Last year, Mongolia was hit by a devastating dzud – an extremely harsh winter that follows a very dry summer. With heavy snow and temperatures as low as -40 to -50 Celsius, large parts of the rural population were unable to access any form of healthcare. Hospitals and clinics were damaged, more babies died, and the government declared a national emergency.

Mongolia © Christine Ferrier
In January, the first snows of the winter of 2010 coated a ger in Uvs province.

Once the snow had melted in late spring, Médecins Sans Frontières (MSF) responded by sending an exploration team to find out what people’s medical needs were. MSF recently completed a pilot project to help people in one of the hardest-hit provinces prepare for the coming winter.

The pilot project took place between September and the beginning of November 2010, in Uvs in the northwest of Mongolia, a province where around 70 per cent of the 80,000 people living there were affected by the dzud.

Mongolia © Christine Ferrier
An MSF team member hands out first aid kits and leaflets to a nomadic herder.

“Last year’s dzud compromised maternal and neonatal health. Heating systems in health facilities were broken due to heavy use and some local hospitals partially closed,” says Christian Ferrier, head of mission for MSF in Mongolia.

In winter, access to Uvs is possible mainly by plane, and during the summer the province is a three-day cross country drive away from Ulan Bator, the capital of Mongolia. Most people are nomadic herders who live in small groups of isolated gers – large tents situated in the rolling grasslands that are covered in snow between November and April. Most people make their living from raising goats, sheep, horses, camels, cows and yaks. During last year’s dzud, a high percentage of livestock was wiped out, leaving many herders destitute and more vulnerable to illness this winter.

MSF targeted five of the 19 counties in the province for the project. These five were chosen because of their distance from the provincial capital and the high numbers of children under five years old who died during the dzud.

Mongolia © Christine Ferrier/MSF
A collection of gers.

The project pilot involved a range of activities. These included improving infrastructure in five regional health facilities, providing a back-up stock of essential drugs and supplies in provincial and county hospitals, distributing basic first aid kits and health leaflets to 3,000 herder families, and giving refresher training and drugs to 16 community-based medical officers.

In the selected health centres, electricity supply and back up were repaired and window insulation was improved in hospital wards.

“The local level medical officers had varying levels of education and age. Some were in their 60s, some were in their early 20s, but they were all very enthusiastic and studious,” says Dr. Mark Stover, MSF’s medical coordinator for the project.

“In the trainings we focused on helping the medical officers recognize medical emergencies, and we tried to cover the illnesses that we were told were most common in the winter,” says Stover.

Giving the basic first aid kits and leaflets to the herder population posed a logistical challenge, because many people live in isolated gers and have no access to mobile phones or landlines.

Mongolia © Christine Ferrier
A nomadic herder readers a leaflet distributed by MSF.

“In the end, the bush telegraph worked well. Word of mouth about our distributions was how the information was spread,” says head of mission Ferrier.

The harsh winter has already started again in Mongolia, and in the spring an MSF team will return to evaluate the project. In the meantime, MSF is looking into starting tuberculosis projects in Ulan Bator, as well as supporting the health needs of thousands of families who live in ger shanty settlements on the outskirts of the capital.