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21 HOW MSF WORKS HOW DOES MSF CLOSE PROJECTS Planned or not there always comes a time when Doctors Without Borders Mdecins Sans Frontires MSF has to close a project. An emergency may have passed a suitable partner might have been found to take over or the conditions on the ground might have made it categorically unsafe. Whatever the circumstance it is a complex procedure. For example nurse Carissa Guild was part of a team that closed a project. In April 2012 Guild was with MSF in Nyanzale in DRCs North Kivu province. It was kind of a forgotten district Guild says a deeply impoverished place with minimal health systems. Their task was to support a local hospital so it could serve the local community and nearby health centers then turn it over to the Ministry of Health. It took a long time to get it going she recalls. Security was a constant issue for the team. Progress was visible however Everything was open. Pediatrics was open. It was really working. But then a group of army soldiers that came to be known as M23 mutinied rendering an already unstable area even more so. Following a series of armed robberies of MSF personnel and facilities the expats were ordered to return to Goma. We basically threw everything into our cars and took off not knowing when wed be back Guild says. I gave the key to the pharmacy to the people in Nyanzale and then just made a lot of phone calls trying to figure out how to get medications to the other three centers trying to sort out how we were going to support them. She put together kits for each health center so theyd have supplies for the short term. The team hoped theyd return soon but the worsening conditions suggested otherwise. During an earlier mission in Burkina Faso Guild had seen how preparations for handing over a project can last months even years. But in North Kivu the abrupt departure meant making contingency arrangements on the fly. Staff in the health posts theyd left were fretting about what would happen next. People were calling Guild asking Now what do we do It was terrible to leave she says. There was so much need there and the staff were super motivated and had been doing everything exactly as we asked. They didnt have the resources or training that the now-departed teams had however and the systems that had been set upthe cold chain for instance