A Monthin Focus – December 2014Ebola – New needs, new strategiesIraq – Left to fend for themselvesCAR – A year of chaosCameroon – Refugees treated for malnutritionEbolaThree months afterthe appeal launched by MSF, the international community is stepping up its response.As the situation evolvesrapidly in the countries that are affected, constant adjustments have to be made to the aid effort.Effective management of Ebola requires:Daily monitoring for a period of three weeks of all thosecoming intocontact with an infected person…Isolating and treating patients immediately... Ensuring safe funeral and cremation practices to prevent the spread of infection. And trained staff must be on-handin the places where they aremost needed.As the situation evolves, the international community must be able to react quickly and adjust their operations accordingly. Joanne Liu, présidente de MSF international, en françaisEven when we do manage to contain the outbreak somewhere, it doesn’t mean the battle’s won. What we need today is the flexibility to be able to re-direct resourcesto areas where there are new outbreaks. For example, the number of cases in Liberian capital Monrovia is dropping so the capacity of its treatment centrescurrentlyexceeds requirements.Now themost urgent is to restore health services, in spite of the virus, and ensure that it doesn’t break out elsewhere. Raising awareness among communities is absolutely vital in the other regions of West Africa where the epidemic continues to spread.Containing the Ebola epidemic demands resources that the countries concernedquite simplycannotprovide alone.IraqTwo million Iraqis have fled from the bombs and advancing Islamic State forces.Finally safe, these peopleare left to fend for themselves.Many people fleeing the violence in Iraq go to Kirkuk in the north. Half-built buildings become home to whole families who have been forced to leave everything behind. Here they are finally safe, but, they receive almost no humanitarian aid.  IDP Woman (woman in Arabic)No one has come to seeus, no UN agency or anything, just the Governor (of Kirkuk) and the Red Crescent, no one else. We've made requests, asking for help, mattresses, for stoves, oil, and such like, carpets. No one has given us anything.This woman is being treated in a clinic set up by MSF. She has a brain tumour and needs a special diet for high blood pressure, but she has no money. And hers is not an isolated case. The medical teams witness the harsh living conditions the people are subjected to—overcrowded shelters, sanitation not fit for purpose and insufficient food—conditions causing large numbers of peopleto contract respiratory, urine or skin infections or tobecome anaemic.International aid efforts are focused on Iraqi Kurdistan... while Kirkuk, on the other side of the border that has seen no fighting and remains accessible to aid organisations, has become a city abandoned to its fate...Central African Republic December 2013: Despitethe deployment of French peacekeeping force Sangaris, Bangui was attacked by anti-Balakamilitia. A year later, in spite of international aid efforts, the country is enduring a real catastrophe.Sangaris, Eufor, Misca, Minusca... International military forces have been deployed in Central African Republic for months now and,while they have to some extent managed to contain the mass violence, they haven’t been able to help the country to return to normal. MSF is witnessing the dire reality,particularly from the security and humanitarian perspective. While the violence is indeed more sporadic, it still exists and crime is rife.Claude Cafardy, chef de mission adjoint, MSF (en français) What’s really striking in the Central African Republic is the impression of despair.A huge amount of humanitarian aid has been delivered and although theMinusca operation is not the firstpeacekeeping mission to be deployed, the atrocitiescontinue.The country feels like a gigantic camp where peopleare constantly intimida