Gaza Under Fire Again: The Devastating Impact On The Palestinian Population

Published 19th March 2025

Doctors of the World expresses its deep dismay at the resumption of Israeli attacks in the Gaza Strip, which have struck densely populated urban areas, makeshift schools, residential buildings, and temporary shelters for displaced people. This violence has left more than 400 people dead, mostly civilians, including women and children. The situation in Gaza was already critical due to the total siege imposed by Israeli authorities more than two weeks ago, which completely blocked the entry of humanitarian aid into the enclave. The resumption of attacks and the issuance of forced displacement orders over entire areas of the Strip have further exacerbated the humanitarian crisis, driving hundreds of families to live in a cycle of continuous displacement that has persisted for a year and a half. 

An unacceptable violation of international humanitarian law  

The return to indiscriminate bombings and the resumption of forced displacements in Gaza constitute a clear violation of the fundamental principles of international humanitarian law. The international community must not remain silent in the face of the manipulation of humanitarian aid as a tool of political pressure, nor in the face of the systematic violation of human rights in the occupied Palestinian territory. 

The urgent need for a permanent ceasefire  

After months of destruction and suffering, the Palestinian population in Gaza cannot face mass killings, civilian mutilations, forced displacements, and the demolition of essential civilian infrastructure again. The ceasefire offered an opportunity to address accumulated suffering and to rebuild the health system after its intentional collapse. Doctors of the World urgently calls on international leaders to take responsibility and exert effective political pressure on Israel. It is essential to stop the attacks, ensure full humanitarian access, and commit both parties in the conflict to establish a permanent ceasefire. 

Press contact: media@doctorsoftheworld.org.uk

Photo ©Mohammed Zaanun

RAF Wethersfield: High Court makes judgement

Published 14th March 2025

HIGH COURT FINDS THE HOME SECRETARY ACTED UNLAWFULLY IN ACCOMMODATING THREE ASYLUM SEEKERS AT RAF WETHERSFIELD

Today, the High Court found that the Home Secretary acted unlawfully by accommodating three vulnerable asylum seekers at a containment site at RAF Wethersfield. These individuals are victims of trafficking, torture and/or serious physical violence who each suffered a serious decline in their mental health as a result of living at Wethersfield. The Court also held that the failure to assess the equalities impact of the Home Secretary’s asylum accommodation policy was “a most serious and inexplicable omission”.

As a humanitarian organisation that has provided medical care to residents of the camp through our mobile clinic, we welcome the court’s recognition that the Home Secretary’s asylum accommodation policy has, and continues to, fail to adequately protect asylum seekers with special needs or disabilities. This ruling adds to the mounting evidence that mass containment sites like RAF Wethersfield are wholly unsuitable and unsafe for people seeking protection in the UK.

Doctors of the World is proud to have assisted the court with this case by providing a witness statement highlighting the severe impact this facility has had on the health and well-being of the people housed there.

However, despite this welcome judgment from the court, we remain deeply concerned about the ongoing safety and healthcare challenges at RAF Wethersfield. Our experience supporting patients at the site has consistently shown that containment camps such as this one are profoundly damaging to residents’ mental health. The enclosed, isolated environment, lack of community integration, and uncertainty about the future continue to cause severe distress. We know that, between October 2023 and December 2024, more than 62% of our patients at Wethersfield presented with severe mental distress and 30% with suicidal ideation.

Our position remains that RAF Wethersfield must be closed on medical and humanitarian grounds. People should be placed in safe, dignified accommodation within the community, where they have access to comprehensive physical and mental healthcare, so they are able to get on with rebuilding their lives.

Doctors of the World will continue to call for the urgent closure of RAF Wethersfield.

Press contact: media@doctorsoftheworld.org.uk

South Kivu, DRC: “Our teams continue to provide aid, even at 2,400m altitude”

Published 11th March 2025

As fighting intensifies in the east of the Democratic Republic of the Congo, our humanitarian teams continue to assist several regions of North and South Kivu, including at an altitude of 2,400m in the High Plateaux. The movement of displaced people continues, both within the eastern provinces of the Democratic Republic of the Congo and towards Burundi.

Since January, violence has been spreading throughout the province of South Kivu. Following offensives by the armed group M23/AFC in Goma and Bukavu, the fighting has now shifted towards the territory of Uvira, near the Burundian border.

“Due to the worsening insecurity – including the bombing of health centres, looting, and theft of medicines – many people have been forced to flee to other areas, facing even more precarious living conditions, health issues, and significant risks of violence. Those affected are in urgent need of healthcare for respiratory infections, malnutrition, and the risk of cholera, of psychological support, and of protection,” warns Lucas Franceschin, Project Coordinator in the Democratic Republic of the Congo.

Our teams continue to intervene, providing healthcare and psychological support to those in need.
In the territory of Kabare, we support the Katana General Hospital in treating patients affected by monkeypox (Mpox). In this region, two mobile clinics are already operational, covering six health centres in the health zones of Minova and Buknyakiri. We have conducted over 6,500 medical consultations in four healthcare facilities and more than 1,100 medical consultations in mobile clinics.

We are also strengthening patient care in five health centres and the general referral hospital in the Lemera health zone. Additionally, we are supporting access to sexual and reproductive health services in five health centres in the Uvira health zone. Starting now, we are treating monkeypox (Mpox) cases at the Uvira General Hospital.

In February, our teams also trained community workers, community leaders, and local leaders to identify and refer survivors of violence to healthcare facilities we support.

In the High Plateaux, Doctors of the World continues to provide healthcare to communities throughout the region, including through two hospitals (Itombwe and Minembwe), 12 health centres, and 24 community healthcare sites.

“Despite the inaccessibility of areas located at over 2,400m altitude and the severe impact of recent conflicts, our teams have continued to deliver aid to those in need. Reaching some health centres can require up to six hours of walking,” explains Lucas Franceschin.

Photo © Caroline Thirion

West Bank: Aid efforts suffocated as Israeli authorities scale up violence and movement restrictions, survey of 42 humanitarian organisations reveals

Published 3rd March 2025

Israeli forces and settlers have systematically undermined humanitarian aid making life untenable for Palestinians, according to a survey of Doctors of the World alongside 41 other humanitarian organisations working in the occupied West Bank, including East Jerusalem.

Since the pause in hostilities in Gaza took effect on 19 January 2025, aid workers in the West Bank have increasingly faced direct threats to their safety. Aid deliveries and other activities are frequently blocked or delayed as Israeli authorities have established new checkpoints and tightened movement restrictions.

All 42 of the humanitarian organisations operating in the West Bank who responded to the survey have found it more difficult to deliver aid since 19 January. Additionally, 83% of the organisations surveyed have been forced to modify or cancel humanitarian activities due to security risks. 

The surge in violence and movement restrictions by Israeli forces and settlers has led to the forced displacement of Palestinians and the constant disruption of daily life. Two days after the pause in hostilities in Gaza took effect, Israeli forces launched a major military operation in the West Bank. Between 21 January and 20 February, Israeli forces killed 51 Palestinians, including seven children. Israeli authorities have acknowledged that 40,000 people have been forced to leave their homes.

Simon Tyler, Director Doctors of the World UK, said “Israeli forces and settlers are suffocating everyday life in the West Bank. These brutal tactics, which have devastated Gaza, including airstrikes, large-scale forced displacement orders and targeting of healthcare facilities, are now being inflicted on communities across the West Bank. Civilians must be protected from violence, forced eviction, and collective punishment.”

“A week ago, a female colleague and I approached a checkpoint. We followed protocol, driving forward slowly. Suddenly, one soldier fired multiple shots into the air, then aimed his gun directly at us. I thought we were going to die. I have nightmares every night. I often break down in tears just thinking about it,” – aid worker in the West Bank.*

Obstruction of humanitarian aid

Access to aid and healthcare is severely restricted by the vast network of at least 800 Israeli military roadblocks, barriers and checkpoints. Dozens of new checkpoints, intensified security checks, and movement restrictions are ravaging humanitarian efforts. 

Twenty-four organisations surveyed reported 305 incidents where aid workers were denied access at checkpoints, preventing them from reaching communities in need. There were 222 reported cases where aid deliveries were delayed for more than three hours. In 98 instances, aid was fully turned away at the checkpoint.

Anna Miller, Head of Policy and Advocacy at Doctors of the World UK, said “Humanitarian aid is being systematically disrupted. As the occupying power, Israel has a legal obligation to ensure the provision of medical care, food, and other essential humanitarian aid to the Palestinian population in the West Bank. The denial of access to healthcare has already had deadly consequences. The international community must ensure that Israeli authorities dismantle barriers and checkpoints, and allow free flowing humanitarian aid throughout the West Bank.” 

“Some of our health workers have been injured while saving other people’s lives, some have been arrested and one health worker was killed. They are under constant threat daily, facing Israeli soldiers as they carry out home visits to our health patients,” – aid worker in the West Bank.*

Threats to civilians and aid workers

Twenty-five organisations reported a total of 257 cases of staff facing threats to their safety, while 60% of organisations reported experiencing violence or intimidation at checkpoints, putting both aid workers and beneficiaries at risk. Over 85% of organizations surveyed reported increased exposure to violence, intimidation, and displacement as Israeli forces and settlers escalate pressure on Palestinian communities. 

“Every day, I have to cross three checkpoints to go to work and it takes hours in the mornings and hours in the evenings to do so. I wake up at 4 a.m. and sometimes don’t return until 10 p.m. The soldiers at one checkpoint stop me daily, checking my computer, my phone, my documents—despite seeing me every day. They are aggressive. I am exhausted, afraid, and overwhelmed. It has never been this bad,” – aid worker in the West Bank.*

Editor’s Notes

  • *Anonymous for safety reasons.
  • In a survey conducted in February 2025, 42 international and national aid organisations including Doctors of the World (Médecins du Monde) operating in the West Bank shared their experiences delivering humanitarian aid and services from the start of the pause in hostilities in Gaza on 19 January to 11 February 2025.

Survey key findings

  • Humanitarian Access: 100% of surveyed humanitarian organisations reported increased difficulties in delivering aid since the pause in hostilities in Gaza.
  • Movement Restrictions: 93% of surveyed organisations reported that roadblocks, permit denials, and checkpoint delays  hinder operations.
  • Modifications and Cancellations: 83% had to modify or cancel humanitarian activities due to security risks.
  • Threats to Communities: 86% of organisations surveyed reported increased exposure to violence, intimidation, and displacement as Israeli forces and settlers escalate pressure on Palestinian communities. 
  • Demolitions as a tool of displacement: 74% reported intensified demolitions of homes, schools, and essential infrastructure.

Press contact: media@doctorsoftheworld.org.uk

Gaza Under Total Siege Again: Doctors of the World Warns of Catastrophic Humanitarian Consequences

Israeli authorities reinstate a full siege on Gaza: Doctors of the World (Médecins du Monde) warns against catastrophic consequences for its patients and the population and asks world leaders to act against weaponisation of deprivation of aid.

On Sunday 2 March, the Israeli government stopped all entry of supplies, including humanitarian aid, into the Gaza Strip. After systematically blocking lifesaving resources for 15 months, Israeli authorities are reinstating a full siege against the enclave by closing all crossings for the entry of humanitarian supplies. Doctors of the World knows from experience that this decision will have catastrophic consequences on people’s health.

After the ceasefire agreement entered into force on 19 January 2025, Israeli authorities lifted part of the heavy impediments imposed on entry of aid into the Gaza Strip, restoring the volume of supplies to levels seen prior to October 2023. Fifteen months of atrocities committed against Palestinians and the widespread destruction of civilian infrastructure have resulted in a humanitarian disaster that can only be addressed through the full, unrestricted, and large-scale delivery of lifesaving supplies and materials.

In less than two months of pause in hostilities and enhanced access, Doctors of the World and other health actors managed to re-establish primary healthcare centers in previously inaccessible areas, restore functionality, and expand services in existing structures. However, half of Gaza’s hospitals remain non-functional, northern Gaza and Rafah continue to face a shortage of health services, and the conditions for an outbreak of communicable diseases, including polio, persist.

Our efforts to restore lifesaving healthcare for Palestinians in Gaza are now being incapacitated by the reimposition of the total Israeli siege on the Strip. This dangerous decision also threatens to collapse the fragile pause in hostilities, once again trapping two million Palestinians in constant mass bombardment, destruction, displacement and starvation.

Morgane Rousseau, Director of Médecins du Monde Switzerland: “By cutting off again 2 million people from food, medicine, and other lifesaving supplies, Israeli authorities are condemning the most vulnerable, including children, the elderly, and the sick, to die from starvation, lack of medical care, and substandard shelter.”

Jean François Corty, President of Médecins du Monde France: “Humanitarian aid must never be used as a bargaining chip in political negotiations and turned on and off at will, leaving the lives of two million Palestinians in Gaza subject to the shifting tides of political agendas. The deliberate manipulation of aid as a pressure tactic is not just unacceptable; it is a grave breach of international humanitarian law. Israel, as an occupying power, holds a clear obligation to facilitate the delivery of humanitarian assistance to those in need.”


José Fernandez, President of Médicos del Mundo Spain: “For 15 months, world leaders have failed to apply genuine political pressure on Israeli authorities to halt the mass killing, maiming and forcible transfer of Palestinians, and the widespread destruction of their homes, schools, health system, and essential infrastructure necessary for survival. But it is never too late to act. Now is another critical moment for Third States to prove that their commitment to respecting and ensuring respect for international humanitarian law is more than just words. Now, more than ever, we must reaffirm that international humanitarian law remains relevant and applicable to all by applying real pressure on Israeli authorities to reopen all border crossings for the access of humanitarian aid and call the two parties of the conflict to commit to a permanent ceasefire.”

Press contact: media@doctorsoftheworld.org.uk

Violence in Eastern Democratic Republic of the Congo: A Humanitarian Catastrophe 

Published 31st January 2025

Following the escalation of the armed conflict between the M23/AFC armed group and the Congolese army in North Kivu (Goma), and its expansion into South Kivu—where an imminent threat to the city of Bukavu is expected in the coming days – Doctors of the World (Médecins du Monde) warns of the immense needs of the affected populations. The organisation also raises alarm over the difficulties in delivering humanitarian aid. 

Amid new offensives by the M23/AFC armed group in the cities of Minova and Goma since January 19, 2025, hundreds of thousands of people have once again been forced to flee their homes, while reception and assistance capacities for displaced persons are already overwhelmed. 

What is happening in Congo?

According to the United Nations, the escalation of violence has already displaced more than 230,000 people since the beginning of the year in North and South Kivu, which already host 4.6 million internally displaced persons. 

The humanitarian situation is catastrophic. Among the 1,672,220 displaced persons in South Kivu alone (according to the Provincial Humanitarian Coordination Report, South Kivu-OCHA), thousands who had been sheltering in displacement sites and host families have now fled further into South Kivu, in the health zones of Mianda, Kusisa, Matitura, and Tushunguti. Doctors of the World teams working in these areas registered 14,538 displaced persons between January 4 and 15. This number has continued to rise since then,” warns Mamadou Kaba BARRY, General Coordinator of Doctors of the World in the Democratic Republic of the Congo. 

Lack of Access for Humanitarian Organisations in Congo 

He adds: “Whether in North or South Kivu, people are being deprived of access to food, water, electricity (in Goma), and healthcare. Due to insecurity along the roads and the risk of attacks, humanitarian organisations, including Doctors of the World, are unable to access all affected areas. This prevents us from delivering essential medical supplies (hospital equipment, medical devices, etc.) and vital medicines to health centers and hospitals. The situation is extremely alarming: for example, childbirth care cannot be provided optimally, nor can treatment for acute malnutrition. Once again, it is civilians who are paying the price.” 

We call on all parties to the conflict to guarantee unimpeded humanitarian access, allowing organizations like Doctors of the World to provide healthcare and protection for affected populations. 

Achieving this requires strong commitment from the international community in support of humanitarian organizations to ensure that life-saving aid reaches those in need. 

Doctors of the World Response 

Doctors of the World is responding through an emergency programme in six health zones (highlands of Kalehe territory in South Kivu and Tushunguti). Our teams operate in a conflict-affected context where humanitarian access is severely restricted. Doctors of the World’s key actions include: 

  • Providing primary and secondary healthcare 
  • Ensuring nutritional support for children under five 
  • Offering maternal healthcare services in health centers and hospitals 
  • Improving sanitary infrastructure and access to water in healthcare facilities 
  • Providing care for survivors of gender-based violence, including sexual violence 

Doctors of the World is also conducting similar activities in the highlands of Mwenga and Fizi. Since December 2024, following combat in these areas, 75,000 people have been forced to flee their homes, seeking refuge in forests or with host families already living in precarious conditions. 

Press Contact 

media@doctorsoftheworld.org.uk

Gaza: Doctors of the World Welcomes the Announcement of a Ceasefire but Reiterates Its Call for a Permanent Ceasefire

Published 16th January 2025

An agreement has been announced today for a ceasefire in the Gaza Strip and the release of hostages. Doctors of the World welcomes this progress after 15 months of massacres inflicted on the Palestinian people. We renew our call for a permanent ceasefire, a vital condition for the large-scale delivery of humanitarian aid and the establishment of lasting peace.

As Gaza experiences its second winter under fire, this agreement offers a glimmer of hope and relief for our teams on the ground, the civilian population, and for hostages, prisoners, and their families. However, this announcement remains fragile, contingent on numerous steps and conditions. Caution is therefore essential to ensure the effective implementation of this agreement and to prevent a return to violence.

The agreement must now be accompanied without delay by the removal of all restrictions on the entry of humanitarian aid into the Gaza Strip to address the urgent needs of 1.9 million displaced civilians surviving in inhumane conditions.

Rebuilding Gaza, especially its healthcare system—systematically targeted and destroyed by the Israeli military—must be a priority. Israel, as the occupying power, and the international community must urgently enable the rehabilitation of hospitals and health centres. Our teams are ready to support and contribute to this critical reconstruction effort alongside local and international partners.

“For over a year, Palestinians have been losing family members, friends, their homes, and their neighbourhoods every day. Constantly displaced, they are deprived of healthcare, food, and water. Their suffering is immense. This agreement must swiftly lead to a lasting ceasefire to restore access to healthcare today and to begin the path to reconstruction tomorrow,” said Dr Jean-François Corty, President of Médecins du Monde France.

Photo © M. Zaanoun

Haiti’s unprecedented health and humanitarian crisis, 15 years after the 2010 earthquake 

Published 13th January 2025

On January 12, 2010, a magnitude 7.3 earthquake killed more than 280,000 people, injured 300,000 and destroyed millions of homes along with nearly 60% of Haiti’s healthcare infrastructure. Doctors of the World now reviews our efforts to response to the emergency in the country and warns of a humanitarian crisis that could be as catastrophic as what was experienced with the earthquake and is progressively worsening. 

Haiti: A forgotten crisis and a healthcare system in a fragile state 

Haiti is facing a downward spiral of unabated violence 15 years after the earthquake hit, compounded by multiple health, humanitarian and security challenges that are plaguing the country. According to the United Nations (UN), more than 5,600 people were killed in 2024 as the result of a surge in violence, an increase of more than 1,000 people when compared to 2023. 

“The January 2010 earthquake created havoc with a healthcare system that was already not optimal. And institutions have found themselves under attack over the past two years and simply cannot function properly. A large part of the populace has difficulty accessing health care,” according to Doctors of the World’s medical coordinator in Haiti. 

The public system is chronically underfunded, with a shortage of resources and a critical lack of staff. Currently, only 37% of healthcare facilities in Port-au-Prince are fully operational; according to the UN, those that are fully operational remain difficult to access due to insecurity. The United Nations Integrated Office in Haiti (BINUH) believes more than 40,000 healthcare workers have fled the country due to the violence. Most private facilities have shuttered, and many people cannot afford to access the services of those that remain. Staff, patients and healthcare facilities are being targeted, a situation that Doctors of the World strongly condemns. The international community’s response continues to be insufficient to properly deal with the situation’s urgency and the collapse of the healthcare system. 

“When someone experiences knee pain, for instance, the pain tends to be sharp initially, so it immediately grabs a person’s attention. This individual will seek prompt care to relieve their suffering. But if the pain persists for an extended period, the person will learn to live with the pain; it becomes ‘the norm,’ and it’s no longer front and centre. This is what’s happening with Haiti,” said Doctors of the World’s medical coordinator in Haiti. 

The crisis in Haiti continues to worsen day by day. 5.5 million people require humanitarian aid. 

“Our goal is to have the healthcare system become capable of functioning on its own, and that’s why we are offering our support. When we take stock of what we’ve accomplished this far, we know it is important to continue. Haitians are resilient: We witnessed that firsthand starting January 12, 2010, when even those who’d lost everything still took the time to help others, continued to live their lives,” recounted Doctors of the World’s medical coordinator in Haiti. 

Trusted relationships in emergency response 

Doctors of the World has been supporting healthcare services in Haiti since 1996, well before the January 12, 2010 earthquake. Being present in the community for close to 30 years enabled local teams to act quickly to meet the urgent needs of the population around the hard-hit capital city of Port-au-Prince. 

“I was working as a general practitioner in Port-au-Prince when the earthquake hit, and I ended up joining Doctors of the World as part of the post-earthquake response in 2010. Long before the 2010 disaster, however, Doctors of the World was supporting healthcare services in Cité Soleil through HIV, nutrition, and maternal and child healthcare programs, while also conducting community awareness activities. Doctors of the World’s close relationship with the community facilitated the rapid deployment of mobile clinics, benefiting not only displaced people who were living in the camps but also residents of adjacent neighbourhoods who were often deprived of healthcare access even before the earthquake hit,” said Doctors of the World’s medical coordinator in Haiti. 

Following the January 12, 2010 earthquake, Doctors of the World deployed a semi-permanent clinic in a displaced persons camp, as well as mobile clinics serving eight camps and several districts in Cité Soleil. In addition to medical care, displaced people received mental healthcare support to address the trauma incurred by the disaster. Emergency interventions and reconstruction efforts continued until 2012, at which point the focus shifted to strengthening existing healthcare centres (done in collaboration with public institutions, healthcare authorities and local communities). 

Our fight against the cholera epidemic 

A cholera outbreak broke out along Haiti’s Artibonite River in October 2010. This serious intestinal infection originated with Nepalese soldiers of the United Nations Stabilization Mission in Haiti (MINUSTAH). According to estimates from Haiti’s Ministry of Public Health and Population (MSPP), 9,792 Haitians died between 2010 and 2019 as a result of cholera. Doctors of the World – in collaboration with local authorities and other partners, and thanks to its community presence – has fought against the spread of the disease for 10 years, namely by creating 19 oral rehydration stations; a treatment centre in Cité Soleil; and deploying Mobile Rapid Intervention Teams (EMIRA), ultimately treating nearly 10,000 people and raising awareness among more than 141,000 individuals. Doctors of the World’s response to the epidemic ultimately extended to Port-au-Prince’s entire metropolitan region as well as to the Nord-Ouest department. During an official ceremony marking the elimination of cholera in Haiti in 2022, Doctors of the World’s efforts were praised by the prime minister and the Minister of Public Health and Population. 

A cholera outbreak re-emerged in Haiti in October 2022. This came after nearly three years without any cases being reported. Cholera spread quickly across the country. Insecurity, fuel shortages and difficulties in accessing healthcare worsened the situation and led to a resurgence in six of Haiti’s departments. Although the outbreak is now under control, the current environment remains conducive to the spread of cholera and other diseases like dengue, tuberculosis, measles and polio, particularly in areas that house displaced people. Doctors of the World reaffirmed its commitment by quickly responding to the needs of affected communities. 

Doctors of the World in Haiti 

Doctors of the World has been working in Haiti for close to 30 years, providing healthcare, sexual and reproductive health support, mental health and protection, as well as training health workers and advocating for infrastructure improvements in the healthcare system. In collaboration with multi-skilled community healthcare officers (ASCPs), healthcare authorities and partners, Doctors of the World responds to the healthcare needs of local communities and facilitates access to care, despite a complex security context. 

Photos © Lahcene Abib

Nepal: Waste Collectors at Risk

Published 8th January 2025

For thirty years, Doctors of the World has been working in Nepal, providing emergency assistance to populations frequently affected by violent earthquakes. Today, our focus has shifted to supporting a community whose work poses a direct threat to their health: waste collectors.

The noise is deafening, and the stench is unbearable. By early morning, the sun already scorches Kathmandu Valley, casting shadows of hundreds of figures scrambling over towering heaps of rubbish at the landfill. Amid the constant activity of bulldozers and trucks unloading waste from the capital, waste collectors work relentlessly, risking everything to sort through the refuse swiftly. Along the way, they salvage items for resale, ensuring some semblance of an income.

Everyone here fears accidents, but there are other dangers too—exposure to toxic or sharp materials,” says Jano Dangol, a representative of the Sasaja waste collectors’ association.

The Dangers of Waste Management in Nepal

In Nepal, waste management is a complicated and undervalued system. It relies on the labour of some of the most vulnerable people, including Indian migrants and members of lower castes—often referred to as Dalits or “Untouchables.” These individuals face societal neglect, stigma, and even violence, as the lowest rungs of the social ladder.

People don’t want to speak to us or touch us,” explains Madan Pandit, a door-to-door waste collector. Only a small minority are formally employed by municipalities and provided with basic equipment. “All others are informal workers in extremely precarious conditions, with no safety assurances or stable income,” raises Abdul Saboor Khan, Doctors of the World’s country coordinator.

The dangers are numerous: cuts, infections, burns, poisoning, exposure to tetanus and transmissible diseases, as well as musculoskeletal trauma. Yet, access to healthcare is severely limited. “Nepal’s health insurance scheme is effective in covering basic health needs,” Abdul Saboor explains, “but it is way too expensive for the vast majority of informal collectors.” This challenge is compounded by a lack of healthcare support and, in some cases, reluctance from healthcare providers to treat them.

A New Healthcare Model in Nepal

In 2015, Nepal launched Urban Health Promotion Centres (UHPCs), designed to provide accessible care for the most vulnerable and remove some of the pressure on the country’s seven hospitals. Doctors of the World saw this as an opportunity to promote inclusive healthcare. However, due to a lack of political will or resources, progress stalled. In 2019, we opened the first UHPC in Kathmandu.

Our aim was to demonstrate the effectiveness of this model and provide a blueprint for the government to replicate it across the country,” recalls Abdul Saboor. “But we insisted on one condition: these centres must include healthcare in response to the specific needs of waste collectors.

Today, this centre serves approximately 15,000 residents in the neighbourhood and has become essential to informal collectors, offering free, specific care. Aastha Lamichhane, a nurse at the UHPC, notes, “People understand the immediate risks of their work but are less aware of indirect consequences. Because survival is their priority, we often see delayed treatment, which worsens their health conditions. We take a proactive approach to their care, including free vaccinations for diphtheria and tetanus.

Thanks to partnerships with local associations like Sasaja, the centre maintains trusted relationships with the community, organising field awareness activities. The success of this model has prompted Kathmandu’s municipality to take over the centre’s management, with plans to replicate it in 32 districts of the capital. Doctors of the World continues to support the growth of UHPCs and provides direct aid to five of these centres, as well as other paramedical facilities in Kathmandu and Nepalganj.

The Fight for People’s Right to Healthcare in Nepalganj, Nepal

In Nepalganj, a border city where another UHPC has been established, the Balmiki caste has managed waste for over 500 years. “Originally, we were forbidden from taking any other job. Even now, we cannot eat or worship with people from other castes,” shares Jagdish Balmiki, a community member.

To combat this deeply rooted stigma, Doctors of the World helps these communities organise and advocate for their rights. “Since uniting our voices, we feel more respected, which has greatly helped negotiations to improve our working conditions,” says Jagdish. In Kathmandu, the organisation Sofai Yoddha pledged to represent Nepalese recyclers on international platforms.

Abdul Saboor believes working hand in hand with affected communities offers hope. “Nepal’s healthcare system is evolving slowly but surely. Challenges remain, but we will face them together.

2,100 waste collectors supported
427 families enrolled in health insurance

Safer working conditions in Nepalganj, Nepal

Tarka Bahadur Thapa, Doctors of the World’s programme manager in Nepalganj, talks of another vulnerable group—farmers exposed to pesticides.

In Nepalganj, where the use of pesticides is widespread, farmers are also endangered by their work.

Respiratory and dermatological problems, tetanus and diphtheria, as well as musculoskeletal issues are common. We were struck by their acute lack of access to healthcare, as their income is too low to afford health insurance.

We have therefore developed a comprehensive health response in collaboration with our local partner, Bee Group. This began with the distribution of protective equipment and awareness campaigns on reducing risks associated with pesticide use. We also support the transition of farmers to organic farming. And we provide assistance to three health centres to ensure free and specific care, including vaccinations and registration to health insurance schemes.

Today, a significant portion of the supported farmers has embraced organic farming. By improving their health, we are safeguarding the wellbeing of the entire population of Nepalganj.

Photos © Christophe Da Silva

Cyclone in Mayotte: Doctors of the World Mobilises in Response to the Emergency

Published 17th December 2024

In Mayotte, Doctors of the World is mobilising to help the population and is calling for solidarity.

After the devastating passage of Cyclone Chido in Mayotte, the situation is catastrophic. Doctors of the World teams on the ground are preparing to intervene to assist the population. They are especially concerned about the emergence of epidemics, such as cholera.

In Mayotte, Cyclone Chido has swept everything in its path and plunged the French department into chaos. Mayotte is the department most exposed to precarious conditions: 77% of the population lives below the poverty line. In the territory, four out of ten homes are made of sheet metal, and the sanitation network is largely inadequate: drinking water, already scarce, risks becoming almost impossible to find following Cyclone Chido. This is compounded by the strain on healthcare infrastructure, which is already vastly insufficient to meet the needs of the population.

“We are very worried about how the situation will evolve. On the archipelago, which contains many slums, everything has been destroyed. The roads and communication channels are cut off, there is no electricity, and no water, which forebodes the worst. In the aftermath of the cyclone, the shock is extremely severe for all the inhabitants of Mayotte, including our teams on the ground. Our priority at the moment is to re-establish contact with them to ensure everyone is safe, particularly our 25 volunteers who live in affected neighbourhoods.” – Yannick Le Bihan, Director of French Operations for Doctors of the World

Doctors of the World is preparing to provide an appropriate response and is organising to strengthen its teams as soon as possible in order to assist the entire population.

Furthermore, Doctors of the World is calling on public authorities to act swiftly and decisively to meet the vital needs of all the inhabitants of Mayotte without exception. The major issue of access to water and the lack of essential services, particularly healthcare services, has been neglected for far too long. The dramatic situation in Mayotte today underscores the urgency of state intervention to ensure lasting public health security for everyone.

About Doctors of the World in Mayotte

Present in Mayotte since 2007, Doctors of the World works daily to achieve universal access to a quality public healthcare system, particularly for those living in slums. Through mobile activities carried out with committed volunteers, the organisation conducts health mediation actions to improve access to healthcare for all the inhabitants of Mayotte, without discrimination.

Doctors of the World Strengthens Humanitarian Assistance Across Syria

Published 10th December 2024

Following the recent power change in Syria and the rapidly evolving national and regional context, Doctors of the World is adapting its activities to address the shifting needs of the 16.7 million Syrians reliant on humanitarian assistance.

For the past 14 years, civilians in Syria have borne the brunt of the conflict, with over 500,000 casualties and 11 million people displaced either within or outside Syria, as humanitarian needs have reached unprecedented levels across the country. During the war, critical infrastructure, including hospitals, power plants, and major access routes, has been attacked, severely hampering humanitarian activities.

While the political and security situation evolves rapidly, the dire humanitarian crisis persists. Doctors of the World (Médecins du Monde) is adapting its activities, particularly in response to the massive displacement of populations within Syria and near its borders. Since November 27, 2024, between 800,000 and one million people have been displaced across Syria, including 345,375 in Idlib Governorate alone and more than 100,000 in Northeast Syria. As a healthcare actor, Doctors of the World has witnessed the collapse of the Syrian healthcare system since the conflict began in 2011. Our teams should be able to reach newly accessible areas to support and strengthen local healthcare capacities.

Doctors of the World Rapid Response in Syria

As part of our emergency response in northwestern Syria and formerly government-controlled areas, Doctors of the World will prioritise the swift deployment of medical teams and supplies to regions affected by hostilities between November 27 and December 8, 2024. Our initial focus will be on providing essential medical care in Aleppo, followed by Hama, Homs, and Damascus. We will coordinate closely with local health authorities and international partners to ensure the efficient distribution of medical supplies, including medicines and consumables.

“Our teams are also assessing the broader health needs of the population, ensuring a timely response to the evolving situation. We are committed to providing life-saving services and will adjust our operations based on ongoing assessments and security developments,” said Hakan Bilgin, President of Doctors of the World Türkiye.

Doctors of the World is also active in northeastern Syria, where recent developments have exacerbated security challenges for both the population and staff. Health services are overstretched, with most facilities reliant on NGOs. The arrival of over 20,000 refugees from Lebanon and 100,000 displaced individuals from northwest Syria has further strained the fragile healthcare system. Access challenges and a critical funding gap limit aid expansion, making additional resources urgently needed to scale up the response.

Doctors of the World Calls on All Parties to Respect Human Rights and Facilitate Humanitarian Assistance in Syria

We urge all parties to respect the human rights of the Syrian people and facilitate humanitarian assistance for the 16.7 million people who need it. As the situation in Syria is strongly connected to regional issues, we call on all parties to cease hostilities and protect communities exhausted by years of intense conflict. Civilian infrastructure, including medical facilities, must be protected and never targeted. They are vital for the protection of civilians and the delivery of humanitarian aid. Humanitarian access must be respected, facilitating the access of health workers including non-medical personnel.

As humanitarian and security conditions remain insufficient to ensure the safe return of Syrians living abroad, we call on states to uphold the principle of non-refoulement, maintain asylum procedures for Syrian nationals, and refrain from deportations to Syria, respecting individuals’ right to decide their future.

We call on donors to prioritise support for:

  • Ensuring safe and sustained access to primary healthcare services across Syria,
  • Strengthening medical supply chains to mitigate critical shortages of essential medicines and surgical kits.
  • Expanding mental health and psychosocial support services as current services only reach a fraction of those in need.

About Doctors of the World in Syria

Doctors of the World began its activities in Syria in 2008, providing primary healthcare services in Aleppo Governorate in partnership with the Syrian Arab Red Crescent (SARC) before the conflict began. Over the past 14 years, Doctors of the World has implemented numerous medical and humanitarian assistance to provide access to healthcare and humanitarian assistance for Syria’s war-affected population. These include emergency medical care, reproductive and sexual health services, consultations for communicable and non-communicable diseases, and mental health and psychosocial support, particularly for vulnerable groups such as children and women.

For more information or to arrange an interview: media@doctorsoftheworld.org.uk

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