Open for Covid and non-Covid diseases: 'Doctors without borders'

​​The medical aid provider, also known as ‘Doctors without borders’ in the English-speaking world, foresees a spike in Covid cases in the hinterlands as several lakhs of migrants return to their villages.

AFP
Not many in the world know how to fight a raging epidemic - like the MSF does.
MUMBAI: Medecins Sans Frontieres, an international medical humanitarian organization of French origin, is planning to set up a 150-bedded facility in Patna (Bihar) to treat moderate-to-severe Coronavirus-afflicted patients.

The medical aid provider, also known as ‘Doctors without borders’ in the English-speaking world, foresees a spike in Covid cases in the hinterlands as several lakhs of migrants return to their villages.

“The care centre would begin admitting patients from early-June,” assures Farhat Mantoo, director general of Medecins Sans Frontieres (MSF) in India.


“We’re also looking at the situation in Mumbai closely… We may set up a Covid hospital there too, if things get real bad. We can also partner with hospitals to treat these patients,” she tells ET in an exclusive interview.
Not many in the world know how to fight a raging epidemic - like the MSF does. Right from the Nicaragua earthquake in 1972, which killed over 20,000 people, to the refugee crisis in Pol Pot’s Cambodia, the Lebanon war during the 80s, the Gujarat earthquake in 2001, the tsunami devastation in 2004, the meningitis outbreak in eastern India post cyclone-Aila in 2009, the 2013 Ebola epidemic in West Africa, MSF doctors and volunteers have been on the frontline fighting natural calamities, man-made disasters, deadly viruses, bacteria and parasites.

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“For sure, Covid poses a huge threat to humanity… It is affecting the whole world at the same time. So Covid is a serious epidemic… But at the same time we should be conscious of non-Covid diseases too,” says Mantoo.
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“The impact of non-Covid diseases on human beings is too large to be ignored completely. We should not forget numbers like, 4.8 lakh Indians die of tuberculosis (TB) every year,” she adds.

MSF employs over 600 medical and non-medical staff in India. Of this, nearly 580 are local-hired employees while the rest are foreign nationals. While Mantoo refused to divulge the exact number of doctors in India, her office estimated it to be around 75 to 80 – graded between junior resident doctors, primary health physicians, experienced doctors, general surgeons and even some plastic surgery experts.

“We believe in international solidarity; so we’ve a mix of Indians and foreign nationals as doctors. We also employ a lot of trained paramedical staff to take burden off our doctors,” Mantoo says.

MSF recruits doctors on its payrolls and also hire “volunteers” (medical professionals who commit themselves pro bono services) who are offered a stipend. Doctors are also given an option to work in overseas projects - as and when their help is required elsewhere.
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Since the lockdown in March, MSF has not been able to reach out to communities as they did previously. Currently, the organization is running a HIV-TB-Hepatitis care programme in Manipur, a drug-resistant TB project in Mumbai, treating malnutrition in Jharkhand, a mental health project in Jammu & Kashmir, a HIV & Kala Azar care programme in Bihar and primary healthcare projects in Andhra Pradesh, Chattisgarh and Telengana.

“We’re giving care to in-patients in several of these projects… But out-patient registrations are not happening in big number anymore. People are scared to visit care centres now,” says Mantoo.
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“It’s a matter of worry for us, as several of our TB/HIV patients are on critical drugs and they’ve to be monitored periodically. Their drug in-take cycle should not be hampered,” she adds.

Mobility of MSF field staff and their drug supply lines too have been disrupted due to the lockdown. Limited outreach programmes into impoverished communities may also increase India’s non-Covid disease burden, MSF officials believe. The disruption in drug supply lines may affect the whole world as India is the largest producer of generic drugs used for treating a wide range of diseases. For instance, over 95% of the drugs used to treat drug-resistant TB is produced by Indian pharma companies.

“We’ve requested the government to allow a ‘global waiver’ (like the one it issued to export Hydroxychloroquine to treat Covid patients worldwide) to ship out drugs needed to treat non-Covid diseases too,” says Mantoo.

MSF also has tied up with ICMR (and five other global medical research organisations) to derive treatment protocols for ‘neglected diseases’ – which still have high mortality rate world over. Neglected diseases such as kala azar (or black fever), paediatric-HIV, filariasis, mycetoma and hepatitis-C still cause a lot of deaths and debilitation in third-world and developing countries. Take, for example, India which has seen close to 60,000 kala azar cases between 2013 and 2019.

“We’ll have to keep chasing these diseases – much like the way we’re dealing with Covid now,” says Mantoo.

“We’ll have to make people aware of the disease, treat afflicted people, do contact tracing, keep up surveillance and bring in community-level engagement… That’s the only way to fight epidemics and pandemics,” she sums it up.
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