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Publications

War and humanitarianism, medicine and public health, rights and justice... Discover CRASH publications sorted by themes.

The fact that CRASH publications are written from an aid practitioner's, rather than researcher's, perspective, does not exempt them from the demands of rigorous research methods. We try hard at this, with the help of (volunteer) research professionals. The publications are not the MSF party line, but rather tools for reflexion based on MSF's framework and experience. They have only one purpose: to help us better understand what we are doing. Criticisms, comments and suggestions are more than welcome - they are expected.

Stopping HIV in Ndhiwa
Article

Controlling an HIV Hotspot. A Realistic Ambition?

This article was published on December 22nd, 2021, in the Journal of Humanitarian Affairs (Issue 3, Volume 3).
Despite a concerted international effort in recent decades that has yielded significant progress in the fight against HIV/AIDS, the disease continues to kill large numbers of people, especially in certain regions like rural Ndhiwa district in Homa Bay County, Kenya. Although there is still no definitive cure or vaccine, UNAIDS has set an ambitious goal of ending the epidemic by 2030, specifically via its 90-90-90 (treatment cascade) strategy – namely that 90 per cent of those with HIV will know their status; 90 per cent of those who know their status will be on antiretroviral therapy and 90 per cent of those on antiretroviral therapy will have an undetectable viral load. These bold assumptions were put to the test in a five-year pilot project launched in June 2014 by Médecins Sans Frontières (MSF) and Kenya’s Ministry of Health in Ndhiwa district, where an initial NHIPS 1 study by Epicentre (MSF’s epidemiology centre) in 2012 revealed some of the world’s highest HIV incidence and prevalence, and a poor “treatment cascade”. Six years later a new Epicentre study, NHIPS 2, showed that the 90-90-90 target had been more than met. What explains this ‘success’? And given the still-high incidence, is it truly a success? What follows is an interview on the political, scientific, and operational challenges of the Ndhiwa project with MSF Deputy Director of Operations Pierre Mendiharat and physician Léon Salumu, Head of MSF France Kenya programs, conducted by Elba Rahmouni.

image ce que nous dit le sida
Article

What AIDS teaches us

In this article, Rony Brauman identifies the dynamics and events that made bending the HIV/AIDS epidemic curve possible. He explains the climate in which the tug-of-war with parts of the pharmaceutical industry played out from MSF’s perspective, and recalls that fears about international security and political stability also helped push governments to mobilise against the epidemic.

illustration la prise en charge de l'enfant douloureux
Article

Management of the suffering child: a medical and operational challenge

 

Based on the example of the hospital in Moïssala, Chad, the two authors reflect on the management of pain in children at Médecins Sans Frontières. This article was first published on March 25th 2022 in the journal Alternatives Humanitaires.

cover-reconstructing-lives
Book

Reconstructing Lives. Victims of war in the Middle East and Médecins Sans Frontières

Reconstructing Lives was published in January 2022 by Manchester University Press. The book is the result of extensive fieldwork, in collaboration with the Crash. Here is the presentation of the book and its contents, as well as a short introductory video.

Jean-Christophe Nougaret/MSF
Article

About the possibility of controlling an HIV epidemic hotspot

This article was first released in the 18th volume of the Humanitarian Alternatives magazine. Designed to reduce the incidence of HIV/AIDS in a Kenyan district, a Médecins Sans Frontières project successfully exceeded the “90-90-90” target set by UNAIDS. A look back on the results that the authors of this article - Pierre Mendiharat, Deputy director of operations at MSF France and Léon Salumu Luzinga, Program manager at MSF France, interviewed by Elba Rahmouni - believe are encouraging but by no means a guarantee that the epidemic will be over by 2030.

After days of heavy fighting between Hutu and Tutsi rebels, many Hutu refugees are on the run for the continuing violence.
Article

Patrick de Saint-Exupéry: a counterfaiter in Congo

In his book, La Traversée. Une odyssée au cœur de l’Afrique, Patrick de Saint-Exupéry challenges the reality of Hutu Rwandan refugees’ hunt and massacre facing the advancement of the Rwandan Patriotic Army and their Congolese allies in 1996-97. This systematic exercise of denying reality – especially the denial of the Mapping Report written by the Office of the United Nations High Commissioner for Human Rights (1143 pages, published in June 2009) – but also this denial of Human Rights Advocacy groups’ investigations, and those of journalists’ witnesses present in DRC at the time – does not spare MSF’s teams who came to help these refugees in 1996-97. However, as a front-line witness of the Tutsi genocide in Rwanda, MSF was also one of the organizations noticing the intense violence perpetrated by the new Rwandan political regime in Zaire / DRC back in 1996 and 1997, mostly against a population constituted at three-quarters of women and children. 

 

Violences extrêmes. Enquêter, secourir, juger République démocratique du Congo, Rwanda, Syrie
Book

Extreme violence. Investigating, Saving, Judging Democratic Republic of Congo, Rwanda, Syria

Over the last few years, Rwanda, the Democratic Republic of Congo (DRC) and Syria have been places where situations of extreme violence took place. As witnesses and investigators of such, the authors of this book shed light on three key-moments that marked these tragic episodes:  the investigation, the intervention of emergency relief teams and the implementation of justice procedures leading to judgement.