A couple of sample dilemmas faced recently in the clinical programmes of the medical humanitarian organisation Médecins Sans Frontières (MSF).

“This HIV positive woman in her first trimester of pregnancy is currently on an efavirenz-based regimen, what should we do?”

“The patient I just saw in clinic has HIV infection and is hepatitis C antibody positive; he is doing well on antiretrovirals. His liver function is mildly abnormal—he asked whether we can treat the hepatitis C. Can we treat hepatitis C in this country?” more…

Why does a medical humanitarian organisation like Médecins Sans Frontières (MSF) hold a yearly scientific conference? The common image of MSF has more in common with Angelina Jolie’s film efforts than with the well trodden academic routines of powerpoint presentations and poster galleries. Although venues and audiovisual technology have changed since the conference was first launched in 2004, the overall aim has remained the same: to improve the quality of research presented by MSF and ultimately it is hoped the quality of MSF’s medical programmes.

Of the many descriptions of what research brings to MSF, one of the best is by Philipp du Cros in this video where he explains how research presented at the MSF Scientific Day can ultimately save lives. more…

As the Kony 2012 campaign continues to sear the image of Joseph Kony—head of the Ugandan guerilla group, the Lord’s Resistance Army— into the world’s consciousness, it’s worth remembering that there is another, more deadly killer at loose on the African continent. This killer is tuberculosis.

The two have much in common. They have no respect for international borders. They prey on the vulnerable. They kill relentlessly. And they are ignored by global leaders. more…

A doctor’s protest

Principles

Four months ago en route to work I read an article about how the blood transfusion services in Syria had been taken over by the Ministry of Defence as a means to target patients injured in demonstrations against the government. I found this deeply disturbing and described it as a “violation of medicine” in an e-mail to some senior colleagues later that day. As the world watches the conflict unfold in Syria, principles and ethics may seem a little academic and self-righteous, but ethical principles underlie our very claims to civilisation and humanity. For the medical profession, the Hippocratic Oath forms a binding contract between practitioners and society, outlining the responsibilities we have toward our patients and the communities in which we work. Even in times of conflict, in fact especially in times of conflict, there are international rules and ethical principles that protect health facilities, medical staff, and patients’ access to care. more…

The RSM’s Global health and human rights film club launched on 8 September 2011 with a screening of director Mark Hopkins’ Living in Emergency.

Filmed in the war zones of Liberia and Congo it follows four volunteer doctors providing emergency care under the aegis of Médecins Sans Frontières (MSF). The film’s urgent title is borne out by its content. The doctors work in chaotic overcrowded clinics, there is limited diagnostic equipment, and often they have sole responsibility for the lives of all the patients they treat.  more…

What goes through a person’s mind when they are told they have multidrug resistant tuberculosis (MDR-TB) and face at least eight months of injections and nearly two years of medication? What are they thinking when they find out that the drugs they have to take will make them feel sick, and the side effects they will experience could range from severe to life threatening? more…

A group of doctors warned last week that if climate change is not effectively tackled we all face a health catastrophe. What they did not say is that the catastrophe is already here for millions of the world’s poorest people, because when they get sick, or even have a baby, they cannot afford the medical bills. A new mother who has to undergo an emergency caesarean section in Sierra Leone can expect to be presented with a bill of up to £175 –three times higher than the average annual salary. Her family then risks slipping into even deeper poverty than it is in already. more…

Stephanie Pearl-McPhee is a Canadian knitter who challenges people to think long and hard before they buy something over the course of a week. At the end of the week, during which you’ve hopefully resisted the temptation of capuccinos, theatre trips, jeans, shoes, meals out etc, you work out what you’ve saved and donate the money to medical charity Médecins Sans Frontières (MSF). Then you tell Stephanie via her blog what you’ve saved. more…

This evening I am pretty tired again. January and December tend to be the busiest months for the Emergency Unit and there have been a higher percentage than normal of really sick HDU/ITU type cases lately.

The days are pretty unpredictable, like A&E at home. The numbers may not seem that high on paper, but often I am swamped, trying to figure out how to fit four adults and a mother and baby onto two beds and a stretcher whilst writing notes, giving drugs, asking the nurse for various things and my poor translator trying to translate my 500 questions at once. more…

My name is Tejshri Shah and I am the head of the medical unit of Médecins Sans Frontières UK, the Manson Unit. When asked to be a guest blogger for the BMJ and help promote the BMJ Christmas Appeal for MSF, my mind raced back to my first mission and a little boy, who for the purposes of this letter, and to protect his identity, I will call A. more…