In photos: 8 medical needs of children in humanitarian settings

14 May 2021

Around the world, Médecins Sans Frontières/Doctors Without Borders (MSF) teams are working to ensure children receive the best healthcare possible. The stories below talk about the enormous challenges faced by these young patients and the impact of MSF programs on helping them survive and stay well. 


A baby girl lies in the neonatal department of Ad Dahi Rural Hospital, Yemen. “The baby suffers from birth asphyxia [oxygen deprivation] as a result of her delivery at home and she cannot breastfeed naturally, so we provide her with fluids and take care of her here,” says Wadie'e, a nurse at Ad Dahi Hospital. In 2020, over 290 neonates were admitted to Ad Dahi hospital suffering from birth asphyxia. © Majd Aljunaid / MSF October 2020.

1. Preventing measles for children under five 

Measles is one of the most highly contagious diseases in the world and one of the leading causes of death in children under five years old—even though it is easily prevented by a vaccine. Vaccination is particularly important because there is no specific treatment to cure measles. We provide routine measles vaccinations as part of paediatric care, both in emergency settings and in areas where government immunisation programs are not operational. During outbreaks, we provide supportive care for infected children and treat any complications to prevent them becoming fatal. 


In Bakalawa, Democratic Republic of Congo, Gbamia Some is carrying his youngest son who is about to be vaccinated. Bakalawa is part of the Dekeré health area, where many cases of measles have been reported among children aged under 15. © Pacom Bagula / MSF March 2021.

2. Treating malaria in vulnerable communities 

Malaria is a deadly disease carried by mosquitoes. Every year, it kills around 410,000 people and infects more than 220 million. Ninety per cent of these deaths occur in sub-Saharan Africa. Children under five years old are especially vulnerable to infection and serious consequences of malaria since they haven't yet developed immunity. In South Sudan, Democratic Republic of Congo and Central African Republic, our hospitals sometimes double in size to treat severe cases in the malaria season. Our malaria strategy is focused on improving prevention, reaching and treating the most vulnerable, and enhancing advance planning for malaria seasons in the most affected regions where we work. 


A nurse stops to check the patient file of eight-year-old Adut Chuor Kujal, who is receiving treatment for cerebral malaria in the inpatient ward at the MSF-supported hospital in Aweil, South Sudan. Her family lives in a remote rural village. Adut’s father first took her to a private clinic closer to their home, but it had no malaria drugs in stock. © Diana Zeyneb Alhindawi / MSF October 2015. 

3. Providing adolescent sexual and reproductive health 

Adolescent sexuality is both a natural part of healthy development and highly stigmatised in many communities. In many countries where we work, a host of barriers prevent teenagers from accessing sexual and reproductive health services safely and confidentially. Young adolescents or older children may start having sex and experimenting as early as 12 years old, frequently without protection or information on how to prevent unwanted pregnancies, STIs and HIV infection. In response to this, MSF has established adolescent-friendly clinics and clubs to encourage interaction with health services at this pivotal period of their lives. 


Teenagers relaxing in the ‘adolescent friendly corner’ at the Edith Opperman clinic in Mbare, Zimbabwe, where MSF offered free general health check-ups, HIV testing and counselling, screening for sexually transmitted infections (STIs) and contraceptive services. © Charmaine Chitate / MSF March 2018.

4. Fighting malnutrition in children  

Malnutrition is the underlying contributing factor in nearly half of the deaths of children under five years of age. It can lead to a weakened immune system meaning children are more vulnerable to disease, creating a vicious cycle. Treating malnutrition involves ready-to-use therapeutic food (RUTF). RUTFs include all the nutrients a child needs for development and helps reverse deficiencies and gain weight. Where malnutrition is likely to become severe, we take a preventative approach by distributing supplementary RUTF to at-risk children. 


MSF nutrition nurse Ajmal Wardak is measuring a child’s middle upper arm circumference in our clinic in Herat, Yemen. This special measuring tape is the simplest tool to help medical staff detect malnutrition. © Waseem Muhammadi / MSF December 2020.

5. Pneumonia: a preventable infection in children 

Pneumonia is a leading cause of death in children under five, and a common complication for a lot of other diseases affecting children, for instance measles. Often it starts as a simple cold, which then develops into a chest infection. There, the virus causes inflammation of the lung tissue, and this allows any potential bacteria to get past the local immune defences and set up a secondary infection spreading quickly. The lungs become affected, and the child has a high fever, cough, and can be seen to be breathing rapidly. Children can be protected against pneumonia using the pneumococcal conjugate vaccine; however, the high price prevents some governments including it in their immunisation schedule. MSF continues to advocate for lower-priced vaccines to overcome this barrier.  


Two-year-old Sheku Kamara is being treated for malnutrition, malaria and pneumonia in the intensive therapeutic feeding centre at the MSF hospital in Sierra Leone. It is often the case with childhood diseases that one causes children to become easily susceptible to others. © Peter Bräunig / MSF September 2020.

6. Impacts of conflict on children’s wellbeing 

The effects of conflict are both direct and indirect and are associated with immediate and long-term harm. Children and adolescents often have to deal with tough situations and painful memories, while they have not yet developed coping mechanisms that would allow them to deal with their suffering. In humanitarian crises, mental health and psychosocial care for children are usually an invisible need that remains unmet, even though the risk of developing a mental disorder often traces back to childhood. The violence and conflict in Diffa, Niger has generated a host of traumatic experiences and events for children.    


Twelve-year-old Anas and his parents left Nigeria four years ago. Anas’s parents were small traders and the family lived well, but they had to give everything up due to the conflict. Anas witnessed several murders when his village was attacked. MSF is running a mental health and psychosocial support programme for children and adolescents in Diffa, to prevent possible psychological and social repercussions following the traumatic events they have experienced. © Juan Carlos Tomasi / MSF August 2018.  

7. The long and gruelling treatment for tuberculosis 

Tuberculosis (TB) is often thought of as a disease of the past, but a recent resurgence and the spread of drug-resistant forms makes it very much an issue of the present day and age. It’s caused by a bacterium (Mycobacterium tuberculosis) that is spread through the air when infected people cough or sneeze. The disease most often affects the lungs, but it can infect any part of the body, including the bones and the nervous system. Children aged under 15 years are particularly vulnerable to TB and those under five years are a key at-risk group. This is because once infected, they have a higher risk of progressing to the disease. To combat TB we conduct active case finding, push for new drugs, child-friendly formulations and shorter treatment regimens, and emphasise holistic, patient-centred models of care.   


Six-year-old Jane Matthews James has completed two years of treatment for tuberculosis in Papua New Guinea. She has finally been able to start school, as she couldn’t go before due to the treatment. Her mother said, "It was painful for her. The treatment supporter sometimes spent 20 minutes until she was calm enough for the daily injection." Jane now wants to become a nurse. © Sara Bechstein / MSF June 2019. 

8. Combatting the stigma of noma 

Noma is a non-contagious disease that mostly affects children under seven living in poverty. It starts as an inflammation of the gums, with the infection quickly starting to then destroy bone and tissue. It can cause pain, breathing complications and eating difficulties. Without treatment, noma is fatal in 90 per cent of cases. But if it detected early, its progression can be rapidly halted, through basic hygiene, antibiotics and nutritional rehabilitation. Noma patients experience high levels of stigma within their communities as they are often considered cursed, and face exclusion or abandonment as a result. MSF supports the world's only dedicated noma hospital in northwest Nigeria. We provide treatment and support community outreach, active case finding, health promotion and mental health support. 


Eight-year-old Umar and 15-year-old Adamu, noma patients, look out from the entrance to our post-operative ward in the Sokoto Noma Hospital, Nigeria. © Claire Jeantet / Fabrice Caterini / INEDIZ / MSF October 2018. 

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