Simple, innovative solutions are improving access to insulin in the world’s largest refugee camps.

One night, in the summer of 2017, Lalu Begum awoke to her next-door neighbour’s house on fire.

Their town was being attacked as a wave of horrific violence swept across Myanmar’s Rakhine state. On Aug. 25, 2017, the Myanmar government had launched a military campaign against the Rohingya people, a predominantly Muslim ethnic minority group who had suffered decades of discrimination and persecution.

As military forces moved through the neighbourhood, setting homes alight, Begum, along with her husband and two sons, gathered what they could and made for the Naf River, which separates Myanmar from neighbouring Bangladesh. The family spent the rest of the night in the forest, keeping hidden as best they could, until they found an abandoned boat at the river’s edge and crossed the border.

Begum and her family were among more than 700,000 Rohingya people who were driven out of Myanmar in a matter of weeks. In Bangladesh they joined hundreds of thousands more who had fled their homes in previous cycles of violence, settling in the sprawling Kutupalong refugee camps.

“Often these people were walking three hours or more to come to their clinic visits, and they’re walking because no motorized transportation — or wheeled transportation at all — is permitted within the camp.”

Anjoli Anand, an MSF noncommunicable diseases advisor

Today, more than one million Rohingya people remain stateless in Kutupalong and Balukhali near the coastal city of Cox’s Bazar. Kutupalong is itself, the largest refugee camp in the world. Most people live in shelters built from strips of bamboo and plastic sheeting set among the hills of what was once the Ukhiya forest area. Unable to leave the camps or return home and barred from working, Rohingya refugees are totally dependent on humanitarian assistance for essential services, including healthcare.

After nine years of living in the camp, Begum began to feel sick. She visited a Doctors Without Borders/Médecins Sans Frontières (MSF) hospital and was diagnosed with diabetes.

An evolving emergency

MSF has worked continuously in the Kutupalong refugee camp since the early 1990s, providing a range of services to both Rohingya people and Bangladeshi communities in the region, including both inpatient and outpatient care, 24/7 emergency room services, neonatal and pediatric care and more at three hospitals. As successive waves of refugees arrived in the camps over the decades, MSF adapted medical services to meet the needs of the growing — and aging — community, which included a need to treat noncommunicable diseases like hypertension and diabetes.

For Rohingya refugees living in the camps, every aspect of daily life is challenging. Vast stretches of forest were hastily cleared to make room for the exodus of people forced to flee from Myanmar. The makeshift camps are prone to flooding and landslides during the long rainy season.

Refugees receive food rations and other services from government donors and nongovernmental organizations, but it is nowhere near enough to meet the massive needs. Those living with chronic diseases like diabetes face even greater challenges.

When MSF began providing diabetes care in the camps, patients had no choice but to travel to hospitals for glucose testing, and to receive medication.

“It’s difficult to overstate just how challenging it can be to get around in a place like this,” says Anjoli Anand, a physician and MSF noncommunicable diseases advisor who provides medical guidance and direction to our humanitarian teams. “Often these people were walking three hours or more to come to their clinic visits, and they’re walking because no motorized transportation — or wheeled transportation at all — is permitted within the camp.”

As the number of diabetes patients grew, MSF teams faced a challenge: If people were struggling to reach treatment for diabetes, how could we bring care to them?

Old-fashioned solutions to modern challenges

In many parts of the world, diabetes is largely managed by patients at home. People living with the illness are taught to monitor their own glucose levels and administer insulin themselves using a syringe or injection pen. But insulin needs to be kept cool, which poses a unique challenge in a setting where average high temperatures hover around 32 degrees Celsius and most people live without access to electricity.

Enter the humble clay pot.

“Historically, when people were trying to store vegetables at home or keep water cool for longer periods of time, they often stored these things in clay pots,” says Anand. “Clay pots are cheap and widely available; they can be found in local markets almost anywhere MSF works.”

The pots help regulate temperature through a simple process called evaporative cooling. At MSF facilities, patients living with diabetes are given sets of nesting clay pots and taught how to put one inside the other and fill the gap between them with wet sand. Patients keep the sand damp, and as the moisture evaporates it pulls heat away from the inner pot, keeping the insulin stored inside cool.

For two years Abdur Shukkur, had to travel to a clinic every day to get his insulin injections.

“We don’t have money, or electricity, for a freezer,” says Shukkur. “So, the clay pot service is a huge support for me.”

Spreading the word

Many people living with diabetes in the Rohingya refugee camps were not aware of the disease before being diagnosed, and misconceptions and social stigma can deter people from seeking care. That’s where MSF’s health promoters come in.

Several times a week, MSF community promotion volunteers Ferojdul Haque and Yeasin Juhar crisscross a section of the refugee camps to spread the word about the services MSF provides and teach people about diabetes and other noncommunicable diseases.

Both Haque and Juhar — and the rest of MSF’s community promotion team in the camps — are themselves Rohingya refugees. It’s this connection to the community that helps them reach people with important messaging about their health.

“It’s helpful because I know everyone in the area,” says Haque. “It makes it easier for me to teach them. They accept what I have to say because they are my relatives and friends.” He’s noticed the positive impact his years of work has had in the community.

“At first there were a lot of rumours about diabetes,” he says. “[For example], if a woman got diabetes, her husband might send her out of the house out of fear that the disease was contagious. Now we don’t see anything like that — they understand what diabetes is and how it works. That’s the thing I love most about this work: helping people.”

Calling for equitable access to care

While simple solutions like clay pots and health education have had major impacts on the health of people living with diabetes, many advances in medicine and technology remain out of reach. Most people living with diabetes in the camps who use insulin to control the disease get it in vials, from which they need to measure dosages and use syringes to inject the medicine. Insulin pens, which are widely available in high-income countries like Canada, are much simpler and safer for people to use.

The number of people living with diabetes around the world is skyrocketing: from around 200 million in 1990 to 830 million in 2022. However, access to insulin pens is extremely limited in low- and middle-income countries, where more than 80 per cent of people affected by diabetes live. MSF is calling on governments, funders and pharmaceutical corporations to improve access to insulin pens and ensure that people with diabetes everywhere have more equitable access to care.

MSF has provided some patients with insulin pens in the Rohingya camps and is in the process of making them the standard of diabetes care. While the pens are still too expensive to implement widely, the patients who are using them describe improved quality of life.

“[Using the pen] makes it easier to take insulin regularly, so my diabetes is under control,” says Lalu Begum, who has been using insulin pens prescribed by MSF for several months. “I am feeling much better than before.”

Meet the health workers responding to Ebola disease while living through the outbreak themselves.

Democratic Republic of Congo (DRC) is experiencing the largest and deadliest Ebola disease outbreak in its history. According to Ministry of Health figures, in nearly six months since it was declared, almost 11,000 people have been infected and more than 5,300 have died as a result. The real figures are likely higher.

The staff working on the Ebola disease response operate in challenging environments. Some have lost loved ones, family members or colleagues.

Ebola disease responders are not immune to the disease. While the risk of contracting the virus in Ebola Treatment Centres is generally limited thanks to strict infection prevention measures, most responders come from communities affected by the outbreak, where a risk of transmission in everyday life exists.

Even tiny levels of exposure to the Bundibugyo virus, spread through bodily fluids, can cause infection – and the mortality rate is close to 50 per cent.

Nationwide, hundreds of responders have been infected and dozens have died, according to official figures. People working for or with Doctors Without Borders/Médecins Sans Frontières (MSF) haven’t been spared. Since the declaration of the outbreak, out of the 2,900 people mobilized or supported, 29 were infected, most likely within communities, and three died.

Despite the challenges, thousands of workers remain determined to bring the epidemic under control and save lives. Each has their own story.

“When I look at my patients, I see myself.” – Sylvain Radjabu Lubangi, physician

Sylvain Radjabu Lubangi is a physician who worked in MSF’s Elikya Ebola Treatment Centre (ETC) in Bunia, Ituri province. The ETC has since closed. He entered the high-risk zone each day for months to care for patients with Ebola disease.

Having survived the disease himself, he knows how frightening it can be.

“At the beginning of the outbreak, many people were dying. I thought I was going to die too,” he says.

Lubangi contracted the virus before joining the MSF-run treatment centre. Admitted to this facility, he learned that other health workers had died in the region. “That was very hard. I kept thinking maybe I would be next,” he says.

But he found the strength to fight.

“I told myself Ebola is a disease like others — you can receive care and recover,” he says.

After recovering, Lubangi chose to continue supporting the Ebola response.

“I know the fear, the pain and the uncertainty. That gives me even more empathy and more strength to help them,” he says.

“They can seem fine one day and the next day they are dead” – Carla Schwanfelder, pediatrician

Carla Schwanfelder is a pediatrician from Germany, working at MSF’s Ebola Treatment Centre (ETC) in Mongbwalu, Ituri.

While children represent a minority of patients seen at this facility, they represent a larger proportion of patients who die from the disease.

“Most of the children we treat who test positive die,” says Schwanfelder. “They are among the groups most vulnerable to this disease, alongside older people and pregnant mothers.”

“They can seem fine one day – eating and playing – and the next day they are dead,” she says. “It is no longer surprising, but it is deeply sad. When we see them deteriorating, there is not much we can do.”

So, seeing children recover provides a dose of relief to the team.

“When they are beginning to get better, we have fun – we fist bump through the plastic screen designed to stop infection,” she says. “They laugh and we laugh with them.”

This is Schwanfelder second Ebola disease reponse.

“I can’t sit at home and watch from afar when I know I have skills I can use to help,” she says.

“People listen to me. I know what it is like to suffer from Ebola.” – Dieudonné Tchuma Longa, health promoter

Dieudonné Tchuma Longa works as a health promoter with MSF in Mongbwalu, raising awareness in communities about the dangers of Ebola disease and advising people how to stay safe.

“We go door to door, organize community meetings and speak with religious and other community leaders,” he says.

Since July, Longa has lost eight members of his family to Ebola disease, including his father and son. He believes he was infected at his father’s funeral.

“People listen to me. I know what it is like to suffer from Ebola disease. Explaining the seriousness of this outbreak is essential if we are to save lives.”

“We share our feelings with each other to lighten the load.” – Charlotte Borive, mental health agent

Charlotte Borive provides mental health support to patients at the ETC in Mongbwalu.

“Most of my job is about identifying the needs of patients and helping them overcome their fear of the treatment centre,” she says.

“People are scared of being isolated, they are scared of Ebola disease and they are scared of people in personal protective equipment (PPE).”

Borive says that the death of health workers in Mongbwalu has been difficult for the team to handle.

“It really impacted us,” she says. “These are people who wanted to help the community.”

“Every night, my heart was bleeding for our patients.” – Alice Alyerunga, nurse

Alice Alyerunga is a nursing supervisor from Bunia, working at MSF’s ETC in Mongbwalu. Although she has worked with MSF for the past 12 years, she has never responded to an emergency on this scale.

“It is the most stressful intervention I have been a part of,” she says. At the beginning, it was catastrophic. We had no survivors for three weeks. Around 100 people died. Every night, my heart was bleeding for our patients. When we had our first survivor, it was a joyous moment.”

“As frontline health workers, we face high levels of exposure, even with PPE,” says Alyerunga. “This means that it can be frightening to work here, but we are motivated by our mission to save lives.”

“Sometimes they are dead by the time they arrive.” – Richard Kasereka, ambulance driver

Richard Kasereka is an ambulance driver. He is initially from Goma, North Kivu, and works at MSF’s ETC in Mongbwalu, Ituri, where the outbreak began.

“We have picked up a lot of patients here,” he says. “In bad cases, there is a lot of blood, diarrhea and vomiting. It is risky because these fluids are highly infectious. Sometimes the person is nearly dead already when we pick them up. Sometimes they are dead by the time they arrive.”

“To save lives, we need to earn the trust of the population.” – Samson Balidja, country director support

Samson Balidja grew up in Ituri province. Today, as MSF’s country director support in Bunia, he helps MSF navigate the security and humanitarian challenges of working in his home province.

Around a dozen active armed groups operate in the area, making humanitarian access difficult and complicating the Ebola disease response.

“During clashes, the communities flee,” he says. “This disrupts prevention measures, facilitates the spread of the disease and prevents us from accessing affected areas.”

MSF teams also face deep distrust. Balidja was among the first MSF staff to arrive in Mongbwalu, where the outbreak is thought to have begun.

“We were threatened and a group of youths set fire to a tent we had set up next to the hospital. They didn’t believe Ebola disease was serious. They thought NGOs had created it to make money,” he says.

More recently, Balidja and other colleagues were attacked in another part of the province.

“They threatened us, saying we would not make it out alive,” he says, but remains resolute.

“To save lives, we need to earn the trust of the people,” he says. “We need to reinforce community engagement, help communities understand why we are there and work alongside them.”

“If we fail to act, a single case can wipe out a whole village.” – Judith Mudjagani, nurse

Judith Mudjagani is a nurse in Bunia who joined MSF’s Ebola disease response in May. She worked in Elikya ETC in Bunia, Ituri province, until the closure of the facility, at the end of October.

“For months before the outbreak was declared, we were treating sick patients without proper protection,” she says. “In early June, I tested positive for Ebola disease. I’m sure it was because I had been working without protection.”

“It was frightening. I know other health workers who have died,” she says.

Mudjagani is driven by a strong sense of duty.

“If we don’t isolate and treat patients, a single case can wipe out an entire village,” she says. “But if we keep going I’m optimistic that we can defeat this epidemic.”

“We cannot save everyone. And it weighs on us all.” – Adelard Kasereka Kasisivahwa, water, sanitation and hygiene supervisor

Adelard Kasereka Kasisivahwa is from Butembo, North Kivu. As MSF’s water, sanitation and hygiene (WASH) supervisor at the city’s hospital, he leads and trains around 60 colleagues, to clean wards and create a safe environment for staff, patients and the community.

When a patient dies, his team helps prepare the body — which is highly infectious — for safe burial. Transparent windows in the morgue tent allow families to watch the preparations.

“Families need to see what we are doing and be part of saying goodbye,” he says.

But the process can be hard to bear.

“At MSF, we do everything we can, but we cannot save everyone. And it weighs on us all.”

“When someone walks out alive, it is a great joy.” – Vivuya Kavira Mwenga, nurse

Vivuya Kavira Mwenga is a nurse at MSF’s ETC in Beni, North Kivu.

When patients arrive, her team isolates them, monitors them closely and treats their symptoms.

“We cannot cure Ebola caused by the Bundibugyo Virus yet, but we can treat the symptoms,” she says.

“When someone walks out alive, it is a great joy,” she says. “That is what we want for every patient.”

“We listen, then we tell them the truth.” – Kass Kalume, chief of community engagement

Kass Kalume is chief of community engagement at MSF’s ETC in Beni. He joined the response in August 2026.

His job is to inform patients, families and visitors about Ebola disease and how to protect themselves – and to tackle the rumours that can spread fear.

“Some people say our ETC is a morgue – that no one leaves alive,” he says. “Others say we inject people to make them weak.”

The most difficult moments occur when a patient dies. Mourning can turn into anger, and sometimes into threats and accusations against MSF staff. Kalume and his colleagues respond to disinformation with facts.

“When families accuse us of causing the death, we listen, then we tell them the truth: it is the virus that kills,” he says.

“I am a health worker. When we take an oath, we cannot give up.” – Rachel Mbuto, infection prevention and control supervisor

Rachel Mbuto is MSF’s infection prevention and control supervisor in Butembo, North Kivu. She joined three months ago – her first MSF response.   

She leads 20 people to keep the ETC safe and limit the risk of infection.  

“My job is to make sure everyone follows the protocols,” she says. “One mistake can put everyone at risk.”  

Rachel checks that staff are properly dressed before entering the high-risk zone, that equipment is disinfected and that waste is handled safely.  

“I know the context is dangerous, but I am a health worker. When we take an oath, we cannot give up,” she says.   

Airstrike on Nasser hospital in Khan Younis kills six people, including a child and a surgeon.

Doctors Without Borders/Médecins Sans Frontières (MSF) is utterly appalled and outraged by the Israeli airstrike on Nasser hospital in Khan Younis, Gaza, last night. The airstrike hit Nasser’s surgery building, killing six people, including a child and a surgeon, and injuring 52 others. No warning was given before the attack. Among the injured, MSF has already treated two doctors and a third patient, all of whom required surgery, in a separate building. The hospital’s inpatient department suffered extensive damages with the emergency, radiology, laboratory and operating departments currently out of service.

Nasser medical complex is the main referral hospital for southern Gaza, serving an estimated 1.3 million people and providing essential emergency, surgical and specialist care.

It is unconscionable that patients and medical staff are once again being killed and injured inside a hospital, a place where lives should be saved, not taken.

This is not the first time Nasser hospital has come under attack. Since October 2023, the hospital has been hit by at least six airstrikes, in addition to repeated ground incursions, shelling and gunfire. Healthcare facilities, already struggling to respond to overwhelming medical needs, continue to face attacks, destruction and threats of evacuation.

Hospitals must remain places of safety, where patients can receive treatment and medical staff can save lives without fearing for their own.

In January, MSF had reported a pattern of unacceptable acts including the presence of armed men in different areas of the large compound of the hospital and temporarily suspended some activities. This had not been the case in areas of the hospital where MSF has activities.

Lately, new incidents have been identified and reported to the relevant authorities as has been our practice whenever necessary. These incidents pose serious security threats to our teams and patients as they are being used by the Israeli army to justify attacks on health structures.

Under international humanitarian law, hospitals must be respected and protected. In no conceivable circumstances can attacks on functioning hospitals in Gaza be treated as normal or acceptable.

Israel’s military actions continue to have a devastating impact on communities every day. Between Aug. 30 and Nov. 12, 2026 alone, at least 567 aerial strike incidents, involving warplanes, drones and helicopters were recorded across Gaza.

We urge world leaders to move beyond statements of condemnation and take concrete action to ensure the protection of patients, healthcare workers and facilities in Gaza. The continued attacks on healthcare cannot be met with silence and impunity.

Authorities must halt restrictive policies that amount to the collective punishment and ethnic cleansing of Palestinians.

For 10 days, Palestinians in Hebron and surrounding communities have faced military raids, forced evictions, arrests, demolitions of houses and businesses and severe movement restrictions, with disastrous consequences for their access to healthcare. Many people were prevented from reaching medical facilities, while healthcare workers and Doctors Without Borders/Médecins Sans Frontières (MSF) staff were unable to reach patients. It is unacceptable that entire communities are being deprived of healthcare because of sweeping movement restrictions. Israeli authorities must stop imposing restrictive policies which amount to collective punishment and ethnic cleansing.

The lockdown imposed by Israeli forces on Oct. 23 forced MSF to suspend our regular mobile clinics and in-person mental health consultations. Between Oct. 25 and 29 alone, we estimate at least 380 patients across five mobile clinic locations were unable to access medical consultations outside of Hebron city. These communities depend on our services for essential medicines, treatment of chronic diseases and mental healthcare.

At the same time, restrictions on the movement of medical supplies threaten to deepen existing shortages in an already strained health system. Patients with chronic illnesses, including cancer, face further uncertainty over access to essential treatment.

Beyond the obstruction of healthcare and reduced humanitarian access exacerbated by the military operation, the lockdown left thousands of Palestinians living in fear and uncertainty. Approximately 3,300* people were forcibly displaced, with some families given just one hour to leave their homes, carrying only a single bag and nowhere safe to go.

This lockdown comes on top of escalating settler violence, increased attacks on Palestinian communities during the olive harvest and the expansion of illegal settlements and outposts across the West Bank, further spreading a climate of fear and insecurity in which Palestinians are forced to live.

*According to the Hebron Municipality as of Nov. 1

Attempts to reduce the recorded number of sexual violence survivors in North Kivu by narrowing the definition and limiting care, goes against international medical ethical standards.

The Front for the Refoundation of the Nation (FRN), the de facto authority in North Kivu province in eastern Democratic Republic of Congo (DRC), has been imposing harmful restrictions on seeking care for sexual violence. These policies, carried out over recent months, obstruct people from accessing this essential care and put them at greater risk. Doctors Without Borders/Médecins Sans Frontières (MSF) acknowledges the commitments made by the FRN (formerly the AFC/M23) leadership in early October to address these issues. However, these corrective measures have not yet been implemented. Restrictive measures remain in place. We urge the FRN to immediately implement the agreements made to guarantee safe, confidential access to care.

Since the beginning of 2026, the authorities overseeing health services in North Kivu have introduced or proposed measures for healthcare workers, health facilities and humanitarian organizations that raise serious concerns about medical confidentiality, medical ethics, survivor protection and access to healthcare.

“A drop in reported cases does not mean sexual violence is decreasing. It simply means survivors face barriers to safe and confidential care.”

Akke Boere, MSF director of operations

These measures include: 

• pressuring health workers to reduce survivor numbers by narrowing the definition of sexual violence, for example, by limiting recognition of sexual violence to people presenting with visible signs of injury  

• requiring intrusive and medically unnecessary physical examinations to prove violence or assault  

• requiring survivors to report to the police before seeking care  

• restricting eligibility for care only to people who present within 72 hours of the assault.  

The de facto authorities have also instructed organizations and health providers, including MSF, to use documentation that requires intrusive, stigmatizing, and non-essential questioning that is irrelevant to treatment. These include survivors’ names, addresses and details of alleged perpetrators. This undermines patient confidentiality, puts survivors at further risk and goes against international medical ethical standards. Patients – particularly women – report being questioned or threatened against seeking care at humanitarian-supported clinics.   

Healthcare workers and health partners have told MSF they have been threatened with suspension or even imprisonment if they do not comply with the new measures. These threats are already deterring some healthcare workers from providing essential care to victims and survivors of sexual violence, and, in some cases, causing them to stop their work altogether out of fear. This further reduces people’s already limited access to care. 

Policies are already deterring victims

MSF is already seeing the impact of these measures, with consultations for survivors of sexual violence falling sharply. In several MSF-supported health centres in North Kivu, dozens of entries relating to these consultations were erased from records, drastically reducing the official number of reported cases. Some centres have also stopped recording cases altogether or have reported very few for several months.

Reviewing data from some of the health facilities we support in North Kivu, 41 per cent fewer people had sought sexual violence care in August 2026, when compared to January 2026. Other facilities we support in North Kivu also saw significant declines, from providing care to around 80 survivors per month in 2025 to as few as nine per month in 2026. Communities also report growing fear about accessing services.

“Making the crisis less visible does not make the underlying violence disappear,” says Akke Boere, MSF director of operations. “A drop in reported cases does not mean sexual violence is decreasing. It simply means survivors face barriers to safe and confidential care.”

“The priority must be to remove barriers to care, strengthen protection and access to justice and address the conditions that allow sexual violence to persist,” says Boere. “The current restrictive measures are not the way to achieve this — they only further harm survivors.”

MSF is continuing its dialogue with the FRN.

“MSF calls for immediate action from the FRN to ensure that care for survivors of sexual violence is protected, confidential, accessible, and focused on health needs,” says Boere. “Official guidance must be issued to health authorities to ensure healthcare workers are no longer subjected to pressure, and activities must be overseen in a way that preserves confidentiality and does not intimidate or harm survivors or health workers.”

MSF emphasizes that access to healthcare should never depend on reporting to the authorities or pursuing legal action. While accountability for perpetrators is essential, making care conditional on reporting risks deterring survivors from seeking urgent treatment and potentially exposes them to further harm.

About MSF’s response to sexual violence in eastern DRC

Sexual violence in eastern DRC is a longstanding crisis, driven by decades of armed conflict, the actions of all parties to the conflict, weak justice and protection systems, social normalization and harmful gender norms. MSF currently provides medical care across 16 projects in North Kivu, South Kivu and Ituri provinces, and remains one of the few organizations providing immediate care to survivors in many areas.

In 2024, nearly 45,000 survivors received care in MSF-supported facilities across the DRC; this rose to 53,000 in 2025. In the first half of 2026, MSF teams treated more than 19,400 people for sexual violence in North Kivu alone.

Communities least responsible for climate change bear its burden on health.

Doctors Without Borders/Médecins Sans Frontières (MSF) is calling on all leaders at COP31 to put health at the centre of climate action, turning negotiations and declarations into concrete action for the world’s most affected communities.

“The window of opportunity to avoid a potentially catastrophic future is rapidly closing,” says Maria Guevara, MSF international medical secretary and physician. “Climate action must be urgently stepped up to reflect the scale of the emergency.”

“The health and humanitarian impacts of climate change are real, and they will grow as the world heats up. Every fraction of degree of warming is a matter of life or death for people in many places in the world,” she says.

At COP31, currently taking place in Antalya, Türkiye, MSF is calling for ambitious action to cut greenhouse gas emissions and provide critical support to enable the most affected countries to adapt and cope with increasing health impacts.

Across MSF’s projects, teams are witnessing firsthand the health impacts of the climate crisis. For many communities, climate change is compounding existing vulnerabilities linked to poverty, displacement, conflict and limited access to healthcare.

In Somalia, for example, people are experiencing a severe drought following four consecutive failed rainy seasons, which has triggered widespread displacement and malnutrition due to crop failures. Almost half the children under age five, screened by MSF in Baidoa displacement sites in July this year, were acutely malnourished.

“This is a profoundly unjust situation as the people most affected are not the ones who created this problem in the first place.”

Maria Guevara, MSF international medical secretary and physician

“For us, climate change is not something in the future. It is already here,” says Yahya Mohamed, field communications officer for MSF in Somalia and from Baidoa.

“We see it in the hospital, in children with malnutrition and in families who lost everything to the drought and came to Baidoa with nothing. The people of Somalia did very little to cause it, but we are the ones living with the consequences. Decisions made at the COP31 needs to reach places like Baidoa.” 

South Sudan is also facing severe and overlapping climate shocks, including droughts in some areas and extreme flooding in others. These have devastated harvests and contributed to malnutrition.

Madagascar has this year experienced back-to-back cyclones, in addition to prolonged droughts and erratic seasons. These climatic risks deepen food insecurity, spread diseases such as malaria and severely undermine access to healthcare, leaving people already at risk even more exposed. In response, MSF provides nutritional support and works in partnership with local communities to provide healthcare, while preserving the natural environment and livelihood of people in the area.

In Kiribati in the Pacific, rising sea levels are threatening homes with inundation and contaminating the groundwater table with saltwater. This reduces people’s access to quality drinking water which increases the risk of diarrheal diseases, while the lack of clean water also impacts hygiene, prompting the spread of skin and eye infections. Meanwhile drought reduces the availability of fresh food, compounding longstanding nutrition challenges including undernutrition along with high rates of obesity and non-communicable diseases.

Climate change increases health risks in at-risk communities

The climate impacts facing many of the communities MSF supports are also predicted to be exacerbated by El Niño, increasing the risk of health and humanitarian crises.

“The declaration of El Niño as a Grade 3 emergency and the growing calls to formally recognize climate change as a global health emergency, all point to the same reality: this is not a looming threat, but an emergency that is already unfolding and must be addressed,” says Guevara.

MSF works in more than 70 countries globally, the majority of which are among the most exposed to the health impacts of climate change, and the least able to respond. Many of these countries also hold little responsibility for causing the climate crisis yet are disproportionately bearing its impacts.

“They are paying with their health and their lives for a problem they did not create,” says Guevara, “This is a profoundly unjust situation as the people most affected are not the ones who created this problem in the first place.”

Climate action must be drastically scaled up

COP31 must help translate commitments into clear adaptation plans that ensure communities and health systems are prepared for the impacts of climate change.

“This means having health services that can adapt to the changing and growing needs: clinics that can withstand climate shocks, that have reliable water and energy, prepared health workers, and sufficient medicines and medical material,” says Guevara. “The most impacted countries are repeatedly asking for financial support to deal with the increasing impacts, but they are not receiving it.”

MSF is calling for climate finance to be scaled up, so that countries can prepare for climate impacts and rebuild health systems after a disaster. Finance must be new and not drawn from existing aid budgets; and it must reach the people and communities experiencing the heaviest impacts.

“At COP31, we need to see decisions that translate into real support for the most impacted countries and communities,” says Guevara. “What we are seeing today is simply too little and too slow.” 

As global humanitarian needs soar, Canada’s commitments to international assistance are nowhere to be found in Budget 2026.

No mention of International Humanitarian Assistance

Doctors Without Borders/Médecins Sans Frontières (MSF) is profoundly disappointed that the Canadian government’s Federal Budget 2026 makes no mention of international humanitarian assistance or global health, at a time when global funding cuts have already decimated the support that people affected by crises depend on for survival.

These omissions come despite the recommendations of the government’s own Standing Committee on Finance for the 2026 budget, which called for predictable, flexible and needs-based humanitarian assistance, including for Gaza and Democratic Republic of Congo.

They also follow the more than $2 billion in aid cuts already announced in last year’s budget, suggesting that Canada is turning away from its long-standing leadership role when it comes to responding to international health and humanitarian needs. For a government that has made a point of calling on other countries to join it in standing up for global norms and shared values, this would be a striking retreat.

Around the globe, conflicts are increasing, new crises are emerging, and civilians continue to bear the cost. MSF witnesses the impact of these events first-hand. That is why we have been calling on Canada to restore its international humanitarian assistance budget to at least the level of $1.3 billion reached in 2022-23.

In the days ahead, Canada should make clear what its intentions are when it comes addressing global health and humanitarian needs. Canada must also reaffirm its support for people in crisis around the world by providing a specific funding commitment for international assistance.

MSF’s other recommendations

Increased humanitarian funding wasn’t the only recommendation that MSF made in its pre-budget submission to the federal government. We also called on Canada to provide the funding necessary to uphold International Humanitarian Law and protect the delivery of medical care in the world’s conflict zones by meeting all of its commitments under UN Security Council Resolution 2286 – something that appears nowhere in the budget, despite Canada continuing to publicly voice support for a rules-based world order.

When it comes to access to medicines, there is similarly no mention in this budget of Canada dedicating funding to the manufacture of vaccines or medicines of high public health value but low commercial appeal, as MSF has consistently recommended. This could be done using Canada’s publicly owned manufacturing facilities, including the Biologics Manufacturing Centre in Montreal, which was built in 2021 with a promise of producing 24 million doses of vaccine per year; yet, to date, this publicly owned facility has produced nothing at all.

MSF has also called for Canada’s public investments in medical research and development to prioritize public health over private wealth. While this budget contains measures to increase R&D innovation and commercialization, it makes no mention of including the kinds of binding obligations to public funding of health research that will ensure any ensuing commercial products are made affordable and accessible for the people who actually need them most, both in Canada and elsewhere around the world.

At a time when people’s needs in war and crisis zones have reached historic highs, Canada’s silence on its humanitarian commitments in Budget 2026 is deeply concerning. As other wealthy countries turn away, now is the time for Canada to show more vocal and bold leadership – not less.

In a period covering more than two years of ongoing conflict, mass displacement, damaged infrastructure, disrupted essential services, and restricted humanitarian access in Sudan, Doctors Without Borders/Médecins Sans Frontières (MSF) teams across Darfur treated around 30,000 people who had vaccine-preventable diseases. According to MSF’s new report, Vaccine-preventable disease outbreaks in Darfur, the most common disease was measles and the people most affected were unvaccinated children. MSF urges the Sudanese health and political authorities to lift the barriers and administrative blockages that currently prevent vaccines from entering Darfur. We also urge donor countries and the UN to increase funding and provide the vaccines to health authorities. Without immediate action to restore immunization activities in the country, outbreaks will continue to spiral and people will keep dying from diseases we can prevent.

Between January 2024 and April 2026, MSF-supported facilities in four states of Darfur, recorded more than 28,000 measles cases and nearly 2,000 pertussis cases: 75 per cent of the patients treated for measles were not vaccinated and 69 per cent were children under five years old.

“Several localities including Tawila, El Geneina, Rokero, Zalingei, Nyala and East Jebel Marra saw recurrent transmission over consecutive years, suggesting outbreaks were not fully contained and that immunity gaps persisted despite repeated outbreak response activities,” says Sebastián Traficante, MSF emergency coordinator in Darfur. “Our teams are constantly treating children for diseases that could have been prevented with a vaccine. Many children reach our facilities in critical condition, and they simply don’t make it out of the hospital.”

Wartime collapse of health system, supply and staffing issues

According to the MSF report, transmission was particularly high in South Darfur, where 10,600 suspected measles cases were reported in the first four months of 2026 alone, exceeding the total number of cases in 2025.

Vaccine-preventable diseases are especially dangerous when paired with complications of other medical conditions, such as malaria and malnutrition, which are rampant across Darfur.

With the war in its fourth year, Sudan faces one of the world’s worst humanitarian crises: in 2026, 34 million people need humanitarian aid and 21 million cannot access essential medical care due to the collapse of the Sudanese health system. According to the World Health Organization, 37 per cent of health facilities across the country are non-functional. Those still open in Darfur report severe shortages of staff, medicines, vaccines, equipment and supplies, and many have only partially functioning or non-functioning cold chains to keep vaccines viable.

“Routine vaccination services struggle to reach people, especially in remote areas,” says Dr. Saiful Islam, MSF emergency medical coordinator for South Darfur. “The supply, transport and storage of vaccines face significant barriers, mostly due to administrative delays, such as in obtaining import approvals and travel permits. State-level vaccination offices are often not functioning, leaving little monitoring or supervision. Many health facilities have no permanent vaccination staff and rely on volunteers.”

Both availability and access are major concerns for communities. In South Darfur, where the burden of vaccine-preventable diseases is highest, only a fraction of facilities has fully functional cold-chain capacities. In Central Darfur, which experienced recent measles and pertussis outbreaks, MSF teams reported delays in vaccine arrival, administrative approvals and vaccine mobilization significantly slowed outbreak response activities.

When services do not reach communities, families must travel to find them. But the war has destroyed livelihoods and sent prices skyrocketing, leaving little income for families. For many parents, even the cost of transport to the nearest health facility is out of reach.

“My child had never been vaccinated because we live in a farmland area, about three hours away from Sortony town,” says Fauzia, the mother of three-year-old Faiz. “The rainy season also makes it complicated to move around. Many children in my area are affected by vaccine-preventable diseases.” Faiz was admitted to Rokero hospital, in Central Darfur, for suspected whooping cough. After being examined, the MSF medical team confirmed that he was also affected by meningitis and tetanus. After 16 days in the isolation ward, Faiz passed away.

Emergency vaccination campaigns not enough

Disease surveillance is also a major gap. With limited monitoring and follow-up, outbreaks often go undetected until the disease has spread widely, and emergency vaccination campaigns begin too late.

Some emergency campaigns have taken place in various parts of Darfur since 2024 and can help contain outbreaks. But these campaigns need to be more efficient, ideally including antigens for several diseases and they cannot replace routine immunization. For instance, in Tawila, North Darfur, a severe measles outbreak saw more than 1,900 cases treated at Tawila hospital between January and April 2026. Following an emergency mass vaccination campaign reaching 130,000 children across Tawila town and internally displaced camps, community transmission was brought to a halt, with cases dropping to just 96 between April and September 2026, a 95 per cent reduction.

While these targeted emergency campaigns save lives in real time and MSF has seen cases drop afterwards, without sustained investment in routine vaccination, cold-chain infrastructure, vaccination staff and disease surveillance, outbreaks of measles, pertussis and other preventable diseases will keep returning across Darfur.

“Immunization in Darfur and the rest of Sudan must be adapted to the reality of the conflict,” says Traficante. “That means mobile, outreach and catch-up services run by professional vaccination teams. They can reach unvaccinated children where they are, and also act as our eyes in communities, tracking immunization rates and detecting outbreaks early.”

MSF calls on health authorities, donors and UN agencies to fund and facilitate mobile and catch-up vaccination across Darfur and the rest of Sudan. MSF also urges all warring parties and authorities in Sudan to immediately remove administrative barriers to the import and transport of vaccines.

The full report, Vaccine-preventable disease outbreaks in Darfur, can be read here.

Doctors Without Borders/Médecins Sans Frontières (MSF) calls for the immediate and unconditional release of physician Mohammed Obeid. He remains detained by Israel without any charges since Oct. 26, 2024.  

Mohammed Obeid, an orthopedic surgeon, was arrested while providing lifesaving medical care in the Kamal Adwan hospital in the north of Gaza. Since his detention he has been held under harsh conditions without any direct contact with his family. His only contact with the external world is his lawyer’s visits and they are scarce.  

We are extremely concerned about his health and well-being and we stand in full solidarity with him and his family. We demand his rights, dignity and freedom be restored without further delay. 

Until his arrest by Israeli forces on Oct. 26, 2024, Obeid was one of the few surgeons remaining in northern Gaza.  

Obeid is a respected and brilliant surgeon who has saved countless lives in difficult circumstances and sometimes with limited supplies in multiples hospitals in Gaza.  

He is not alone. Israel continues to arbitrarily detain dozens of healthcare workers from Gaza. Under International Humanitarian Law, medical personnel are protected and should not be punished for carrying out medical duties.  

Gaza needs its doctors. Medical staff such as surgeons and pediatricians are in crucial need today in Gaza. Many children need urgent orthopedic care, and around 6,000 amputees need urgent long-term rehabilitation. Obeid is one of the very few orthopedic surgeons in Gaza. 

We continue to call for his immediate release and his reunification with his family. We call for the release of all medical personnel from arbitrary detention. 

Release Mohammed Obeid. Release all medical staff. 

It is unacceptable that the U.S.-based pharmaceutical corporation Gilead Sciences made more than 8 billion in HIV product sales in the third quarter of this year yet continues to block access to the highly effective HIV prevention medicine lenacapavir for millions of people, says Doctors Without Borders/Médecins Sans Frontières (MSF).

Gilead insists on charging high prices for lenacapavir — more than 28,000 per person per year in the U.S. — even though it can be made and sold at profit for less than 40. This severely limits its availability for people who need it most.

Lenacapavir is an injectable version of pre-exposure prophylaxis (PrEP) that only needs to be given twice a year and is nearly 100 per cent effective in preventing HIV. It is an ideal prevention method for many people who live where MSF operates. This includes people who face stigma, discrimination and exclusion from healthcare, as well as those living in humanitarian emergencies, where access to daily medication or travelling to regular clinic visits can be a major challenge.

This quarter alone, Gilead reported 426.6 million in sales of lenacapavir for PrEPNinety-six per cent was in the U.S. So far this year (January–September), Gilead has made 893.3 million in sales of lenacapavir and is on track to reach a total of 1.4 billion by the end of the year.

MSF recently launched a campaign calling on Gilead to expand global access to lenacapavir. While the company announced last month an “access pathway” for affordable generic lenacapavir in additional countries, it has not made public any concrete details like how much will be available in those countries or how much it will cost. Gilead remains the sole supplier of lenacapavir worldwide, continuing to sell it at very high prices, severely restricting supply to low- and middle-income countries, and refusing to sell it directly to MSF for use in its medical programs.

Melissa Barber, MSF USA’s global health advocacy and policy advisor, says:

“As Gilead’s HIV sales keep climbing, so do infections in the countries where the company continues to block people from accessing affordable versions of lenacapavir.”

“Gilead says it wants to end the HIV epidemic ‘for everyone, everywhere,’ but its actions say otherwise.”

“Any clinic in New York can order lenacapavir today, but our team in Kenya has only been able to get five doses total, and Gilead refuses to sell to MSF at any price. Its shareholders should be asking why. Over 95 per cent of new HIV infections take place outside the U.S., but over 95 per cent of lenacapavir sales are in it. Again, Gilead’s shareholders should be asking why.”

“Wall Street will cheer Gilead’s numbers today. But from southern Africa to Latin America, our teams on the ground will continue to see people every day who need effective HIV prevention options but can’t access them. What good is a medicine if the people who need it most can’t get it?”

“There is no excuse for Gilead to not make lenacapavir more accessible for people living in high-burden HIV countries.”

“Gilead must stop putting their profits before people’s health.”

The people behind the numbers

“In our times, a lot of things can happen to you unexpectedly.” 

Philiswa Mbingo is a young woman in Eswatini, the country with the highest HIV prevalence in the world: one-quarter of the population aged 15–49 is HIV positive. So, for Mbingo, HIV prevention is important.

“I am a very young woman, and in our times, a lot of things can happen to you unexpectedly,” she says, reflecting on the complex realities many young women face in Eswatini, where women and girls face a high risk of sexual violence.

Mbingo knows about the daily oral HIV prevention medication, PrEP (pre-exposure prophylaxis), but she chooses not to use it. “I do not prefer them,” she says, “as pills give me a hard time.” Instead, she has explored other options.

“My first encounter with PrEP was with the ring, which you insert inside your vagina,” she says, referring to the dapivirine ring, which is replaced every 28 days.

But when Mbingo learned about the long-acting injectable PrEP, lenacapavir, it was a turning point.

“[When] I heard about the six-month PrEP injection [lenacapavir] it made me very happy,” she says. While MSF cannot buy lenacapavir, Eswatini’s Ministry of Health has been allocated a limited number of doses, which she was able to obtain at an MSF clinic.

What appeals to Mbingo about lenacapavir is the extended protection it provides, which reduces the need for frequent clinic visits. “I can stay a long time with the PrEP injection in my system — for six months. I only take the injection two times a year.”

Beyond convenience, Mbingo believes the injectable option is more effective. “Another thing that [convinced me to take] the injection is that it works better compared to the ring.” Lenacapavir, the biannual PrEP injection, has been proven to be nearly 100 per cent effective in preventing HIV.

“It is better to prevent than to treat,” Mbingo says.

But despite lenacapavir’s appeal and convenience, the medication is not an option for many people in Eswatini — and around the world — because Gilead’s supply restrictions.

“If it was available, I would take it.”

Every day, *Thembi makes decisions that will protect her future. “I am a person who is conscious about my body and my health,” she says.

Thembi believes everyone should have the opportunity to protect themselves, including through HIV prevention.

Like many young women in Zimbabwe, Thembi understands the realities of HIV. She knows how the virus is transmitted and the importance of safer sex, as well as prevention medicines such as PrEP and PEP (post-exposure prophylaxis). She recently learned about long-acting HIV prevention injections like cabotegravir (CAB-LA) and lenacapavir, which don’t require taking a daily pill.

“I really want the injection,” she says. But wanting protection and getting it are two very different things.

Thembi has been unable to obtain the injections, not because of fear or hesitation, but because she lacks access. With limited supplies in her community , programs prioritize people who are already taking the injections and need to continue their doses. New patients like Thembi simply don’t have the opportunity.

When it comes to lenacapavir, “very few people are being considered,” she says. “If it was available, I would take it. I would go for it when I am positive that the supply is not erratic and that I do not have to wait in long and winding lines to access it.”

Thembi’s story reflects the experience of the many others who are ready to benefit from the latest advances in HIV prevention but remain locked out due to their scarcity and restricted access.

*Name has been changed to protect identity

Due to restrictions and blockages by the Israeli authorities of essential items, Doctors Without Borders/Médecins Sans Frontières (MSF) is unable to continue supporting patients who have suffered extensive facial injuries, including burns.

“We produced the last 3D-printed mask for victims of severe burns in Gaza on October 14, 2026,” says Dr Feras Swairjo, an MSF physiotherapist manager.“ Due to restrictions and blockages by the Israeli authorities of essential items, we are unable to continue supporting patients who have suffered extensive injuries and burns on their faces.

We have the medical expertise and the capacity to help these patients, but we are being deprived of the basic materials needed to do [our] work.

Every day, we witness the devastating consequences of severe burns on our patients in Gaza, many of whom are small children. Some have suffered extensive injuries from Israeli airstrikes, while others have sustained burns while cooking in overcrowded tents or on open fires.

Without these specialized masks, patients face the risk of permanent facial disfigurement and disabilities that can affect their ability to move, see, or even breathe normally.

The blockages of these essential supplies risk leaving children with preventable disabilities for the rest of their lives. It is a man-made problem that can be solved today. Israeli authorities must allow the unrestricted entry of the medical materials needed to treat patients now.”

Kasoki Zawadi sits on a plastic chair in the MSF-supported Kitatumba Ebola Treatment Centre (ETC) in Butembo, North Kivu. She faces her husband Victoire, separated by a plastic screen. Victoire smiles from time to time. He has Ebola disease andhas been hospitalized for 13 days.

In Butembo, 1,472 Ebola disease cases were confirmed and 735 deaths recorded between May and 22 October 2026.

The outbreak is impacting people already facing insecurity and economic hardship. Many families are sheltering relatives displaced by fighting in neighbouring areas, while movement restrictions and reduced trade have made daily life even harder.

At the ETC, MSF psychologists support both the patients and their loved ones as they cope with fear, uncertainty and the wait for test results. .

Every morning, Kasoki arrives at around 6:30am and stays until 6:30pm. Her brother-in-law takes over at night. “We manage to communicate despite the window,” she says. “We’re allowed to see each other, and this brings us comfort.”

Since her Victoire was admitted, she has stopped working as a teacher. Their family is supporting them during this time. She also worries about her own health. And when she leaves the ETC, the separation weighs heavily on her.

“In the evening, when I go home and can’t see my husband, I find it hard to sleep,” she says.

A few days later, Kasoki explains that a negative test result had given them hope that they would soon be able to go home. But a second test came back positive. “When he tested positive again, we were exhausted, mentally and physically,” she says. “Fortunately, the psychologists’ support helped us feel calmer, and we managed to wait.”

Staying in touch during hospitalisation 

Ebola disease and hospitalization can be distressing for both patients and their loved ones. In Butembo, mental health activities supervisor Patrice Muyisa Kokotz provides psychological support and says people not only fear the disease, but also what awaits them at the ETC.

We give them time to express themselves, talk about their past and their emotions,” Patrice says. His team explains how the ETC works, the care provided, and how visits are organised. “

Ebola disease is traumatic and sudden; it is a viral illness,” says Rachel Kashimoto, a clinical psychologist working with MSF in Beni, North Kivu. “So you are under stress, always expecting death at any moment. If you are not mentally stable and not well cared for, even physically, things may not go well. But if you are mentally stable, well supported and well monitored, there will also be physical improvement. Because when you have hope of recovering, you follow all the instructions the medical staff give you, and then there can be rapid improvement.”

Supporting the return home 

Psychological support does not end when patients leave the ETC.“We organise individual consultations as well as group discussions,” says Phoebe Zueya Yonkeu, who manages mental health activities at MSF’s ETC in Mongbwalu, Ituri. “Many tell us they faced stigma when they returned home, lost their jobs or were rejected by their communities, who believed they were still contagious. Others feel guilty towards loved ones who did not survive the disease, and they even wonder whether they were the ones who infected them.”

While some patients face stigma after leaving the ETC and the trauma of having come close to death, returning home can also bring immense relief to them and their loved ones.

In Butembo, on the twenty-third day of Victoire’s hospitalization, Victoire and Kasoki learn that he can now return home. The positive result, following the first negative result, prolonged their wait, but he has since tested negative twice. “Kasoki’s presence really is part of my care,” Victoire says. “I feel comforted. When I see her, it reduces my stress.”

Amid escalating armed clashes in the Haitian capital, Doctors Without Borders/Médecins Sans Frontières (MSF) has received numerous wounded patients at our hospitals, including women and children. We call on the authorities and all parties involved to spare civilians and ensure access to healthcare facilities for all the wounded and sick, without distinction.

Heavy gunfire and drone explosions have increased in the Plaine de Cul-de-Sac area, in the northeastern part of Port-au-Prince, following the disappearance, on Oct. 18, 2026, of several members of the Gang Suppression Force (GSF) during an attack on their vehicle by members of armed groups.

Between Oct. 18 and 26, 30 patients injured by gunfire or drone explosions were admitted and treated at MSF hospitals in Tabarre and Cité Soleil neighbourhoods.

“We are very concerned about this surge in violence in multiple densely populated neighbourhoods of the capital. Among the victims, we have admitted multiple women and children — it is shocking to see them arriving at our hospitals, wounded by gunfire or explosions,” says Davina Hayles, MSF country manager in Haiti. “We fear that these armed conflicts will claim even more victims and displace even more people in the coming days, particularly with the arrival of additional international security forces. Some of our Haitian colleagues have themselves been forced to leave their homes and take refuge in MSF accommodations. It is imperative that civilians be protected and spared.”

Due to the ongoing conflicts, MSF has also observed that multiple patients have faced serious difficulties accessing healthcare facilities.

“Some patients with gunshot wounds took several hours to reach our hospitals in Tabarre and Cité Soleil. Roads and bridges are blocked, and any travel is extremely risky. In a capital city where the healthcare system has collapsed and many facilities are closed, it is essential to ensure there is access to functioning healthcare facilities like ours,” says Hayles.

MSF has also been forced to suspend our mobile clinic operations and distributions of treated water in the various neighbourhoods affected by armed conflict.

“This is a double blow for our patients and for people who lack access to treated water in these neighbourhoods of the capital. At any moment, they could become direct or collateral victims, and on top of that, they find themselves deprived of access to healthcare and water. This situation is dreadful, ” says Hayles. MSF calls on the authorities and all parties involved to spare civilians and protect people’s access to critical medical care.

https://www.swissinfo.ch/eng/international-cooperation/switzerland-suspends-msf-funding-after-reports-of-sexual-exploitation/92274271

Switzerland suspends MSF funding after reports of sexual exploitation

The humanitarian organisation Médecins Sans Frontières (MSF) is accused of failing to adequately inform the Swiss authorities of the scale of reports of sexual misconduct by MSF staff in Chad. The Swiss Agency for Development and Cooperation (SDC) has now suspended funding of CHF1.25 million ($1.52 million) to MSF.

The frozen amount represents one tranche of the CHF6.25 million pledged to MSF for the current year.

According to the newspaper NZZ Am Sonntag, an internal investigation by MSF revealed 59 reports of sexual violence and exploitation, particularly involving women and young girls who are refugees from neighbouring Sudan. Eighteen staff members have been dismissed, including six employees from the NGO’s Swiss branch.

The NZZ explains that this constitutes “widespread sexual exploitation”, adding: “Money, jobs or humanitarian aid in exchange for sex: staff members are alleged to have taken advantage of the distress of refugee women and girls”.

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