A flooded river crossing in Autonomous Region of Bougainville delays the referral by MSF of eight patients to the island's main hospital by three hours, a trip that normally takes between 7-9 hour trip. A key challenge to providing health care in the remotes the areas extremely rugged terrain, limited infrastructure and unpredictable weather. MSF has been working in Buin Health Clinic in the far south of Bougainville and five surrounding smaller health clinics since July 2011. Medical teams work alongside Department of Health staff to delivery healthcare and improve the skills of local staff, while logistics activities focus on rehabilitating the area's health infrastructure.