Communities in Cameroon take an active role in preventing cholera

Source: Médecins Sans Frontières –

Placing communities in Cameroon at the heart of cholera prevention efforts is the basis of a new initiative between Médecins Sans Frontières (MSF) and Cameroon’s Ministry of Health (MoH). The project – launched in November 2024 in Djoungolo, a neighbourhood of the country’s capital, Yaoundé, that has been regularly affected by cholera – addresses factors that contribute to the resurgence and transmission of the disease to strengthen prevention capacities often already in place.

“We had already introduced community cleaning days in each neighbourhood to clear drainage channels, clean the areas in front of homes and public spaces,” says Simon Ahanda, neighbourhood chief in Djoungolo. “Residents were already mobilised to fight diseases linked to poor sanitation.”

A woman sources clean water from a borehole in Djoungolo. Yaoundé, Cameroon, July 2026.
Vanessa Fodjo/MSF

Listening to communities before taking action

Since October 2021, Cameroon has experienced recurring cholera outbreaks. While emergency responses treat patients and reduce the risk of death, additional measures are needed to prevent the disease from returning. Underlying causes include limited access to safe drinking water; inadequate sanitation infrastructure; poor waste management; and inadequate hygiene practices. It is in this context that MSF chose to develop a different approach, based on community involvement.

Our teams held consultations with residents, community leaders, health authorities, and other local stakeholders. The discussions identified community priorities, the challenges communities face, and existing measures. The consultations showed that communities had already identified several challenges and developed local initiatives that needed strengthening. This approach is part of the Patients and Populations as Partners (PPP) approach and made it possible to adapt project activities to the realities on the ground.

“We could not come in with ready-made solutions,” says Frida Tebere, MSF’s PPP manager. “Patients and communities know their realities, their challenges and the problems they face every day better than anyone.” 

“Our role is to listen, create dialogue and build solutions together with them,” says Tebere.

Frida Tebere, MSF PPP manager “We could not come in with ready-made solutions. Patients and communities know their realities, their challenges and the problems they face every day better than anyone. Our role is to listen, create dialogue and build solutions together with them.”

Frida Tebere, MSF’s PPP Activity Manager. July 2026.
© Vanessa Fodjo/MSF

Solutions adapted to the local context

Community consultations helped guide project activities towards concrete priorities including improving access to safe drinking water, strengthening hygiene and sanitation practices, supporting the early detection of suspected cases, and promoting better understanding and adoption of prevention measures.

MSF is supporting the promotion of good hygiene practices, the rehabilitation of seven water points, and the establishment of a chlorine production unit to improve access to safe drinking water. The use of chlorine caused concern among communities. Discussions showed that the concern was based on the practicality of chlorine use – the correct dosage and how to store treated water – and not on treating water itself.

The project developed a strategy centred on model households. These are volunteer families who are trained in chlorine use and, having gained practical experience, then share their knowledge with neighbours.

“At first, we had concerns about using chlorine,” says a member of a model household. “After the explanations and demonstrations, we understood how to use it correctly. Today, we also show other families how to treat their water.”

The MSF team and community members visit water points MSF rehabilitated in Djoungolo. Yaoundé, Cameroon, July 2026.
Fabienne Toumba/MSF

Continuously strengthening community capacities

More than 1.2 million people have been reached through awareness-raising activities since 2025. Approximately 5,000 households are targeted each month in the Djoungolo health district.

Community engagement is a key component of the project. Participation goes beyond awareness-raising. At some sites, communities also help secure worksites and equipment during the rehabilitation of water points. This involvement strengthens local ownership of the infrastructure and aims to create the conditions necessary for its continued use and sustainability.

The project also supports health facilities and communities through a chlorine production unit intended to supply health facilities and households for water treatment. MSF remains ready to support the response to future cholera outbreaks, including through free patient care, strengthening the capacities of healthcare workers, supporting peripheral health facilities when needed, and contributing to preventive or reactive vaccination campaigns.

The objective is therefore to create a continuum between prevention, preparedness and response: strengthening community involvement and health facilities, while maintaining the capacity to respond rapidly as soon as a cholera case is confirmed.

Collective responsibility for sustainable prevention

In a context where humanitarian needs are increasing while available funding is declining, cholera prevention cannot rely on a single organisation. The experience in Djoungolo shows that communities never start from scratch. They already have knowledge, initiatives, and solidarity mechanisms that can contribute to preventing the disease. The role of health organisations is therefore not only to provide expertise, but also to identify, strengthen, and support solutions that already exist locally.

In Djoungolo, preventing cholera is not simply about providing safe water, chlorine, or awareness messages. It is about enabling people to understand the risks, participate in decision-making, and have the means to take action. Prevention becomes more sustainable when communities are not simply recipients of a response, but full partners in shaping it.

Unaccompanied minors in Marseille need continued support

Source: Médecins Sans Frontières –

After six years of operation, Médecins Sans Frontières (MSF) is gradually withdrawing from Marseille, France. We will strengthen our work on the northern French coast, where the situation continues to deteriorate for migrants seeking to reach the United Kingdom. Camille Niel, head of mission for France, reflects on a collective project that has helped hundreds of young people rebuild their lives.

What was the situation like for unaccompanied minors in France, and particularly in Marseille, when our project was launched in 2020?

In 2020, hundreds of young people were sleeping on the streets of Marseille in the middle of winter, due to a lack of support from public institutions. It was at this point that MSF decided to fund 100 emergency shelter beds, in collaboration with associations and collectives based in Marseille. This failure of the state prompted us to intervene more broadly and sustainably with unaccompanied minors in the city, by launching a shelter and care programme.

Unaccompanied minors are young people who arrive in France without their legal guardians. If they are officially recognised as minors by the State, they will be taken into care under child protection services, with access to education and healthcare, and cannot be detained or removed from French territory. If they are not recognised as minors, they will not receive any specific support.

Assessing their age is therefore essential. Each department in France is responsible for this and conducts an assessment through interviews with child welfare professionals. However, the results vary considerably depending on the location of these young people, with some départements (departments – administrative regions in France) having a low recognition rate. This is the case in the Bouches-du-Rhône department where Marseille is situated, even though it was for a long time the city with the second highest number of unaccompanied minors arrivals in France.

View of Notre-Dame de la Garde from the Vieux-Port of Marseilles.
Benoît Guillaume/MSF

When their minority status is not recognised, these teenagers have the option of appealing this decision by petitioning a juvenile court judge. They are then referred to as “unaccompanied minors”; there were 300 such cases in Marseille in 2025. This is a lengthy process, sometimes lasting a year, during which, neither considered adults nor recognised as minors, unaccompanied minors receive no institutional support, and are left to fend for themselves, without access to housing, schooling, or medical care.

This extreme vulnerability has serious consequences for their physical and mental health. Many of the young people we encountered over these six years presented symptoms and disorders requiring long-term care, and for whom referral to appropriate psychological treatment facilities was essential.

In six years of operation, approximately 150 young people were accommodated by our teams, and nearly 1,500 consultations were carried out in the “MSF house”, a building that belonged to the Marseille city hall, where our teams took care of often very complex cases.

Can you tell us about this house?

It was at the heart of the MSF project in Marseille. Its unique feature was that, beyond providing shelter, it offered comprehensive multidisciplinary support to the young people it housed: access to state medical aid (AME in France), education, transportation, a registered address, and basic necessities (clothing, hygiene products, food etc.). Furthermore, all the young people received support in their academic and professional development, and the majority of them were able to access apprenticeships.

On the legal front, our team assisted them with appeals related to their minor status, helping them obtain civil status documents and navigating the procedures for those who reached adulthood (residence permits and Youth Protection Certificates). It was also crucial that these young people become independent.

The organisation of the house and communal living, to which they contributed significantly, played a particularly important role. When we made the decision to withdraw from Marseille, the reorganisation was very gradual, and the teams took the time to support the young people until the very end of the project. They have all now left home with an alternative accommodation solution, social support, and stabilised health pathways.

Two unaccompanied minors, cutting their hair and having some respite at the day center called Le GR1, located in Marseille.
Meryl Sotty/MSF

What is their profile?

Many were in difficult family situations before embarking on their journey or had fled armed conflicts. They took different routes, some passing through Libya against their will, sold by smugglers to human traffickers, or through Tunisia, managing to board a makeshift boat to cross the Mediterranean Sea. Most arrived via Italy, while others entered Europe through Spain via Morocco and Algeria.

Each journey carried its share of risk, violence, and suffering – right up to their arrival in France, and even once they arrived in the country. They have experienced traumatic events; for example, in Libyan detention centres, where torture is commonplace, or while crossing the Mediterranean. Some have lost one or more of the people they were travelling with, whether a friend or a family member. They have faced death and must live with that.

All have experienced the rejection of their minor status by the departmental authorities, following an assessment considered biased, even prejudiced, by organisations that support unaccompanied minors, including MSF. The assessment itself and its outcome are experienced as yet another act of violence, with this institutional violence all the more difficult for these young people to endure, because they were convinced they would finally be safe in France after months of travel. They were able to find respite within the “GR1”, a collective project created in 2024 by organisations based in Marseille.

What role does this structure play?

The needs of unaccompanied minors far exceed our capacity, particularly given the Bouches-du-Rhône department’s refusal to assume its responsibilities regarding child protection and shelter. With several partner organisations – Yes We Camp, Just, Secours Catholique, Ligue de l’enseignement, and the Salvation Army Foundation – we mobilised by creating a place called “GR1”, a name that refers to the gathering of young people in the Sahel region to chat over a cup of tea. It is the only day centre for unaccompanied minors in Marseille. 

It is designed to be a true haven and provide respite for these young people. They can rest, wash, eat and cook, take French classes, receive support with legal procedures and access medical care. Up to 80 young people have been welcomed there daily. For two years, the MSF medical team provided medical consultations twice a week and offered individual sessions with a psychologist once a week.

For these teenagers, each day spent at the GR1 is one less day spent on the street, and an additional chance to rebuild their lives. The programme is now well established after several years of collaborative work and consultation. It is a model worth defending, a shared space that continues to thrive beyond its founding organisations, even if its foundations still need strengthening in the future.

You mentioned the needs of unaccompanied minors, which far exceed the capacities of associations – could you explain?

The GR1 is attempting to provide a response, notably with the support of the City of Marseille, and the Marseille community is mobilising extensively. However, these organisations are facing the underfunding of public services that affects all associations in France. Despite this, they are being called upon to address a reality that exceeds their capacity.

The situation of unaccompanied minors in Marseille remains problematic. They continue to be among the most excluded and invisible communities. This neglect exposes them to abuse, criminal networks, the dangers of life on the streets, and extremely strong stigmatisation, which is politically exploited.

We are faced with a policy implemented by the department that creates a largely avoidable situation and forces associations to step in where the state is failing. It is essential that public authorities abandon their logic of exclusion and invisibility of unaccompanied minors, and work with local stakeholders to build dignified, legal, and sustainable reception conditions.

Africa must not trade its critical minerals for another debt crisis

Source: Greenpeace Statement –

Civil society urges governments to disclose resource-backed deals, strengthen mining taxation and protect communities under the Common African Position on Debt.

NAIROBI, 27 August 2026 – African governments must not sign away future mineral revenues to meet today’s financing needs, civil society organisations warned at the sixth African Conference on Debt and Development (AfCoDD VI). To prevent such commitments from undermining future public revenues, the civil society groups called for resource-backed loans and related mineral agreements to be publicly disclosed and independently scrutinised.

The call came during a session on “Critical Minerals, Debt and Tax Justice in Africa’s Common Position,” which examined how borrowing tied to mineral exports could affect Africa’s debt sustainability, fiscal sovereignty and long-term development.

Africa holds vast reserves of critical minerals like copper, cobalt, lithium, graphite and manganese that are increasingly important to renewable energy, electric transport and the global energy transition. Civil society organisations said this mineral wealth presents a historic opportunity for African countries to build industries, create decent jobs, strengthen public services and finance their own development. Yet many resource-rich countries continue to face high debt, poverty and inequality.

For governments struggling to access affordable finance, resource-backed loans can appear attractive because they provide immediate funding, often for infrastructure, in exchange for repayment through future commodity exports or revenues. But participants warned that such arrangements can carry long-term costs, particularly when they are negotiated without sufficient transparency and safeguards.

“Africa’s minerals should finance development by powering green industrializations, creating decent jobs, strengthening public services and generating the revenue needed to improve people’s lives. By using future mineral wealth as collateral for short-term borrowing risks repeating an old pattern: value leaves the continent, while African countries are left carrying the debt, inequality and the environmental costs. The energy transition must build Africa’s sovereignty, not mortgage it.” said Koaile Monaheng, Global Political Lead, Greenpeace Africa.

Participants said implementation of the Common African Position on Debt should include clear continental principles for borrowing linked to natural resources. These should promote transparency and public accountability, while requiring governments to assess the long-term fiscal, environmental and social consequences of proposed agreements.

They also stressed that debt justice cannot be separated from tax justice. African governments, they said, must ensure mining companies pay their fair share of taxes and close loopholes that allow profits and public revenues to leave mineral-producing countries.

Without fair taxation and greater domestic value addition, Africa risks remaining an exporter of raw materials while higher-value processing, technology, profits and jobs remain concentrated elsewhere.

Further, the civil society called on African governments to:

  • Publish resource-backed loan agreements and the mineral contracts connected to them
  • Require parliamentary and independent scrutiny before future mineral revenues are committed
  • Strengthen the taxation of mining companies and tackle illicit financial flows and other revenue losses
  • Expand domestic and regional mineral processing to create jobs and retain more value within Africa
  • Include affected communities in decisions and guarantee their access to relevant information
  • Enforce strong environmental and human-rights protections throughout mineral supply chains

ENDS

Notes to editors

The Greenpeace Africa report, Exploring the Critical Minerals Landscape in Sub-Saharan Africa: Insights for Development Policy and Practice, was published in October 2025.

Nepal flood a humanitarian disaster and a warning which must be heeded in an overheated world

Source: Greenpeace Statement –

© Prabin RANABHAT / AFP via Getty Images

Greenpeace South Asia expresses its deepest sorrow and solidarity with everyone affected by the catastrophic Bhotekoshi flood and mudslide in the district of Rasuwa in Nepal. Our thoughts are with those who have lost loved ones, those still waiting desperately for news of family and friends, the communities whose homes and livelihoods have been destroyed, and everyone working to rescue survivors and provide assistance.

Hundreds of people are missing, and countless homes have been destroyed. The scale and suddenness of this disaster are horrifying, especially as it comes barely a year after another devastating flood struck the same region. As the climate crisis escalates, frontline communities face a growing risk of being hit by one disaster while still struggling to recover from the last one.

What started in Langtang Himal does not stop there. The Nepal flood also threatens hundreds of communities living downstream, including in India. The states of Bihar and Uttar Pradesh are now on high alert, as they face damaging floods almost every year as a result of their proximity to Nepal.

The immediate priority must be saving lives, finding people who remain missing and ensuring that affected communities have access to safe shelter, food, clean water, healthcare and other essential supplies.

Rescue teams, local communities and authorities are working under extremely difficult conditions. With roads and bridges damaged and electricity supplies disrupted, reaching affected communities and delivering essential assistance remains a major challenge.

Greenpeace calls for all available resources to be mobilised towards emergency response and recovery, with particular attention to vulnerable communities and people whose homes, livelihoods and access to essential services have been disrupted.

Scientists say it’s too early to determine exactly what role global warming played in this particular event, but preliminary investigations have pointed to a collapsed glacier as the cause, and the wider trend is not in question: a warming world is increasing the risk of such disasters.

Global heating, mostly driven by fossil fuel emissions from just 32 companies, is rapidly transforming the Himalayas. Even if warming can be limited to 1.5C as a global average, more than a third of the ice volume of glaciers within the extended Hindu Hush Himalaya region is projected to be lost this century.

Glaciers are shrinking, snow and ice are melting, permafrost is thawing, and mountain slopes are becoming less stable. These changes are creating a more dangerous environment in which catastrophic floods, landslides, and avalanches like this one are more likely to occur.

Every fraction of a degree of additional warming increases the danger, while communities who did least to cause the crisis bear the greatest human and financial costs.

Those costs should not be borne by these families, communities and governments of nations struggling to recover from one disaster after another. These are not simply natural disasters. The climate crisis has been driven overwhelmingly by the extraction and burning of fossil fuels, while year after year, international oil giants have made record profits while we pay the price.

Governments must respond to disasters like this not only with emergency relief but also with action to prevent the next one by rapidly phasing out fossil fuels, accelerating the global shift to renewable energy and electrification, investing in adaptation and resilience, and by making big polluters pay towards the costs of the damage their business helped cause.

Kenya urged to plug plastic ban loopholes as campaigners handover Refill and Reuse Policy recommendations

Source: Greenpeace Statement –

NAIROBI, KENYA –  Environmental groups are calling on the Kenyan government to seal smuggling loopholes that allow illegal single-use plastics to flood local markets. The demand was made in Nairobi during the handover of policy recommendations to key decision-makers on the anniversary of Kenya’s landmark plastic bag ban.

The recommendations set out steps to enforce existing environmental laws and expand refill-and-reuse systems across the country. Nearly a decade after Kenya introduced one of the world’s toughest bans on single-use plastic carrier bags, campaigners warn that porous borders, illegal imports, and unregulated suppliers threaten to reverse gains.

Hellen Kahaso Dena, Plastics Project Lead at Greenpeace Africa, said:

“Kenya is uniquely positioned to lead Africa toward a plastic-free future through its pioneering 2017 plastic bag ban and prohibitions in protected areas, but only if enforcement is strict and consistent. Refill and reuse of packaging represents a major opportunity to cut material waste. Refill and reuse is not new; in African culture, it has existed since time immemorial.”

While the 2017 prohibition initially cut carrier bag use by 80%, illegal packaging streams and thin, non-woven bags continue to slip through into informal urban markets. Civil society groups point out that while the Sustainable Waste Management Act of 2022 and the 2024 Extended Producer Responsibility (EPR) regulations acknowledge refill models, they lack binding legal mandates for manufacturers to adopt returnable packaging.

“The carrier bag ban addressed one source of plastic pollution, other unnecessary packaging remains largely unregulated. Stronger policies are needed to promote waste prevention, reuse and refill, while preventing toxic chemicals in plastic products and packaging. Producer responsibility must also go beyond collection and disposal. Producers should reduce unnecessary packaging, eliminate toxic chemicals, design products that are safe for human health and the environment  and invest in reuse and refill systems. Without clear legal mandates, manufacturers will continue to manage waste rather than prevent it at source,” said Ledoner Okeyo Centre for Environment Justice and Development (CEJAD). 

“Plastic pollution begins affecting nature long before it becomes visible as litter. Preventing waste at source through refill and reuse systems is one of the most effective ways to reduce pressure on ecosystems,” added Yvonne Khaemba, World Wide Fund for Nature (WWF Kenya). “Coupled with stronger corporate leadership and investment across the full lifecycle of packaging, this approach protects biodiversity, conserves resources, and accelerates the transition to a circular economy.

Highlighting the human impact on frontline communities, Joyce Wangari of the Kenya National Waste Pickers Association, emphasised the need for an inclusive transition:

“For our communities, plastic pollution is a daily reality. Those of us living near dumpsites face toxic air, contaminated water, and severe health risks every day. Integrating frontline waste workers into official refill-and-reuse frameworks ensures fair working conditions and dignity for the people keeping our cities clean.”

Key Policy Demands

To halt the flow of illegal plastics, the coalition is urging the Ministry of Environment and NEMA to crack down on illicit cross-border supply chains and update EPR rules to enforce binding targets for returnable packaging. The recommendations demand that manufacturers assume full lifecycle responsibility by shifting investment from post-disposal collection into waste prevention, while formally integrating and compensating frontline waste pickers in national circular economy plans.

ENDS

The policy document can be accessed here

Media contacts:

Sherie Gakii, Communication Manager, Greenpeace Africa, +254 702 776 749, [email protected] 

Greenpeace Africa Pressdesk: [email protected]

Oxfam launches Nepal flood response in worst-hit Rasuwa and Nuwakot, as destroyed roads and swept-away bridges block relief efforts

Source: Oxfam –

Oxfam is launching an emergency response in Rasuwa and Nuwakot, the districts worst affected by Wednesday’s flash flood, as roads and bridges swept away by the surge have left entire communities almost impossible to reach. 

On Wednesday 26 August, a landslide and glacial event around 20km north of the Rasuwagadhi checkpoint blocked the Lhende Khola, triggering a major flash flood. At least 200 people have been killed and hundreds more are missing across Nepal and Tibet. The surge then swept into the Trishuli River via Timure, Syaprubesi and Bhairabkunda, leaving families along the riverbanks of Rasuwa, Nuwakot, Dhading, Gorkha and Chitwan, in peril. 

“Entire neighbourhoods are under mud and rescue teams are still digging. The water rose nine metres in half an hour. What we are seeing so far is only what we can reach,” said Santosh Pandey, Oxfam Humanitarian Lead in Nepal. 

“Entire neighbourhoods are under mud and rescue teams are still digging. The water rose nine metres in half an hour. What we are seeing so far is only what we can reach.”  

Santosh Pandey, Humanitarian Lead

Oxfam in Nepal

The collapse of roads, bridges and communications has severely hampered relief efforts. The Government of Nepal’s has asked for 30 temporary bridges of 50 to 70 metres each, alongside food, shelter and water purification supplies. For now, reaching the hardest-hit communities depends almost entirely on-air access. 

“The rivers are full of debris and sewage, and there is no piped supply left to fall back on. Getting clean water and safe sanitation to most affected people into these valleys is the priority now,” added Pandey.   

Families also need hygiene supplies, emergency shelter and food. The Government of Nepal estimates that 8,692 households – nearly 40,000 people – require emergency hygiene support and water purification, in addition to 3,130 dignity kits and nearly 4,000 baby kits for children under five. 

Oxfam, working with its partners and in close coordination with local authorities, is immediately supplying emergency hygiene kits, incorporating water purification solutions, for 200 households in the hardest-hit Rasuwa district.  But Oxfam urgently needs £1 million British pounds to scale up its response and reach 10,000 people with temporary shelter, clean water, and sanitation and hygiene kits. 

Spokespeople are available. To arrange interviews please contact: 

In Kathmandu, Nepal: Rachana Mukhia | email : rmukhia@oxfam.org.uk | +9779818863063 
In Oxford: Nesrine Aly, Global News Manager (Humanitarian)  | nesrine.aly@oxfam.org 

For real-time updates, follow us on X and Bluesky, and join our WhatsApp channel tailored specifically for journalists and media professionals. 

MSF team arrives in Nepal to assess needs following flash floods

Source: Médecins Sans Frontières –

After a major flash flood struck the Rasuwa district in Nepal, on Wednesday 26 August, a Médecins Sans Frontières (MSF) team experienced in providing emergency response has arrived in Nepal to assess people’s immediate needs. We stand ready to provide urgent humanitarian and medical assistance.  

The floods rapidly impacted the Timure, Rasuwagadhi, and Syabrubesi areas causing significant damage to settlements, markets, and infrastructure. Flood waves are estimated to have been as large as 8-10 metres in some locations. Hundreds, if not thousands, of people are feared to have died, with many people still missing.  

Floodwaters reached the town of Mugling, in Chitwan district, and have since begun to recede. However, authorities say the risk remains high, as the blocked section of the river upstream has not yet been fully cleared.  

High-alert warnings have been issued for communities located along the Bhote Koshi and Trishuli rivers, particularly in Rasuwa, Nuwakot, Dhading, Gorkha, and Chitwan districts. People living along riverbanks have been advised to move to safer locations. 

Authorities are carrying out urgent search and rescue operations in affected areas, and a full health emergency response has been initiated.  

The MSF team arrived in Nepal less than 24 hours after the floods struck, and we are engaging with health facilities to assess if we can support. We know from our years of experience in emergencies that people in affected areas will have urgent needs for shelter, non-food items such as hygiene and cooking items, access to clean water and latrines, and emergency medical and trauma support.  

MSF teams are assessing how we can provide assistance to people and stand ready to support the national response to this tragedy.  

Taiwan: Proposed judicial caning referendum indicates further erosion of human rights protection

Source: Amnesty International –

Ahead of the meeting of the Central Election Commission on 28 August regarding a proposed referendum on introducing judicial caning as a criminal punishment in Taiwan, Amnesty International Taiwan’s Director, E-Ling Chiu, said: 

“It is both disturbing and disgraceful that the Legislative Yuan has chosen to advance a referendum proposal on judicial caning that clearly breaches international human rights law. 

“This proposal is part of a broader pattern that has emerged in recent months. Human rights-related budgets have been cut, the work of independent institutions such as the National Human Rights Commission has been obstructed and the functioning of the Constitutional Court has been undermined. The advancement of a referendum seeking to legitimize cruel, inhuman and degrading punishment further contributes to the erosion of the human rights protection framework that Taiwan has spent decades building.” 

Amnesty International’s Deputy Regional Director Sarah Brooks added: 

“When public anger over crimes is exploited for political gain at the expense of human rights, everyone stands to lose. 

“Amnesty International opposes any legislative proposal to introduce judicial caning in Taiwan and calls on the government to reaffirm its commitment to Article 7 of the ICCPR and the absolute prohibition of torture and other cruel, inhuman, or degrading treatment or punishment.” 

Eastern Chad: Investigating abuse and strengthening prevention

Source: Médecins Sans Frontières –

Safeguarding in humanitarian emergencies

MSF is committed to ensuring an environment free from abuse, including exploitation and harassment.

The term ‘safeguarding’, used throughout this text, refers to the measures we take to prevent, detect, and respond to abuse. The safety, dignity and confidentiality of survivors, and their access to support, are at the centre of this work.

The safeguarding measures we have and are putting in place across our projects and offices aim to create a safe, dignified and respectful environment for patients, communities, and colleagues. 

Investigating abuse in a humanitarian emergency

MSF has worked in Chad since 1981, responding to multiple humanitarian crises, in a country that, prior to the war in Sudan, was already hosting around one million refugees and internally displaced people.

After war erupted in neighbouring Sudan in April 2023, a further 900,000 refugees fled across the border into an area with extremely limited resources, fuelling an urgent need for medical care, shelter, food, water and sanitation. As increasing numbers of people crossed the border, existing camps and medical structures quickly became overwhelmed.

Successive waves of refugees and wounded people have followed peaks of violence in Sudan. For example, in mid-2023, 2,000 refugees were arriving each day. During one particularly intense period in June 2023, 850 wounded people arrived at MSF facilities in eastern Chad in just three days, with nearly 400 arriving at our clinics on 16 June, alone.

The speed and scale of the emergency required MSF to rapidly expand our programmes and recruit large numbers of new staff. By 2025, we employed 2,446 people and provided substantial medical and humanitarian assistance, including 586,900 outpatient consultations and 979,600 vaccinations, and distributing 362 million litres of chlorinated water throughout the year.

In late 2024, MSF was alerted by a media investigation into allegations of sexual exploitation, abuse and harassment linked to humanitarian operations in eastern Chad, including three specific allegations concerning individuals working for MSF.

Following the reports, we launched investigations and deployed trained investigators to establish the facts, enable MSF to provide support to survivors, take disciplinary action against perpetrators, and act to reduce the risk of further abuse. Although investigating specific alerts we receive is standard practice in MSF, in this case we decided to investigate across all areas where our projects operate in eastern Chad, to try to gather a more complete picture of the abuse and identify as many survivors and perpetrators as possible.

The findings published here are a summary of the investigation and the actions taken in response. They do not reproduce the underlying investigation files or case-level information. This is necessary to protect the confidentiality and safety of people involved, including survivors and witnesses, and to avoid information that could identify individuals or locations being made public.

What our investigations found

Over eight months, 16 investigators reviewed 59 allegations involving individuals working in or connected to MSF-supported activities, including employees, daily workers, and suppliers. Most allegations related to sexual exploitation, abuse, and harassment.

Reflecting broader societal inequalities and power imbalances, especially with respect to gender, survivors of abuse, and especially sexual forms of abuse, were predominantly women, and all the perpetrators identified in the process were men. Our investigations found that abuse and misconduct often occurred where there were significant imbalances of power, including between people that had power or authority and those with less power, and between humanitarian workers and the people they were meant to serve.

Every allegation was examined carefully. While some were corroborated, others could not be fully verified, including where survivors or alleged perpetrators could not be identified, or located after moving within or beyond the vast refugee camps in eastern Chad.

Only a limited number of survivors could be identified. Where they were, medical and psychological care was systematically offered, although concerns about confidentiality, judgement or retaliation affected whether people felt safe to access these services.

Where perpetrators were identified and serious misconduct was substantiated, sanctions were imposed. Eighteen staff members were dismissed and permanently barred from working with MSF. Based on our investigations, we also terminated a contract with a service provider.

Beyond individual cases, our investigations identified important shortcomings in how existing safeguarding measures had been implemented across our programmes.

During a period of rapid operational expansion, local recruitment, induction and supervision practices had not consistently ensured that all colleagues understood and upheld MSF’s behavioural commitments. Safeguarding risk assessments, which help to mitigate the risk of abuse, had not been carried out systematically. Many patients, colleagues, and community members did not know how to report abuse safely and confidentially.

The humanitarian context further heightened the risks. Conflict, displacement, deprivation, and dependence on humanitarian assistance created significant imbalances of power. While we cannot avoid this, we can and should pay even more attention to preventing and addressing abuse in such emergency contexts.

Strengthening safeguarding in eastern Chad

Our investigations in eastern Chad led directly to changes in how we prevent, detect, and respond to abuse and misconduct.

Preventing abuse 

We have strengthened local recruitment practices, induction and ongoing training both for individuals and teams, to ensure that everyone working for MSF understands the rules and standards of behaviour expected of them, what constitutes unacceptable conduct, and possible consequences.

In Chad, safeguarding considerations are being incorporated into each stage of recruitment and staff management, including mentioning it in job adverts, during interviews, onboarding and ongoing supervision. For example, in some projects, we ask scenario-based questions in interviews to explore candidates’ understanding of abuse prevention and how they would respond if they witnessed inappropriate behaviour. These practices continue to develop, with greater attention to safeguarding awareness and responsibilities across different roles, particularly those involving direct contact with patients.

Teams have carried out risk assessments to identify circumstances where people might face heightened risks of abuse, allowing preventive measures to be put in place. This includes adapting reporting mechanisms; redesigning activities, services, and programmes; and increasing awareness of abuse and reporting mechanisms among people who are least likely to report concerns.

We have strengthened local safeguarding support to work more systematically alongside our teams in eastern Chad, helping them to incorporate safeguarding into their work and our programmes, and to identify, anticipate and respond to emerging risks.

Improving detection and reporting

Working closely with patients, women’s groups, and community leaders, we have strengthened awareness of abuse and misconduct and how concerns can be reported safely and confidentially.

In some of our projects in eastern Chad, we held focus groups with communities to understand which reporting mechanisms people would feel safest and most comfortable using. Based on this feedback, we put in place a patient liaison officer, whose job it is to regularly engage with patients in hospitals, health centres and communities to explain what constitutes unacceptable behaviour, how concerns can be raised, and to hear directly about people’s experiences with MSF. Maintaining this open communication helps create trusted spaces for people to share and enables teams to identify concerns before they arise.

We are also working to boost the representation of women across our programmes, particularly in maternal and child healthcare, recognising that some patients and staff may feel more comfortable raising concerns about abuse with women.

These changes are intended not only to make it easier for people to report abuse, but also to help MSF identify concerns about abuse before it occurs, or more immediately after so that it can be addressed.

Supporting survivors 

We acknowledge that in eastern Chad the support we provided to survivors was limited. Greater efforts were needed to proactively engage with survivors, understand their individual needs and preferences, and identify appropriate forms of assistance beyond that which MSF could directly provide.

Considerable barriers can prevent survivors from accessing support, and these can be even more acute in the places where we work. Survivors may face significant stigma and face consequences for coming forward; appropriate survivor-centred services may be limited, difficult to access, not widely known or trusted; women in particular may face practical barriers, including caring responsibilities, that make it difficult to seek or receive support; and people may fear that they will face retaliation or lack of confidentiality.

This makes prevention efforts, before abuse occurs, even more important, alongside active detection of cases. Regular consultations and discussions with patients, communities, and colleagues are critical elements of this work. By creating safe and trusted spaces for people to speak, we can better identify concerns early and act before abuse occurs.

We are working to strengthen the support we provide to survivors, and to ensure people know they can seek assistance without fear of retaliation from MSF or losing access to humanitarian assistance.

Challenges that remain  

Underreporting remains a challenge across the humanitarian sector and in wider society. An increase in reports may indicate that people are more confident to come forward, while low reporting does not necessarily mean that problems do not exist. Some people may also fear that reporting abuse could affect their access to assistance or would not lead to action. These barriers are among the multiple reasons abuse can remain hidden and why strengthening trust in reporting systems remains a central priority.

In eastern Chad, as in many other contexts, conversations with local leaders highlighted that sexual abuse and related issues can be highly sensitive or taboo, and that people may not feel comfortable discussing them with outsiders. Mistrust in legal mechanisms can also play a role: people often do not perceive positive outcomes from reporting abuse, and this perception also affects other reporting channels like those put in place by MSF.

This illustrates why effective safeguarding depends not only on robust prevention and reporting mechanisms, but also on understanding the specific risks, behaviours and perceptions within each context, discussion and consultation with different members of the community and adapting our approach accordingly. Building trust depends on showing patients, communities and staff that reports are heard, taken seriously, and acted upon.

Strengthening safeguarding across MSF 

The findings in eastern Chad have also informed changes across MSF. Over the past year, we have strengthened our global screening processes to prevent people found to have committed abuse or serious misconduct from moving between MSF projects and being rehired elsewhere in the organisation. We have strengthened recruitment, induction and supervision, and expanded the number of safeguarding specialists and investigators available to support country teams.

We recognise that strengthened safeguarding policies and systems alone are not evidence of success. What matters is whether they lead to safer environments, greater trust in reporting mechanisms, and better support for survivors. We will continue to assess what is working, address gaps, and report publicly on abuse and misconduct through our annual behaviour and accountability reporting.

This work does not end with the investigations in eastern Chad. Abuse and misconduct can occur anywhere, but the risks can be heightened where significant power imbalances exist. Our responsibility is to reduce those risks as much as possible, create environments where people feel safe to report concerns, support those affected and act decisively when abuse occurs. We are committed to acting on every alert, holding perpetrators accountable, and learning from every case to strengthen how we prevent, detect and respond to abuse and misconduct, wherever we work.

Our commitment to building an organisation where everyone is safe

Source: Médecins Sans Frontières –

Over the past eight  years, Médecins Sans Frontières (MSF) has published annual figures on reports of abuse and misconduct in our organisation. The latest figures tell an important but difficult story. As in previous years, the number of complaints has continued to increase. This may mean people are more aware of our reporting systems, and feel more confident coming forward, but it also makes clear the scale of the work still ahead to prevent and address abuse in our organisation.

Among the most serious cases we confronted last year were those in eastern Chad. Investigations we completed in June 2025, following alerts reported in the media, found serious abuse and misconduct involving people working for MSF, including sexual exploitation, abuse, and harassment.

Our review involved 16 investigators working over eight months to examine 59 allegations concerning employees and others, such as suppliers, who were connected to MSF. Where we were able to establish serious misconduct and identify those responsible, action was taken. Eighteen staff were dismissed and permanently barred from working with MSF. 

Most importantly, I want to acknowledge the harm caused to the patients and colleagues who were abused. As International President of MSF, I feel a profound sense of responsibility and regret that we failed to keep people safe. Sexual exploitation, abuse and harassment are completely incompatible with MSF’s principles, values and safeguarding commitments. When they occur, they represent a profound abuse of trust and can have devastating consequences for survivors, communities and our colleagues.

As someone of Sudanese heritage, with family members who fled the war in Sudan, what happened in eastern Chad also affects me personally. Women who had already survived horrific violence in Sudan and sought safety in Chad had every right to expect dignity, respect and safety from MSF. Female colleagues were also among those affected. This is unacceptable and should never have happened.

Our investigations identified important shortcomings in the safeguarding measures we had in place. As our teams rapidly expanded to respond to hundreds of thousands of people arriving from Sudan, we had not consistently ensured that all staff understood and upheld our behavioural commitments, nor had we systematically assessed and mitigated safeguarding risks. We should have done more to ensure that patients, community members and staff knew how to report abuse safely and confidentially.

We must also acknowledge that the support we provided to the survivors we were able to identify was limited, beyond medical and psychological support.

Considerable barriers can prevent survivors from accessing support, inside and outside MSF, and these can be even more acute in the places where we work. Survivors may face significant stigma and consequences for coming forward; appropriate survivor-centred services may be limited, difficult to access, or not widely known or trusted; and women in particular may face practical constraints, including caring responsibilities, that make it difficult to seek or receive support. This makes prevention work and actively trying to detect abuse cases before harm is caused, even more important.

Despite these challenges, greater efforts were needed to proactively engage with survivors, understand their individual needs and preferences, and identify appropriate forms of assistance, including support beyond that which MSF could directly provide.

The findings have led us to make important changes in eastern Chad. We have strengthened recruitment, induction and training processes, carried out risk assessments across our programmes, put in place measures to mitigate identified risks, and increased the safeguarding support available to our teams so they can identify and respond to risks earlier. We have also worked with patients, women’s groups and community leaders to build awareness of what constitutes abuse and ensure people know how to report concerns.

Beyond eastern Chad, over the past year, we have strengthened our global screening processes to prevent people found to have committed abuse or serious misconduct from moving between MSF projects and being rehired elsewhere in the organisation. We are also working to improve the package of support we can provide to survivors. You can read more about the events in eastern Chad and our response in our dedicated explainer on investigating abuse and strengthening prevention in eastern Chad, which you can access here.

What happened in eastern Chad also reflects broader inequalities and power imbalances that we have a responsibility to confront within MSF. Women face a higher risk of abuse, particularly sexual abuse, while conflict, displacement, deprivation and dependence on humanitarian assistance can create significant imbalances of power that can further amplify risks of abuse. These circumstances make it even more important for us to ensure the safeguards we have in place, across all our projects, are as strong as possible.

We are not starting this work from scratch. Years of efforts by teams across MSF have strengthened how we prevent, detect, and respond to abuse. However, what happened in eastern Chad shows that significant gaps remain. We need to make faster and more substantial progress.

As a doctor, I recognise that creating safe environments for patients, communities and colleagues is fundamental to who we are as a medical humanitarian organisation and to our medical and ethical commitment to do no harm. I take that responsibility extremely seriously.

Every MSF project and office must be a place where people feel safe, respected and protected; where abuse is not tolerated; where people are always encouraged and supported to report unacceptable behaviour; and where the voices and experiences of those who are most affected help shape how we prevent and respond to abuse. Continuing to strengthen this urgent work demands attention, accountability and action from every MSF colleague, every single day.