In an extraordinary demonstration of public support, MSF offices worldwide saw an unprecedented surge of spontaneous donations. One week after the disaster MSF decided to stop accepting earmarked donations for tsunami-related relief operations, a decision which it communicated widely. At that stage, based on funds already received over the internet and through direct bank deposits, MSF estimated donations at over 40 Mââ?š¬ [4th Jan], enough to cover the likely costs of our immediate emergency response. However, spontaneous gifts continued to arrive topping at approximately 100 Mââ?š¬ three months after the disaster.

MSF is extremely grateful for this generosity, a sign of solidarity which has allowed our teams to bring medical, psychosocial, logistical and water and sanitation aid to the most affected people and help them recover from the devastations.

Still, the amount of donations greatly surpasses our financial requirements for emergency medical relief in the Tsunami-affected regions. 100 Mââ?š¬ is equivalent to the entire 2003 annual budget for MSF operations in Angola, Afghanistan, Democratic Republic of Congo, Liberia, Sudan and Ethiopia - six countries with the highest concentration of MSF interventions that year - or more than double the 2004 budget for emergency operations in the Darfur region of Sudan.

To date, 25.57 Mââ?š¬ has been budgeted for operations in Tsunami-affected countries, 12Mââ?š¬ of which has already been spent MSF Operational Budget - India Mââ?š¬ 0.50 - Indonesia Mââ?š¬ 19.60 - Malaysia Mââ?š¬ 0.20 - Sri Lanka Mââ?š¬ 5.17 - Thailand Mââ?š¬ 0.10 Total Mââ?š¬ 25.57 Although MSF is committed to continue working in Aceh and in other Tsunami-affected regions in future, our interventions will not require considerable more funding than budgeted.

This is why MSF aims to derestrict 75% of the funds received. As MSF will not use earmarked tsunami donations for any other purpose without the consent of the donor, MSF offices worldwide have started to contact donors asking their consent to use gifts in other emergencies or forgotten crises.

Overall, the reaction has been very positive and has enabled MSF to re-direct 23.2 Mââ?š¬ to other programs whereas 550.000 ââ?š¬ was reimbursed on request.

MSF is a needs-driven humanitarian emergency medical organization dedicated to alleviating the most extreme suffering of the most vulnerable in the worst conflicts and disasters around the world.

It would be unethical and inefficient to boost operations artificially in one context only on the basis of availability of funds, and leave urgent and massive needs unmet in less prominent crises where the immediate survival of tens of thousands of people continues to be at stake.

The strength with which the tsunami hit the worst affected regions meant help arrived too late for many who died during or immediately after the disaster.

When MSF teams arrived in the worst affected regions within 72 hours, the local relief effort was already well underway.

Many of the emergency needs were covered by capable national medical staff. In the absence of major epidemics or life-threatening diseases except for tetanus, MSF found post-traumatic stress, water and sanitation and the loss of livelihoods the most urgent needs to be addressed in order for people to rebuild their lives. However, when it comes to long-term development programs or more large-scale rehabilitation, reconstruction or infrastructure works, MSF is convinced that state actors and other organizations, specialized in development aid are better suited to undertake these essential tasks.

MSF runs programs in more than 70 countries and continues to need funds for its medical assistance in areas largely forgotten by the media, such as the Democratic Republic of Congo, Darfur, Somalia or the Caucasus.