Humanitarian aid

On the wall above my desk is a picture of a chubby smiling Sudanese baby. When I met Macak he was surrounded by other children who ran around after him screaming and flailing their arms playing, as young children do all over the world. Barely four years old, always grinning and laughing, Macak seemed to know he was lucky to be alive. It was difficult to believe that he had been at the verge of death two weeks before, a skeleton found at the gates of the feeding centre, too weak to chase the flies from his face.

Thousands died in Sudan in 1998 during one of the worst famines of the decade,1 but many lives were saved thanks to the huge humanitarian aid effort. Without a doubt, Macak and many others survived because of the intensive medical efforts of doctors working in the Médecins Sans Frontières feeding programme.

Medical humanitarian aid is emergency medicine on a large scale: clinics are set up according to mortality rates, and treatment is prioritised for the weakest and neediest—children, pregnant women, and elderly people. The response to mass needs for emergency medicine amid situations of prevailing chaos has been developed and improved by experience …