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MSF Scientific Days 2019: Snapshot
In his provoking keynote speech, Dr James Orbinski reminded us to rely on innovation rooted in dignity and respect. Drawing lines between complex geopolitical systems and climate change, James considered where MSF should focus its efforts.
“We are not living on this planet: we are living in and through it. And now we are destroying that home. We need a new story, a new way of seeing ourselves in relation to each other and our planet.”
Vickie Hawkin’s warm welcome to the 2019 SciDays delegates celebrated the impressive work done across the organisation this year but also drew attention to the huge challenges ahead for MSF. “What we are doing now will inform how healthcare looks in the next 20 years – and the road that will get us the there.”
The research presented was broad and dynamic, showcasing 14 research teams and their learning from the field. Kiran Jobanputra summed up the key themes from the day, ranging from climate change to complexities of human behavior.
1. We need to include patients in decisions about their own care.
We are in a position to enable people to regain their agency and dignity. In doing so, we have to be aware of the power balance between patient and doctor. How can we structure our approach in a way that rebuilds that agency?
At the heart of agency lies empowerment. Empowerment can’t be top-down: it is culturally contextual. We learned about how women who are at risk of HIV feel empowered through access to daily PrEP medication. We learned it’s the small things that make a real difference in palliative care. Muneera Pilgrim summarised it well: “What is humanitarian without humanity and humanity without human. At the center of it all, we are just people.”
2. We deal with the complexity of human behaviour – and we need to respond as such.
What people say they do is not always the case, so how do we uncover the real story? We have a duty to empower our staff by training them to undertake difficult conversations. Only then can we build relationships and listen to and understand our patients' motivations.
Stigma is a major barrier to care for patients. Only by understanding the cultural context and providing access to education can we empower patients and caregivers with the information they need to make decisions.
3. We need to focus on those left behind.
We have a responsibility to highlight groups of people who don’t have access to the care or support they need. From HIV and Visceral Leishmaniasis co-infections to the growing need for snakebite antivenins, those affected are the most vulnerable and undeserved. People with advanced or stigmatised diseases have many barriers to care, and we need to allow those people to take part in how we conduct our research.
This year, MSF welcomed the release of the long-awaited WHO strategy to tackle snakebite. While we’ve made so much progress elsewhere, we must still remember that there are peoples subject to structural injustice.
#MSFsci: "Two antivenoms for snakebite in Agok, South Sudan: a prospective monitoring study": the new antivenom protocol is safe and effective and EchiTabPlus is well-tolerated. True polyvalent and affordable antivenemos are urgently needed! https://t.co/Rp6J1STTTl pic.twitter.com/z5z2NEyMkB— MSFPaediatrics (@MSFPaedsDays) May 9, 2019
4. We are in a period of climate breakdown, and we need to define our role within this challenge.
Our stories are emerging already. Within these stories, we’ll find our policy change agenda – as we have done in the past. We will learn how to use our voice to ensure we remember the forgotten.
Research Turbo Talks
Everyone sat up a little straighter when our contestants lined up for the first Research Turbo Talks. 11 people, one minute, one prize: and they were off! Each presenter rattled out why the audience – at home and afar – should vote for their research.
Aaaaaand the winner is… Emilie Venables with ‘Exploring perceptions of malaria prevention and treatment in rural DRC’. Congratulations to Emilie and her team!
The crowd favourite for the day? Muneera Williams, poet and activist, roused the audience with her thunderous summaries of each session. She captured the heart of the conversation to reflect the work and vision of MSF. What a privilege it was to have been witness to her translation of science into poetry!
Innovation Day launched into activity with Eddie Obeng’s interactive and energetic keynote speech. He challenged the audience to scrap the ego, reminding us that humility and really listening are key to innovation. Sometimes listening to problems is harder than it appears, but that’s no reason to shy away from the challenge at hand.
“Go where the fear is! Wherever you sense fear, that’s when you know change is coming.”
The founders of MSF built the organisation to fill a gap that made them uncomfortable and fearful. Within that gap, they found that we have the power to witness, restore dignity and hope. As an organisation, that mission is as true today as it ever was.
So what is innovation? For Eddie, there is no formula. There are four key questions to ask that makes innovation work:
- Where’s the gap?
- What if we don’t fix it?
- What would happen if we fixed it?
- Why haven’t we fixed it yet?
People at the heart of innovation
Session one responded excellently to Eddie’s go where the fear is mantra as work from Nigeria, Lebanon and Greece showed the power of working with and supporting existing networks and communities to develop truly collaborative methodologies for health promotion and advocacy.
Think locally, share globally
In a brilliant example of ‘frugal’ innovation and designing with constraints, Farooq Khan presented a new, tried and tested, gravity-fed water treatment system. By using gravel, gravity, bricks, PVC pipes and sandbags, the system turns poisonous raw water into clean drinking water in Pakistan. He noted that a domestic version is in development that would cost only 20-25GDP. “Not only is it cheap, it will work forever,” said Farooq.
Demo elevator pitches
With stomachs grumbling for lunch, the demo elevator pitches roared into life! Ten innovators took the podium to tease and tantalise the audience about their projects developed in response to real field challenges that were then demoed live in London and by video online.
The world is changing and so too must our approach.
The cultural and environmental climate is evolving around us and humanitarian care has a responsibility to respond to those challenges. From balancing the opportunities and risks of big data through to developing locally-implemented tech, there needs to be a people-first approach.
Big data is an issue that affects us all – and a conversation that will be ongoing. If running towards discomfort was the theme for the day, the session on how we use data was no different. The inter-sector panel debated issues of data protection and security that created ripples of agreement and disagreement across the room.
Data collection in a humanitarian context brings with it unique concerns. Alexandrine Pirlot de Corbion reminded the audience that the core of MSF's humanitarian mandate is to assist and protect data – so we need to make decisions about how to use that data responsibly. This most evident when considering how people can consent to data collection freely and meaningfully. If a person in a refugee camp needs care, will they be able to give their consent in a meaningful way?
Innovation for a core approach
Kiran reminded us that there is fear in facing the world’s challenges – and we need to run towards that fear instead of away from it. There is a need to engage deeply with the communities who are facing these challenges. We may have to give some of our power away through collaboration to find solutions to problems, but that is where we need to go.
There is a false dichotomy between palliative and curative care. By focusing on communication and support, MSF teams have implemented successful neonatal palliative care frameworks in Afghanistan. Dr Nikola Morton expressed her hope that MSF operations will integrate palliative care as a core part of their humanitarian work.
“Palliative care should not be seen as an innovation but part of our core business as humanitarian organisations.” – Nikola Morton
In her powerful presentation, Dr Manisha Kumar called to MSF staff to accept abortions as a core aspect of healthcare. She called out a clear lack of knowledge as the root of misconceptions around abortion. Not only do 1 in 4 pregnancies end in abortion, but the procedure is also safer than an injection of penicillin.
“We have to stop seeing abortion as a women’s issue and start seeing it as a healthcare issue.” – Dr Manisha Kumar
Dare to Change
And with one final surprise, Muneera Pilgrim joined us again on stage. Brought to the stage with tremendous applause, she Dared us to Change. She dared the audience to be brave to embrace the space in which we can say, “I don’t know”.
It is easy to shy away from uncomfortable situations, but that is where the heart of innovation lies. MSF has risen to that challenge. Let’s see what challenges we can run towards next.
“Let us retain the humility in listening to the people we have pledged to support.” – Kiran Jobanputra
What were your key takeaways from Scientific Days 2019? We’d love to hear your thoughts. Tweet us at @MSFSci or send us an email at firstname.lastname@example.org