MSF curtails homeless assistance in favour of emergency work

Medecins Sans Frontieres (MSF) has pulled the plug on a programme targeting the specific needs of homeless families in Madagascar, opting instead to provide medical support to the population during emergencies. The French-based medical relief agency confirmed on Monday that it would no longer provide free medical care to homeless families, saying the difference between those who were destitute and the rest of the population had blurred. "When we started in 1993, we intended to help those children and families who were living on the street but, over the years, we have come to realise that there are many poor families in desperate need of assistance," MSF's Madagascar country director, Brigitte Doppler, told IRIN. With more than 70 percent of its population living in abject poverty, the giant Indian Ocean is one of the poorest countries in the world: an estimated 10,000 homeless people live on the streets of the capital, Antananarivo, a city of 1.4 million. Doppler said it was not part of MSF's mandate to replace the authorities in providing healthcare to all the city's poor. "The health issue is a big problem, and we cannot cope." She pointed out that government efforts to improve medical access were underway, especially for poor communities. "The government has said that affordable healthcare is a priority, and it does have a plan to make sure that there is access to drugs and care - but I do think they are also a bit overwhelmed," said Doppler. The UN Children's Fund (UNICEF) has expressed concern over the move, saying MSF's decision to scale down its operations in the impoverished country was bound to impact on the welfare of the homeless. "It is important for MSF to evaluate its interventions to make sure that it is being as effective as possible. Over the years they have proven to be excellent implementing partners; I fear that without their contribution there will be gaps in providing services to those in need," said UNICEF Resident Representative Barbara Bentein. MSF's programme for street children, with a budget of US $314,000, provided 15,000 consultations and 3,000 hospitalisations per year. "Because of our years of experience in the country, we are able to direct the homeless to local welfare organisations who are able to provide assistance. However, we will remain committed to providing assistance when it is most needed, especially during emergencies, for example, famine, cyclones and hurricanes," Doppler said. MSF arrived in Madagascar in 1987 to run an emergency food distribution programme in response to severe drought that lasted for five years. The medical NGO began its programme for street children in 1993, and also undertook schemes to fight malnutrition in the capital as well as work in Malagasy prisons.