MSF Australia Annual Report 2009

MÊdecins Sans Frontières Australia Annual Report 2009

Contents Part A Médecins Sans Frontières – Charter

2

Message from the President

3

2009 – Year in Review

5

Map – Médecins Sans Frontières projects funded by Australian donors

7

Médecins Sans Frontières Australia International Field Staff in 2009 Summary Activity Charts

8 11

Médecins Sans Frontières worldwide 2008 Extract from International Activity Report 2008

12

Part B Médecins Sans Frontières Australia Financial Report 2009

COVER: Australian nurse Devi Lalloo examining a child during a nutritional assessment in August 2009 in Djibouti. Médecins Sans Frontières opened a project to treat malnutrition in Djibouti, situated in the Horn of Africa, at the beginning of 2009. © Jean-François Herrera/MSF

13

Médecins Sans Frontières Charter Médecins Sans Frontières is a private international organisation. Most of its members are doctors and health workers, but many other support professions contribute to Médecins Sans Frontières’ smooth functioning.

All of them agree to honour the following principles:

Médecins Sans Frontières offers assistance to populations in distress, to victims of natural or man-made disasters and to victims of armed conflict, without discrimination and irrespective of race, religion, creed or political affiliation.

Médecins Sans Frontières observes neutrality and impartiality in the name of universal medical ethics and the right to humanitarian assistance and demands full and unhindered freedom in the exercise of its functions.

Médecins Sans Frontières’ volunteers undertake to respect their professional code of ethics and to maintain complete independence from all political, economic and religious powers.

As volunteers, members are aware of the risks and dangers of the mission they undertake, and have no right to compensation for themselves or their beneficiaries other than that which Médecins Sans Frontières is able to afford them.

2

Message from the President The past year has been one of challenges and opportunities for Médecins Sans Frontières. The challenges have involved the blocking of our assistance to trapped populations; and the further erosion of respect for neutral humanitarian action.

Moreover attacks on our workers in the field persisted in 2009; and the ongoing state of inattention for people suffering from neglected tropical diseases also continued to challenge us.

mobile clinics, hospital programs, vaccination campaigns, cholera treatment programs, and relief item distributions. But in the North Kivu region, civilians were cruelly targeted in what can only be described as a deliberate breach of International Humanitarian Law, when people gathering for a vaccination campaign being conducted by our teams came under attack during a Congolese army offensive against the Forces Démocratiques de Libération du Rwanda (FDLR). The attack threatened to severely undermine the trust necessary to carry out independent medical humanitarian work in conflict settings.

The opportunities come from the ongoing tremendous work of all our field workers in over 60 countries around the world, without which millions of people would not have benefited from the medical treatment that we could provide.

In Pakistan, it was again civilians who were severely affected by intense fighting, with tens of thousands fleeing and unable to access food, water, and medical care, and with hospitals struck by mortar fire. In the Swat Valley two Médecins Sans Frontières workers were killed while driving in a marked ambulance on their way to retrieve civilians injured during fighting in the town of Charbagh. In a region where western powers involved in counterinsurgency operations are also major aid donors, the provision of humanitarian aid has largely been perceived as being linked with political objectives. In Pakistan, Médecins Sans Frontières refused funding from any government, relying solely on private donations from the general public for our operations. In 2009 our teams continued to provide emergency medical and relief services in more than a dozen sites in the North West Frontier Province, in the Federally Administered Tribal Areas and in Balochistan Province.

Civilians were again victims in many of the conflicts in which Médecins Sans Frontières worked in 2009, and in some instances we saw they were completely cut off from lifesaving medical assistance.

The long, brutal conflict in Somalia continued, with hundreds of thousands more people displaced from Mogadishu and aid workers increasingly under threat. Regrettably two Médecins Sans Frontières staff were abducted (and thankfully later released) and another was tragically killed in an explosion in which 30 others died. Late in 2009, some of those who could have become our colleagues in medical work were killed when a medical graduation ceremony was bombed in Mogadishu, killing 23 and wounding many more. The graduates were only the second class in two decades to earn a medical degree in Somalia. Despite the escalating violence, thanks to our committed Somali staff, supported by a team in Nairobi, we have been able to continue to run ten projects across eight regions of Somalia, providing emergency obstetric care, treatment to malnourished children and medical care to victims of violence.

We also relied solely on private donations for our work in Afghanistan, where we returned in 2009 following a five year absence after five of our colleagues were killed in 2004. The need there for emergency medical assistance remains acute.

In eastern Kabul, we began supporting a wide range of medical services at Ahmed Shah Baba hospital in an area where the influx of returnees from Pakistan and displaced people fleeing war in the eastern provinces has nearly quadrupled the population.

Despite the needs and low health care coverage, this area has so far been neglected because it is not a NATO or ‘coalition’ priority in counterinsurgency aid policies. Our teams also started working in the only public general hospital still functioning in Lashkargah, the capital of Helmand Province.

In the Democratic Republic of Congo (DRC) civilians continued to bear the brunt of fighting among various armed groups.

In eastern DRC hundreds of civilians were killed, thousands of women, children and sometimes men were raped, and hundreds of thousands were displaced from their homes.

Médecins Sans Frontières ran sexual violence treatment clinics,

3

Message from the President continued It remains difficult for impartial and neutral humanitarian organisations to convince all parties involved that their only objective is to provide assistance to the population. The distinction between armies, reconstruction and development activities and humanitarian aid has become confused.

International coalition forces have co-opted assistance for “hearts and minds” initiatives, occupied hospitals, and arrested patients in their beds, while armed opposition groups have targeted health care workers and health structures because of the presence of international forces providing relief.

partnership with the Drugs for Neglected Diseases initiative (DNDi), our field teams recently successfully tested a new combination treatment for sleeping sickness, nifurtimoxeflornithine combination therapy (NECT). The new combination treatment is easier to administer, shorter in duration and considerably safer than the existing standard treatment, melarsoprol, which kills up to 10 percent of patients treated with it.

In our region we were also confronted with three natural disasters in 2009 (Typhoon Ketsana in the Philippines, the Sumatran earthquake and a tsunami in Samoa), all in a matter of days of each other in September. Our team in Sydney was important in providing a timely human resource response in every case, including another emergency response to the cholera outbreak in Papua New Guinea that occurred in July.

Médecins Sans Frontières also faced challenges treating diseases that much of the world ignores. The success over the years of getting more and more people living with HIV/AIDS onto treatment was threatened in 2009 with several international donors announcing plans to reduce or limit funding. At a time when research is telling us that we need to get people on treatment sooner, this is particularly vexing. With only 4 million people in the developing world receiving treatment out of the 10 million people urgently needing it, this is not the time for people to be turned away from clinics because of a lack of funds. Out of those 4 million, Médecins Sans Frontières has been providing treatment for 140,000 people in 30 countries.

In 2009 we called for improved access to treatment, to provide patients with the more robust and better-tolerated treatments that are widely available in wealthy countries, and to provide better adapted paediatric formulations.

Finally, I would like take this opportunity to thank Philippe Couturier and all the staff and volunteers in the Sydney office, and the other members of the Australian board for another year of solid support to the operations of Médecins Sans Frontières.

The Project Unit has been instrumental in bringing medical advice to the field in 17 countries of operation around the world. The Communications Department supported operations in the Nigeria meningitis outbreak (where seven million people were vaccinated), as well as the emergency cholera outbreak in Papua New Guinea. Congratulations must also be made to all the other staff and departments involved in ensuring the steady increase of income generously provided by our supporters in Australia, without which we could not deliver emergency and humanitarian assistance to the level and quality which is always necessary. Finally thanks must go to our donors who have made possible even greater contributions to our operations in 2009 that were once again professionally supported by our Australian and New Zealand field workers.

Tropical diseases like human African trypanosomiasis (sleeping sickness), American trypanosomiasis (Chagas), and visceral leishmaniasis (kala azar) continue to be neglected. Most treatment and diagnostic tools for these diseases are old, ineffective, or non-existent. Those that are not, like liposomal amphotericin B for kala azar are effective but prohibitively expensive or difficult to transport and store in the areas where it is needed for treatment. The people who suffer from these diseases tend to be in remote or insecure areas with difficult access to health care.

Thank you Dr Matthew Reid President Médecins Sans Frontières Australia

Research and development of new medicines and diagnostic tools to enable better treatment is sadly underfunded. In

4

2009 Year in review This year, Médecins Sans Frontières Australia has focused on four key objectives, enabling us to contribute effectively to the international organisation’s medical humanitarian activities.

Our first objective was to focus on maintaining the quality of our international field staff, who remain integral to our achievements both here and abroad. Secondly, we concentrated on boosting our medical support to our field programs including the organisation’s emergency response capacity in the AsiaPacific region. Our third aim was to further develop our communications efforts for our field activities. Finally, we strived to increase our financial support, particularly from private donors, for the benefit of our patients, who otherwise may not have been able to access the medical care they needed.

Days provide future field workers with the opportunity to familiarise themselves with Médecins Sans Frontières as well as be exposed to the often challenging professional, cultural and security situations that they will face.

The Field Human Resources Department also provides new and experienced field workers with the opportunity to participate in specific international training courses developed or recommended by Médecins Sans Frontières. These courses are offered to further our field workers’ professional skills and expertise. In 2009, 20 Australians and New Zealanders participated in courses ranging from refugee health, logistics, management and French language.

Our field workers are also supported by the Project Unit here in the Sydney office – a team consisting of three medical doctors and one midwife. In close collaboration with the Field Human Resources Department, the Project Unit prepares departing field workers with medical briefings and technical training, helping to ensure an optimum level of preparation for their work in the field.

I am pleased to be able to say that we have been successful in all these endeavours. We have identified, trained and deployed qualified field workers to various projects; we have provided medical and operational support to programs with women’s health, paediatric and HIV/AIDS and tuberculosis components; we have effectively communicated about our activities; and we have significantly increased our financial support to our field programs.

The core of the Project Unit’s work formed Médecins Sans Frontières Australia’s second key objective for 2009: to enhance the provision of medical support to projects in 17 countries.

Focusing on their areas of expertise: paediatrics, paediatric HIV/AIDS and tuberculosis, and women’s health; members of the team spent a total of 140 days in the field last year. They provided direct medical and operational support to our field teams in Malawi, Democratic Republic of Congo, South Sudan, Iran, Nigeria, Central African Republic, the Palestinian Territories and India.

In 2009, despite experiencing a slight decrease of our overall operational activity as can be explained by the various challenges in the President’s Message, the total number of departures of medical doctors, nurses, midwives and non-medical international field staff remained high. No less than 118 field positions were filled by Australians and New Zealanders who responded to the medical and humanitarian needs of people in more than 30 countries. Forty-three of them were deployed for the first time while 22 out of 77 experienced field workers took on increased responsibilities at field and coordination level either as Project Coordinators, Medical Coordinators or Heads of Mission.

A new and exciting development in the Project Unit in 2009 was the close collaboration with the emergency response team in Paris, who initiated a new mechanism aimed at strengthening Médecins Sans Frontières’ capacity to respond to emergencies in the Asia-Pacific region. The mechanism quickly demonstrated its potential by deploying an emergency team to carry out initial assessments during the cholera outbreak in Papua New Guinea in September. With the support of an Emergency Coordinator in Sydney, Médecins Sans Frontières Australia also played a significant role in the organisation’s emergency

The Field Human Resources department places great emphasis on ensuring our professional and dedicated teams depart for the field with a high level of preparedness for the work ahead.

One of the most crucial aspects of the preparation of newly recruited field workers is the four day training course, known as Welcome Days, held in Sydney three times a year. The Welcome 5

2009 Year in review continued response to the trio of natural disasters which struck almost simultaneously in Samoa, the Philippines and Indonesia later that month.

development activities and independent humanitarian action, continues to be of significant concern to us. Demonstrating and defending our humanitarian principles of independence, neutrality and impartiality and engaging with all actors involved in humanitarian issues, is therefore a key component of our objectives.

Further development of this mechanism is planned for 2010.

This will increase our capacity to respond swiftly and effectively during the crucial exploratory phase of an emergency, when our teams assess the medical and humanitarian needs of populations affected by natural or man made disasters and epidemics. Where appropriate, this will lead to the opening of an emergency intervention.

Mindful of this in key contexts such as Pakistan and Afghanistan, it was also our objective to increase our financial and direct private support for the benefit of our patients. In 2009, the Australian community generously donated over AUD$43.5 million to Médecins Sans Frontières Australia and has contributed tremendously to the financial independence of Médecins Sans Frontières.

Our third objective for the year was realised in the efforts of our Communications Department, specifically to raise awareness of and engage the Australian community on the plight of the patients we treat. The team in Sydney reported on our activities and the challenges we face, not only to our donors here in Australia but also to the wider public in the region.

They generated wide media coverage in a variety of media in Australia and New Zealand, highlighting crises such as the devastating cholera outbreaks in Zimbabwe and Papua New Guinea, and the conflicts that persisted in Democratic Republic of Congo, Sudan, the Palestinian Territories and Sri Lanka. Media coverage was also achieved in some key areas of the organisation’s medical expertise such as HIV/AIDS and malnutrition.

The commitment of over 70,000 members of the community who support us as Field Partners, contributing a small gift to our work each month, cannot go unacknowledged. The solid income stream provided by Field Partners allows us to plan and budget so much more effectively and for that we are so grateful. The support of another 40,000 Australians who have responded to a request for a donation throughout the year is also sincerely appreciated.

Our thanks also go out to various trusts, foundations, and corporations, including sponsors of Refugee Camp in Your City and those who contribute to our work through their workplace.

Finally, myself, the Board of Directors and all of our office and field staff acknowledge and thank those who have provided for Médecins Sans Frontières in their wills. Your commitment to our work is an inspiration to us all.

Members of the communications team were also deployed to the field throughout the year to provide support to operations.

This was especially critical during the meningitis epidemic and resulting massive vaccination campaign in West Africa (Nigeria) and the cholera outbreak in Papua New Guinea.

In its second year in Australia, our event Refugee Camp in Your City toured again with more than 7,500 people visiting the replica refugee camp in Adelaide and Melbourne. Guided by experienced international field staff, members of the public were given the opportunity to connect with the organisation and learn of the living conditions faced by the millions of refugees and internally displaced people (IDPs) around the world.

My thanks also go to all of the Sydney staff for their hard work and commitment, and the office volunteers for their extraordinary support which helps keep our office running costs as low as possible. Finally, I wish to extend my thanks to all of the returned field workers for their great support to the different events we have organised throughout the year.

Philippe Couturier Executive Director

As highlighted by Dr Matthew Reid in his message, the confusion between the role of military forces involved in reconstruction and

6

Médecins Sans Frontières field projects are run by five operational centres (France, Switzerland, Spain, Holland and Belgium). The Australian section is an offical partner of the French operational centre, and Australian donors fund projects run by both the French and the Swiss operational centres. When needed, Médecins Sans Frontières Australia also provides human resources and medical support to all operational centres’ projects.

MEDECINS SANS FRONTIERES PROJECTS FUNDED BY AUSTRALIAN DONORS 75

Country 1.

2.

3.

4.

Burkina Faso Cambodia Cameroon Central African Republic

5. Chad 6. China 7. Democratic Rep. of Congo

8.

9.

10.

11.

12.

13.

14.

15.

16.

17.

Iraq Iran Kenya Kyrgyzstan Laos Malawi Mozambique Myanmar Niger Nigeria

A$ MSF France 760,000 1,500,000

600,000 480,000 690,000

1,826,915 2,000,000 1,300,000

180,000

540,768 125,000 2,200,000 1,400,000 740,000 590,000 700,000 1,000,000 300,000

20. Phillipines 21. Somalia

1,900,000

Sudan Sri Lanka Swaziland Thailand Uganda Yemen

750,000

1,100,000 2,960,000

18. Pakistan 19. Palestinian Territories

22.

23.

24.

25.

26.

27.

A$ MSF Switzerland

605,768 2,500,000

600,000 3,000 1,050,000 400,000 1,300,000 500,000

Other countries * can include measles, meningitis, cholera, malaria

140,000

Activity type nutrition, malaria, HIV/AIDS, tuberculosis HIV/AIDS, tuberculosis Buruli ulcer, primary healthcare, nutrition paediatrics, surgery, obstetrics, primary healthcare, nutrition, HIV/AIDS, tuberculosis primary healthcare, gynaecology/obstetrics, response to epidemics*, vesico-vaginal fistula HIV/AIDS primary healthcare, surgery, cholera, emergency healthcare, sexual violence, obstetrics, paediatrics, in-patient hospital care, burns unit, response to epidemics* surgery, burns unit, emergency healthcare mother and child healthcare, primary healthcare HIV/AIDS, tuberculosis, nutrition tuberculosis HIV/AIDS HIV/AIDS, tuberculosis HIV/AIDS HIV/AIDS, tuberculosis, primary healthcare paediatrics vesico-vaginal fistula, obstetrics, emergency healthcare, nutrition, response to epidemics* primary healthcare, cholera, nutrition emergency health care, surgery, post-operative care, mental health, paediatrics primary healthcare primary healthcare, emergency healthcare, surgery, obstetrics, tuberculosis obstetrics, paediatrics, nutrition emergency health care, surgery, obstetrics, mental health HIV/AIDS, tuberculosis HIV/AIDS, tuberculosis HIV/AIDS, tuberculosis, nutrition, response to epidemics* emergency health care, surgery, nutrition, mother and child healthcare

74 66

11 8

19

6

9 18

16 1

2

5

17

27

22 4

3 9

7

15 12 25 2

26 10 21 13

24

14

23

20

International Field Staff in 2009 Médecins Sans Frontières Australia

Australian medical doctor Heidi Spillane examines a patient in Nanning, China. Médecins Sans Frontières has been providing treatment to HIV-infected patients in Nanning since 2003.

Photo: Jonathan Browning, courtesy of GPRA.

Armenia

Cambodia

Lynette Huang

administration-

Democratic Republic

financial coordinator

of Congo

Franck Boulay

logistician

Carol Nagy

field coordinator

Anthony Flynn

field coordinator

Brent Skippen

medical doctor

Shella Hall

medical coordinator

Lainie Grummitt

field administrator

Louise Johnston

nurse

Stephanie Johnston

pharmacist

Alan Scott

medical doctor

Emmanuel Lavieuville

head of mission

Ruth McKeown

medical doctor

Ethiopia

Anne Taylor

head of mission

Brett Adamson

nurse

Genevieve Walls

medical doctor

Matthew J Ball

medical doctor

Chad

Cassandra Arnold

medical doctor

Sushila Desai

field administrator

China

Kaye Bentley

administration-

Malcolm Hugo

psychologist

financial coordinator

Victoria Mowat

nurse

Djibouti

Heidi Spillane

medical doctor

Ruth Dabell

nurse

Sarah Clemons

nurse

Georgia

Cath Deacon

field coordinator

Devi Lalloo

nurse

Serene Hu

medical doctor

continued over...

8

International Field Staff in 2009 Médecins Sans Frontières Australia continued Georgia

June Mitchell

nurse

Nigeria

Liz Bannister

medical doctor

Elise Page

nurse

Margaret Bell

midwife

Janthi Price

field coordinator

Gareth P Brown

field administrator

Tracy Zordan

nurse

Rebecca Caporn

nurse

Haiti

Brian Moller

head of mission

Rachal Davis

medical scientist

India

Lisa Errol

nurse

Jacinta Droste

nurse

Indonesia

Kevin Baker

anaesthetist

Fiona Gillett

midwife

Marco Antonio Osti Avila

anaesthetist

Sonia Girle

nurse

Natasha Martin

pharmacist

Katrina Harper

medical doctor

Naomi McLean

field administrator

Abi Kamara

logistician

Peter Wigg

psychiatrist

Tonia Marquardt

field coordinator

Iraq

Kenya

Matthew Apostola

logistician

Rachel Marsden

operating theatre nurse

Daniel A’Vard

logistician

Sunaina Miranda

medical doctor

Helen Boland

medical doctor

Marco Antonio Osti Avila

anaesthetist

Debra-Lee Holman

field coordinator

Helle Poulsen-Dobbyns

field coordinator

Damien Moloney

logistician

Robert A Simpson

medical doctor

Helen Parker

nurse

Vicki Slinko

epidemiologist

Sally Thomas

logistician

Adam Stone

Peter Wallis

medical doctor

Laos

Sean Healy

head of mission

Rachel Tullet

medical doctor

Liberia

Melanie Pountney

medical doctor

Graeme Washer

surgeon

Karin Rautenbacher

medical scientist

Bill Wilson

Paras Valeh

epidemiologist

Malawi Mozambique

Myanmar Nepal Niger

logistician/ administrator

logistician/ administrator

Robert Atkinson

medical scientist

Kevin Baker

anaesthetist

Rupa Kanapathipillai

medical doctor

Pakistan

Kaye Cussen

medical doctor

Ellen Kamara

administration-

Marilyn Keane

nurse-midwife

financial coordinator

Sue Petrie

psychologist

Barbara Telfer

epidemiologist

Siobhan Reddel

medical doctor

Deanna Beaumont

logistician

Michael Rowell

administration-

Devika Tharumaratnam

medical doctor

Christina Ambrose

medical coordinator

financial coordinator

Heather Harris

nurse-midwife

Cassandra Arnold

medical doctor

Brett Stathis

psychologist

Sarah Clemons

nurse

Raewyn Turner

operating theatre nurse

Debra-Lee Holman

nurse

Colin Watson

nurse

David Walkley Palestinian Territories Helle Poulsen-Dobbyns

Papua New Guinea Margie Barclay

logistician field coordinator

Louise Johnston

nurse

Warren Keen

logistician

Vanessa Cramond

medical coordinator

nurse

Devi Lalloo

nurse

Veronique De Clerck

medical coordinator

continued over...

9

International Field Staff in 2009 MÊdecins Sans Frontières Australia continued Papua New Guinea Catherine Georgeson

Philippines

Samoa

Sudan

nurse-midwife

Kate Hardie

paediatrician

Shella Hall

medical team leader

Katrina Harper

medical doctor

Vance Painter

logistician (water-

Janine Issa

midwife

sanitation)

Abi Kamara

logistician

Sally Stevenson

head of mission

Shannon Lo Ricco

logistics coordinator

Mattias Armstrong

logistics coordinator

Laura Margison

nurse

Warren Keen

logistician

Victoria Mowat

nurse

Richard Smith

medical doctor

Uma Naguleswaran

medical doctor

Lisa Trigger-Hay

medical doctor

David Nash

logistician

Veronique De Clerck

head of mission

Linda Pearson

field coordinator

Kate Ferguson

logistician (water-

Michael Rowell

administrationfinancial coordinator

sanitation) Somalia

South Africa Sri Lanka

Sudan

Sue Mitchell

psychologist

Anne Taylor

head of mission

Debra Blackmore

medical doctor

Nicole Trim

nurse

Amy Radford

nurse-midwife

Murray Trubshaw

medical doctor

Shelagh Woods

head of mission

Raewyn Turner

operating theatre nurse

Helen Cox

epidemiologist

Richard Urmonas

logistician

Shelagh Woods

deputy head of mission

Swaziland

Robert Gardner

administration-

Uganda

Deanna Beaumont

Liz Bannister

medical doctor

Philippa Boulle

medical doctor

Roslyn Brooks

medical doctor

Angela Cropley

medical doctor

Judith Forbes

anaesthetist

Judy Coram

nurse

Eu-Gin Lim

anaesthetist

Jonathan Ng

medical doctor

Kirryn Lowe

medical doctor

Kelly Wilcox

nurse

Jayne Martin

field coordinator

Thomas Wong

pharmacist

Michael O'Brien

nurse

Joanne Oo

medical doctor

Amanda Stack

nurse

Peter Wigg

psychiatrist

Kelly Wilcox

nurse

Matthew Apostola

logistician

financial coordinator

Yemen

logistician

Haydar Alwash

surgeon

Matthew Merrington

logistician/ administrator

Zimbabwe

Sunaina Miranda

medical doctor

Ahmose Abrahim

logistician (watersanitation)

Vanessa Cramond

medical team leader

Eugene Athan

epidemiologist

Kelly Drew

midwife

Kate Ferguson

logistician (water-

Eileen Goersdorf

operating theatre nurse

Hamish Graham

medical doctor

Carolyn Merry

deputy head of mission

Lainie Grummitt

field administrator

Vidthiya Rajasundaram

medical doctor

sanitation)

10

Summary Activity Charts 2009 Highlights • • • • •

In 2009, there were 118 field positions filled by Australians and New Zealanders in more than 30 countries.

Thirty six percent of these were Field Staff on their first mission.

Funding spend on social mission increased 16% to $36.7 million in 2009 from $31.7 million in 2008.

Income from fundraising for the year ended 2009 increased to $43.7 million in 2009 from $40.3 million in 2008.

At the same time, the total cost of fundraising decreased from 17% in 2008 to 16% in 2009.

The number of people supporting the work of Médecins Sans Frontières Australia grew from 104,600 to 116,300.

2009 Income Field Partners (62.4%) Bequests (3.8%) Other private donations (26.9%) Income from other MSF sections (5.2%) Other income (1.4%)

Project Funds by Region

Gifts in kind (0.3%)

Africa (64%)

Field Human Resources by type

Asia (15%) Middle East (21%)

Medical (36%) Paramedical (39%) Non medical support staff (25%)

Summary Financial Results

Donation Income Total Income Social Mission Costs Total Costs Surplus/(deficit) Reserves 11

$m 2009

$m 2008

$43.7 $46.8 $36.7 $45.9 $0.9 $6.7

$40.3 $43.5 $31.7 $40.5 $2.9 $5.8

Médecins Sans Frontières worldwide 2008: Extract from International Activity Report 2008 The figures presented here describe Médecins Sans Frontières’ finances on a combined international level. The 2008 combined international figures have been set up in accordance with Médecins Sans Frontières international accounting standards that comply with most of the International Financial Reporting Standards. The figures have been jointly audited by the accounting firms KPMG and Ernst & Young in accordance with international auditing standards. A copy of the full 2008 financial report may be obtained upon request. The figures presented here are for the 2008 calendar year. All amounts are in millions of Euros.

Income

In M€

In %

Private Public International Other

587.4 67.7 20.3

86.9% 10.0% 3.0%

Total Income

675.4

100.0%

How was the money spent?

In M€

In %

Operations* Témoignage Other humanitarian activities Total social mission Fundraising Management, general & administration

494.8 24.7 7.2 526.8 81.2 40.2

76.3% 3.8% 1.1% 81.2% 12.6% 6.2%

Total expenditure Net exchange gains & losses (realised and unrealised) Surplus/deficit

648.2

100.0%

-4.7 22.5

* Programmes & HQ programme support costs

Balance sheet

In M€

(end-year financial position) Non-current assets Current assets Cash & equivalents

37.0 73.3 375.6

Total assets Permanently restricted funds Unrestricted funds Other retained earnings Total retained earnings and equities Non-current liabilities Current liabilities Unspent donor-restricted funds

485.9 2.5 423.8 -13.9 412.4 4.6 66.6 2.3

Total liabilities and retained funds

485.9

HR Statistics

In M€

In %

International departures (full year): Medical pool Nurses & paramedical pool Non-medical pool

4,617 1,052 1,452 2,113

100% 23% 31% 46%

First time departures (full year):

1,142

25%

25,973 2,029 23,944

100% 8% 92%

* in % of total international departures

Field positions International staff National staff

12

MÊdecins Sans Frontières Australia ABN 74 068 758 654

Part B Financial Report for the Financial Year ended 31 December 2009

Médecins Sans Frontières Australia ABN 74 068 758 654 PO Box 847, Broadway NSW 2007, Australia Tel: +61 2 8570 2600 1300 136 061 Fax: +61 2 9552 6539 Email: office@sydney.msf.org www.msf.org.au © 2010 Médecins Sans Frontières Australia