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MÉDECINS SANS FRONTIERS : 28 YEARS RESTLESS
At the end of this millennium it is almost dutiful
to sum things up in the sector that concerns us directly, the state
of health all over the world and in detail in our country. The result
in both cases is not stirring. It is true that researchers has achieved
remarkable results both diagnostic and pharmacological, but all that
has not been enough to bridge the moral, ethical and behavioural gap
that is getting even more evident and pressing.
That's why we issue for the first time and as a leading
article the history of a group of physicians that wanted to give a special
humanitarian worth to their profession and this way bringing the function
of the physician back to its founding principles, that must be helping
who suffers beyond any other interest.
We tell the history and the activity of Médecins sans
a frontier that is ever more present where human suffering gets to peaks
beyond description, all latitudes.
We want to give, by the means of fair information,
a chance to whom perhaps does not know it yet and nevertheless would
like to take part in this project. Telling about 'Médecins sans frontiers'
is surely the best way to end the nineteenth century and to begin the
year two thousand.
Some years ago Francis Fukuyama, an American historian
of Japanese origin, advanced the original conjecture called the "end
of history".
After the fall of the wall of Berlin, our century,
just ending, has not anything more to tell and the western model will
expand all over the world, as if history were only the one related to
the Nato or the Pact of Warsaw, military alliances, to which, what's
more, it did not belong the most populated countries over the world
as China and India.
Instead, over 1989 up to today, we have assisted to
an escalation of conflicts, often ethnical kind, and at little distance
from our limits. Iraq, ex Yugoslavia, Central Africa, the soviet empire
breakdown (that Moscow tries somehow to hold), the endless tragedy of
the Afghanistan, the Algerian massacres, the Kurdish matter, the early
events in East Timor and so on. The United Nations Organization by the
means of its branches (Fao, Unicef, High Commissariat for refugees...)
carries on a praiseworthy work, besides a statutory duty, but we would
be hypocritical if we did not acknowledge that inside the UNO the opposite
political trends sometimes lead to questionable decisions lying on the
idea that some international cases are, heaven knows why, more important
than others.
Well then, over the past ten years, it has been the
no-governmental organizations to play a first-rate role in assisting
refugees, even victims of wars, earthquakes or floods.
Its origins
At the end of the sixties the war in Biafra turned into
a real genocide under the unarmed eyes of the physicians of the Red
Cross. Some of them, French, gather to some colleagues coming back from
the Bangladesh, upset by a flood, and decided to establish an independent
association dealing with the emergency medical aid. This way Médecins
sans frontières established in 1971.
Since then a following one another of tragedies, wanted
or undergone by men, has engaged in the front line the volunteers of
Médecins sans frontières, that 28 years later are nearly 2.500, belonging
to 45 countries, and covering as far as 85 countries. But what is Médecins
sans frontières ?
"A private organization - so it says the "Chart of
principles" - of international character. The sizeable part of its members
are physicians and health operators, but it avails of the contribution
of other professions employable in its activity".
The yearly budget rounds 300 millions dollars. It's
esteemed that among supporters and private sponsors nearly four millions
persons in the world support the activity of an international organization
having 19 seats in: France, Belgium, Holland, Spain, Switzerland, Luxembourg,
Greece, Italy, United States, Canada, Japan, Great Britain, Denmark,
Sweden, Norway, Hong Kong, Australia, Germany and Austria. The Italian
branch established in 1993, the first volunteer departed instead in
1989 and from then hundreds of departures have followed each other.
Currently there are in the world nearly 50 millions
counting in refugees and evacuees a mass of desperate for whose surviving
Médecins sans frontières.
The assistance work lies over the basic medicine, the
epidemiological control, prevention, vaccination campaigns, the nourishment
watch, and main matters, the water supply and the building of health
structures, however temporary they are.
The three big logistic headquarters are in Brussels,
Ostenda and Amsterdam; at 48 hours from starting the emergency the Organization
air-cargos start interventions.
The humanitarian interventions carried out, during
the thirty-years history of "Médecins sans frontières " are several,
in all regions of the world, for all sorts of causes. We will examine
only some emblematic cases in three continents Africa, Asia and Europe.
Africa
When it is talk about the Africa continent it's difficult
to give a priority to problems: famines, under nourishment, ethnical
clashes, rough ways to democracy, residual of a colonial past that really
has not passed yet.
Angola is a country where all these dramas are still
live.
Médecins sans frontières is in Angola since 1998, covering
9 provinces of the immense southwestern Africa state.
Assistance to population is, and it cannot be otherwise,
the result of cooperation of different bodies, when it is possible;
MSF works so in collaboration with the catholic hospital of Cubal, in
the Benguela province, while in other areas the support is supplied
by the governmental health structures.
But there's another African country where currently
and absolutely disregarded by the international mass media, the civil
war has devastating effects over population. We are talking about the
Congo-Brazzaville, equatorial region neighbouring the Democratic Republic
of the Congo (ex Zaire) on the East.
In the capital there has been an upsurge of conflicts,
since December 1998 between the governmental forces and rebels. Hundreds
of thousands persons have been compelled to refuge in the tropical forest
of Pool, at the south of the capital. The testimonies recollect by the
representatives of MSF report about villages attacked on purpose by
the troops of both factions, or bombed from helicopters, and about men
used as human shields. The refugees, in continual escape from village
to village, must face the unstable hygienic-sanitary conditions and
the risk of epidemics.
Past May it has started the return of the refugees
to Brazzaville, since the governmental forces seem to have the whole
control on the capital and the south area. Among the several harassments
on damage of population it did not lack rapes, as far a 500 the cases
denounced to the physicians of Médecins sans frontières. The volunteers
in the area of the capital have the task to examine refugees to check
them health conditions and to address them to the health structures
or to the feeding assistance centres. MSF has prompted three therapeutic
feeding centres where children affected by serious undernourishment
are taken care of.
Francois Guillemot, MSF's physician, writes from Brazzaville:
"Day starts. Entering the paediatric unit of the Makelekele Hospital
I cannot prevent to sense a feeling of terror. Which new drama is waiting
for me?"
Balkans and Turkey
Before and after war maybe are most important than
the war itself and it is in these straits that humanitarian organizations
turn to be essential.
The Serbian repression towards the Albanian ethnic
groups has turned into systematic since the first months 1998; 23 mobile
clinics of Médecins sans frontières have assisted for all the year the
Kossovo refugees, distributing medicines in villages. When the war burst
out teams of volunteers were compelled to leave the Kosovo for safety
reasons, but they soon prompted assistance programs for the deportees
in Montenegro, Albania and Macedonia.
The third phase, that of the return to Kosovo, is critical
as well, both by the political point of view - since managing the renewed
life in common between Kossovarians and Serbians is not easy - both
on safety and health side.
Towns as Pristina, Prizren, Pec and Djakovica underwent
very serious infrastructures damages. So the matter was to reactivate
health services, to rebuild hospitals, to give back running water.
The Médecins sans frontières volunteers are also engaged
in communication. The live explosive devices still in the territory
represent the sad inheritance of armed conflicts. So it started off
an awakening campaign about the danger of mines by the means of radio,
posters and leaflets given to the refugees that got back to the origin
place or to those that were to. It's clear that in this special context
the MSF is going beyond its statutory tasks, replacing the institutions
whose concern is, among others, that of informing about risks and perils
in the territory.
Turkey over last weeks must face a double emergency
due to earthquakes. The last one dates back to November 12th and affected
the northwest area of the country.
The Kaynasli village is the one having undergone the
greatest damages; already on November 14th Médecins sans frontières
put on disposal its pharmaceutical dispensary, while a little team of
physicians and nurses gathered the camps arranged by the Unicef and
the Red Crescent.
East Timor
Reviewing the hottest places in the world we have become
aware once more that violence, injustice and sufferance has many facets:
from resignation facing the raging of the fratricidal war elements,
to the authoritarianism masked as democracy and the permanent violation
of human rights.
It's the case of the Timor Island that after a regular
referendum achieved the independence from Indonesia - only for its East
zone -. The pro-Indonesian troops did not like it - no-officially supported
by the Jakarta government- and laid waste East Timor till the intervention,
not exactly timely of the UNO forces.
The situation is by the moment not different from the
Balkan one: East Timor inhabitants, evacuated in the country or even
escaped from the country, when the raids by the Indonesian troops started,
are slowly getting home, fearing among others to meet once more the
soldiers of Jakarta.
Once more Médecins sans frontières volunteers, siding
the institutional organizations (World Health Organization and High
Commissariat UNO for the refugees), must struggle against emergency,
misery, the hate between opposite factions, between men turning time
by time from victims of persecution to persecutors.
In short
The excursus of the nearly thirty-years activity of
Médecins sans frontières, a real roundup of the most important events
of early history, sets many questions about the international situation
at the eve of the changes that are waiting for us in the new millennium.
Since fifty years there 's in the world a privileged
area, the industrialized west enclosing part of Europe and two third
of North America, and an appendage in the Far East (Japan) and in Oceania
(Australia).
That means that in nearly the whole southern hemisphere
and a in a part of the northern one the social, political and economic
uneasiness is quite spread. Ethnical conflicts, that are maybe the most
glaring phenomena of the last ten years, often rise from the imperfection
of political structures as in the case of the Yugoslavia Federation.
The same way the immigration waves coming from Africa
are the consequence of policies toward the third world having not given
the expected results. In short, while war, misery and famine mainly
affect the most backward areas of the world, to pay for its consequence
it will be unavoidable also the West, which has to support them. Migration
fluxes, hard to hold and to rule, provoke unavoidable repercussions
over the social settlement.
The Italian reality is emblematic: the southern regions,
having already a high unemployment rate must face with the daily disembarkment
of desperate, of which only a minority will succeed in integrating since
cultural and religious differences often are a barrier hard to get over.
Médecins sans frontières is always in the front line
when the concern is helping populations in troubles, but solutions for
certain problems are still far and mainly they are not within the capacity
of the volunteers of a humanitarian organization.
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