Failing States, Not Forgotten People: International Medical Corps’ Commitment to the World’s Most Vulnerable Communities

International Medical Corps welcomes The Failed States Index, an annual ranking of 178 nations based on their levels of stability and the pressures they face, published by The Fund for Peace. The index provides an opportunity to shine a spotlight on many of the world’s most neglected crises.



Several of the countries on the list, such as Afghanistan and Somalia, are well-known emergencies, regularly given significant public, media and diplomatic attention. Iraq – where International Medical Corps has worked continually since right before the outbreak of war in 2003 – is among the fastest-improving nations on the index. However, the Failed States Index also features many long-term, chronic crises which do not command international attention or funding.

Whilst the needs of vulnerable people living in places such as Chad and Central African Republic are just as pressing, the challenges of delivering lifesaving assistance and building self-reliant communities become more formidable when a crisis is neglected by international aid donors. A recent assessment by International Medical Corps found that more than 45,000 people are facing a major food crisis and require immediate assistance in the remote northeastern areas of Central African Republic. Better-known crises in the neighbouring Sahel region or in Somalia, combined with the isolation of these communities, cut off by poor roads and insecurity, can make it seem hopeless to even begin trying to help. Instead, with funding from ECHO, International Medical Corps is responding now, providing nutrition services and basic health care to those most at risk, while laying the foundations on which the government and people of CAR will one day be able build a functioning healthcare system.

Abandoning these countries as being beyond help is the surest way to guarantee they remain at the top of the Failed States Index.

An International Medical Corps supported pharmacy in rural CAR

International Medical Corps currently operates in all of the top ten most failed states on the Index, reflecting a commitment to provide immediate services, and to support and rebuild devastated health systems no matter how challenging the context. Our long experience of working in vulnerable states of all kinds provides unique insight into the needs of communities in crisis. This is why International Medical Corps is speaking out to make sure neglected crises, like those in Chad, CAR and others, cannot be ignored and that innocent families caught in the terrible reality of these emergencies are not forgotten.


International Medical Corps is Secretariat for the Health and Fragile States Network, a group of humanitarian organisation professionals and academics committed to raising awareness and speaking out on issues related to healthcare in the world’s most vulnerable nations. Recognising that functioning health care systems, with fair access for all to high quality and appropriate health care is an essential part of building stable societies, International Medical Corps prioritises training of local health professionals and supporting Ministries of Health in order to build the capacity of these countries to care for their own people over the long-term.

“In fragile states, where resources are scarce and capacity is limited, it is inevitably more complex and costly to rehabilitate health systems that have been destroyed by disaster or conflict,” says Steve Commins, Co-chair of the Health and Fragile States Network. “Yet these are the areas where the need is greatest. We must strive to move communities from relief to self-reliance, to share best practices and to believe in the potential of countries, no matter how failing they might seem today.”


You can read about our work in each of the most failed states in Where We Work 


Just 22 hours after the devastating 7.0-earthquake hit in January 2010, International Medical Corps’ Emergency Response Team was on the ground in Haiti providing medical care to survivors. Our doctors and nurses were able to mobilise on an unparalleled scale to provide 24-hour emergency care to the acutely injured at the Hôpital de l’Université d’État d’Haiti (HUEH), a 700-bed hospital in Port-au-Prince. HUEH was badly damaged in the earthquake and many local health care professionals were missing. We were able to save thousands of lives through emergency and trauma care in the critical days following the earthquake.

At the height of emergency operations at the hospital, International Medical Corps treated approximately 1,000 patients per day. Our early entry also gave us the foundation to rapidly expand our operations to 15 mobile clinics throughout Haiti to provide critical services. Through the hospital and mobile and fixed clinics, International Medical Corps teams provided more than 110,000 patient consultations during the first year following the emergency.

When reports of acute diarrhoea emerged from the north of Haiti in October 2010, International Medical Corps doctors and nurses immediately deployed to the region providing emergency relief for the growing cholera crisis. Our network of rapidly constructed cholera treatment centres, supported by 820 community health volunteers to educate communities on how to prevent and identify cholera, meant that more than 30,000 cholera patients received life-saving treatment within the first year following the outbreak.



Libya ambulanceInternational Medical Corps was among the first organisations to enter Libya once the conflict began in February 2011, providing emergency medical care to casualties from the fighting and support to hospitals with medical staff and supplies. Among the first challenges our Emergency Response Teams encountered was a chronic shortage of nurses, as thousands of foreign nurses had fled the country. In partnership with the Jordan Health Aid Society, International Medical Corps immediately deployed volunteer nurses to health centres across eastern Libya moving them to towns and cities throughout the country as access permitted. Volunteer nurses trained the local counterparts while working alongside them.

At the country’s borders and within Libya, we supplied those displaced by the fighting with essential relief items, including blankets, bottled water and food. Recognising the danger posed by communicable diseases, our sanitation and hygiene specialists constructed latrines and washing stations in transit camps along the Tunisia borders.

Libya 5As the fighting went on International Medical Corps worked as close to the front line as possible, providing emergency treatment to those injured in the conflict, and medicines and supplies to besieged towns and cities. In Misurata, inaccessible by road, we evacuated nearly 500 injured civilians by boat. International Medical Corps’ mobile field hospitals treated the wounded from battles in Tripoli, the Western Mountains, Bani Walid, Sabha, Jufrah and Qaddafi’s hometown of Sirte.



Mali - villagerInternational Medical Corps mobilized an emergency response in Mali in January 2013 after rebel armed forces from the north began moving south, triggering French military intervention. In Timbuktu, which had spent months under the control of armed Islamist rebel our team were amongst the first international organisations to arrive and found pillaged clinics, missing medical personnel and damaged health infrastructure.

We immediately began supporting eight strategically targeted health clinics in remote areas around Timbuktu, where the Malian Ministry of Health has been unable to maintain adequate services to local communities. By providing medicines, training staff and recruiting qualified doctors and nurses, we can ensure local people will now have access to basic primary and secondary health care for the first time in months

Mali-Road-to-TimbuktuTrue to our mission to build self reliance, International Medical Corps is also already training community health workers to go out to local markets and spread essential hygiene, reproductive health and nutrition messages. We are also working to rehabilitate clinics damaged during the conflict, by building or repairing latrines, water systems, solar panel systems and other infrastructure repairs, enabling health workers to have stable and well-equipped facilities to help the people of Mali.


Basanti & Bishal's story

Basanti, a young mother of two in Nepal, returned home from fetching water for her family to find her 8-month old son Bishal had fallen into the open cooking fire. Basanti was in shock, but she wrapped her baby in blankets and ran for help. No one in their village or at the local health post knew what to do so she had to travel more than six hours by bus to seek emergency care at the closest hospital. The district hospital could only stabilize Bishal and wasn’t able to treat his wounds properly. As a result, his little fingers contracted into a fist as the burned skin contracted and “healed” over the coming year, making it impossible for him to use his hand. His cheek, lips and eyelid also contracted and tightened, threatening his vision.

After selling part of their farm to pay for transportation to Kathmandu, Basanti sought further treatment for her baby. However, two hospitals in the nation’s capital could not help either. Adding to Basanti’s struggles, her husband abandoned the family, leaving her alone to care for Bishal and his four-year-old sister.

Thankfully, Basanti heard about the surgical care available through ReSurge International, our trusted partner with a 43-year history of serving burn victims. Dr. Rai, ReSurge’s Outreach Director in Nepal, and his team restored Bishal’s eyelid and his hand will soon be surgically repaired as well.

Even though it took more than a year for him to get appropriate treatment, Bishal is one of the lucky ones. Thousands of children never get the care they need to live a normal life after a disabling burn.


Our impact through training in 2012



Our Mother Care Group Approach


Read more about our community based approach to prevention and treatment of malnutrition