AMR: A threat hidden in plain sight

In places where MSF operates, getting access to the right antibiotics is a matter of life or death. Antibiotics are the cornerstone of modern medicine, treating a vast range of infections. But, over the last few years we've been seeing a troubling phenomenon where the standard antibiotics used to treat some diseases have simply stopped working. This is known as antimicrobial resistance (AMR), which is when some of the bugs which cause disease mutate and find ways to avoid the effective elements of antibiotic medicines. What can be done when this happens and what steps is MSF taking to tackle AMR more broadly? We speak to AMR expert Mohamad Khalife. Presented by Laura McCullough Edited by Kate Lee and Sandy McKee Photo: MSF

In the latest episode of Everyday Emergency, we’re looking at the humanitarian crisis in the east of the Democratic Republic of Congo, or DRC – a huge country in Central Africa that’s home to around one hundred and eleven million people. The northeast of the country has endured decades of insecurity since the fallout of the 1994 genocide in the neighbouring country of Rwanda. Driven by ethnic tensions and a fight for resources, the conflict involves more than one hundred armed groups, such as the widely-known M23, as well as Congolese government forces and UN peacekeepers. The most recent phase of the conflict has been rapidly evolving, and intensified since December 2024. It has displaced hundreds of thousands of people, and resulted in many casualties and violent injuries across the provinces of North and South Kivu. Tragically, MSF staff members have also lost their lives. To learn more about what’s been happening, and how MSF has responded, we spoke to Juliette Seguin, MSF’s Emergency Coordinator in Goma, DRC's capital city in the east of the country. If you would like to support our life-saving medical work around the world, please visit msf.org.uk to donate. Thank you. Presented by Kate Lee Edited by Sandy McKee Photo: MSF

Two years ago, MSF doctor Javid Abdelmoneim received a cryptic message from his cousin in Khartoum that said "Your dad is safe". But safe from what? On 15 April 2023, a brutal civil war broke out in Sudan between the Sudanese Armed Forces and the Rapid Support Forces. From early attacks around the capital Khartoum, the fighting quickly escalated and spread to other parts of Sudan. Almost overnight, millions of people found themselves trapped in a conflict. Now, two years on, the situation is both shocking and complex. Sudan has become the world’s largest displacement crisis, with more than 12 million people forced from their homes. Many are without access to essential healthcare, and there have been widespread outbreaks of diseases like cholera and measles. Meanwhile, the number of people suffering from malnutrition, or women and children dying is truly alarming. Throughout all of this, people – civilians – have been subjected to horrific violence. The United Nations recently described this situation in Sudan as “the world’s worst humanitarian crisis”. In this episode of Everyday Emergency, we speak to Dr Javid Abdelmoneim who recently returned from an assignment in the crisis-hit country. He is an emergency medicine specialist, and an extremely experienced MSF doctor who also spent the first eight years of his life growing up in Sudan. His story is deeply personal, at times upsetting, but incredibly powerful. If you would like to support our life-saving medical work around the world, please visit msf.org.uk to donate. Thank you. Presented by Cece Leadon Edited by Sandy McKee Photo: MSF

In crisis zones across the world, hospitals have been attacked, supply trucks blockaded and funding cut. So, what is the state of humanitarian aid today? In this episode of Everyday Emergency, we’re speaking to Chris Lockyear – the Secretary General of Médecins Sans Frontières / Doctors Without Borders (MSF). He’s one of the leading voices in MSF, and an expert on humanitarian aid and the crises we currently face. We sat down with Chris after a recent visit to Sudan, where MSF teams are operating in what has been dubbed a ‘humanitarian void’ despite more than 11 million people being forced from their homes by the civil war. We also spoke about the situation in Gaza following the desperately needed ceasefire, and about the dangerous and far-reaching consequences of the aid cuts recently announced by governments including the UK and USA. If you would like to support our life-saving medical work around the world, please visit msf.org.uk to donate. Thank you. Presented by Nick Owen Edited by Sandy McKee Photo: MSF

At a groundbreaking hospital in the Jordanian capital Amman, a dedicated team from Médecins Sans Frontières / Doctors Without Borders (MSF) work to treat and rehabilitate war-wounded people from conflict zones across the Middle East and North Africa. Rula Marafeh, an experienced physiotherapist, shares her story from a unique project that has been saving and transforming lives since 2006. In places such as Gaza, Sudan, Yemen and Syria, as violence pushes healthcare systems to breaking point, MSF works to evacuate patients in need of the most specialist care. Once in Amman, a spectrum of expert teams work to surgically reconstruct limbs, treat aggressive infections, teach patients to use their new bodies, and crucially, heal the unseen trauma each new arrival carries with them. If you would like to support our life-saving medical work around the world, please visit msf.org.uk to donate. Thank you. Presented by Amber Dowell Edited by Sandy McKee Photo: MSF/Peter Bräunig

MSF’s operations have been closed down in Chechnya in response to the MSF Coordinator’s kidnapping. After his release, three weeks later, MSF tries to restart its operations in Chechnya but there are delays due to security issues, and for now, the only programmes in the country are run through remote control management from Dagestan, on Chechnya eastern border. Most of MSF’s Caucasus staff are behind the return and support MSF speaking out in the media. Meanwhile and in a statement after the September 11th attacks in New York and Washington, Vladimir Putin links Russian military operations in Chechnya with the anti-terrorist combat launched by the American government. These events completely change the landscape for western tolerance towards Russia. IMAGE: © Olivier Jobard/MYOP

Throughout the year 2000, MSF seizes every opportunity to raise the alarm on the Chechen’s fate with governments and institutions around the world, but to little concrete effect other than general condemnation. With still no international staff in the country, MSF sections resort to so-called ‘remote control’ management, using locally hired employees to deliver aid on the ground. Concerns over the organisation’s legitimacy in speaking out remain and soon one of the sections starts making unauthorised and dangerous trips over the border into Chechnya from Dagestan where they ran distributions of basic care items. Under attack in the Russian media, MSF wonders whether it should ignore or address the accusations of espionage regularly thrown at the organization?

In August 2002, the threat to MSF becomes a reality and another Coordinator, a Dutch national, is kidnapped in Dagestan. The organisation is once again faced with the dilemma whether it should speak out in the media about the kidnapping or not. MSF opts to keep quiet at first, but as the weeks turn into months and the MSF Coordinator is still not released, MSF starts questioning whether it should take active steps to secure the hostage’s release by publicly pointing out a government’s responsibilities, negligence, or even complicity when a kidnapping occurs on its soil, or should it not enter into these conversations to avoid the potential for a government to dig in its heels? Tensions are running high, especially between MSF, the Dutch authorities and the family of the hostage, and some feel the structures within the organisation are not helping the situation.

The first war of independence of Chechnya with the Russian Federation starts in 1994 and runs for two years. In 1999, while the country and its people are still struggling to recover, the Russian authorities start bombing Chechnya again. Through these tough years in the North Caucasus and when access is repeatedly blocked by the Russian forces, MSF staff continues to try to provide food and medical aid to people inside Chechnya and to Chechen refugees in the surrounding republics. From the start of the first war, MSF feeds the press with information on the rapidly deteriorating conditions and the Russian’s refusal to let them into many areas of the country.

The situation in the North Caucasus is getting more and more violent as the Russian federal authorities is trying to forcibly repatriate Chechen refugees and force humanitarian organisations out of Ingushetia. When colleagues at other organisations are kidnapped in Chechnya, MSF closes down all operations in the country again. With a diminishing international presence in the warzone, MSF is once again faced with dilemmas - should it continue to speak out about human rights abuses its staff haven't witnessed? How can they help those in need in the region? And how long will it be before one of their own staff is once again held hostage?