After working continuously in Somalia since 1991 the international medical humanitarian organisation Doctors without Borders (Medicins Sans Frontieres) is closing all its programmes in Somalia.
This as a result of extreme attacks on staff in an environment where armed groups and civilian leaders increasingly support, tolerate, or condone the killing, assaulting and abduction of humanitarian aid workers.
In some cases, the same people – particularly but not exclusively in south central Somalia – with whom MSF must negotiate minimum guarantees to respect its medical humanitarian mission, have played a role in the abuses against MSF staff, either through direct involvement or tacit approval. Their actions and tolerance of this environment effectively cuts off hundreds of thousands of Somali civilians from humanitarian aid, MSF said.
During its 22-year history in Somalia MSF has negotiated with armed groups and authorities on all sides. The exceptional humanitarian needs in the country have pushed the organisation and its staff to tolerate unparalleled levels of risk and to accept serious compromises to its operational principles of independence and impartiality.
Incidents include the brutal killing of two MSF staff in Mogadishu in December 2011 and the subsequent early release of the convicted killer as well as the violent abduction of two staff in the Dadaab refugee camps in Kenya that ended last month after 21 months of captivity in south central Somalia.
These incidents are the latest in a series of abuses. Fourteen other MSF staff members have been killed and the organisation has experienced dozens of attacks on its staff, ambulances and medical facilities since 1991.
“In choosing to kill, attack, and abduct humanitarian aid workers, these armed groups and the civilian authorities who tolerate their actions, have sealed the fate of countless lives in Somalia,” said Dr Unni Karunakara, MSF’s international president. “We are ending our programmes in Somalia because the situation in the country has created an untenable imbalance between the risks and compromises our staff must make and our ability to provide assistance to the Somali people.”
Beyond the killings, abductions, and abuses against its staff, operating in Somalia meant MSF had to take the exceptional measure of utilising armed guards, which it does not do in any other country, and to tolerate extreme limits on its ability to independently assess and respond to the needs of the population.
Humanitarian action requires a minimum level of recognition of the value of medical humanitarian work and implies acceptance by all warring parties and communities to allow the provision of medical assistance as well as the operational principles of independence and impartiality. This acceptance, always fragile in conflict zones, no longer exists in Somalia.
“Ultimately, civilians in Somalia will pay the highest cost. Much of the Somali population has never known the country without war or famine. Already receiving far less assistance than is needed, the armed groups’ targeting of humanitarian aid and civilians leaders’ tolerance of these abuses has effectively taken away what little access to medical care is available,” Karunakara said.
MSF will close its medical programmes across Somalia, including in the capital Mogadishu and the suburbs of Afgooye and Daynille, as well as in Balad, Dinsor, Galkayo, Jilib, Jowhar, Kismayo, Marere and Burao. More than 1 500 staff provided services, including free primary health care, malnutrition treatment, maternal health, surgery, epidemic response, immunisation campaigns, water and relief supplies.
Last year MSF teams provided more than 624 000 medical consultations, admitted 41 100 patients to hospitals, cared for 30 090 malnourished children, vaccinated 58 620 people, and delivered 7 300 babies.