus. вI started to worry because I had been bleeding for several days. в She will have to give birth by cesarean section. Yes Regenerative treatments with growth factors such cal-antagon platelet-rich plasma or stem cal-antagon from bone marrow, better through ultrasound-guided infiltrations. The results are good in 60-80 of knee osteoarthritis. Lвautre hГpital MSF se trouvant dans la rГgion dвIdlib est une unitГ spГcialisГe en chirurgie et en traumatologie. 1 324 opГrations chirurgicales y ont ГtГ rГalisГes ces dix derniers mois, principalement pour des blessures liГes aux violences et plus de 3 699 patients ont ГtГ pris en charge aux urgences.

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вFor the moment, there is not, strictly speaking, a war situation, even if armed opposition groups regularly launch asymmetric attacks, such as suicide bombings. Although limited, the population has access to care, but communities in the region continue to face permanent conflict. This is why our presence here is so important. В Since the opening of the new sexual violence treatment clinic, MГdecins Sans FrontiГЁres has seen an average of 35 cases per month. However, since the start of the awareness campaign in September 2015, the number of victims coming to the clinic has doubled. Victims range from young children to adults, both female and male, but the majority are women and children.

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