MSF withdraws life-saving medical treatment to Somalia after 22 years of operations

After working continuously in Somalia since 1991, the international medical humanitarian organisation Médecins Sans Frontières/Doctors Without Borders (MSF) today announced the closure of all its programmes in Somalia, the result of extreme attacks on its staff in an environment where armed groups and civilian leaders increasingly support, tolerate, or condone the killing, assaulting, and abducting of humanitarian aid workers.

In some cases, the same actors – 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.

Unparalleled levels of risk

Over its 22-year history in Somalia, MSF has negotiated with armed actors 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 – much of it bourne by MSF’s Somali colleagues – and to accept serious compromises to its operational principles of independence and impartiality.

The most recent incidents include the brutal killing of two MSF staff in Mogadishu in December 2011 and the subsequent early release of the convicted killer; and the violent abduction of two staff in the Dadaab refugee camps in Kenya that ended only last month after a 21-month captivity in south central Somalia.

These two incidents are just the latest in a series of extreme 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.

Screen Shot 2013-08-14 at 20.43.48“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.”

Today, Dr Unni Karunakara tweeted ‘Respect for humanitarian work and principles no longer exists in #Somalia.’ The question is , though, did it ever exist? Judging from the persistent acts of violence carried out on humanitarian workers in the past it seems unlikely. And if that is the case, it would be interesting to know what prompted such a decision to withdraw all programmes from Somalia.

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 currently do in any other country, and to tolerate restrictions on its ability to  assess and respond to the needs of the population.

Security guarantees needed

“Ultimately, civilians in Somalia will pay the highest cost,” said Dr Karunakara. “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 to the Somali people.”

MSF will be closing 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 a range of services, including free primary healthcare, malnutrition treatment, maternal health, surgery, epidemic response, immunisation campaigns, water, and relief supplies.

In 2012 alone, 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.

Throughout its 22-year history in Somalia, MSF staff have known intimately just how great the needs are of the Somali population. As of now, it is unclear why MSF have chosen this specific time to withdraw from Somalia. Why not in 2011 after the brutal killing of Philippe Havet and Andrias Karel? Why would they withdraw at a time when the conflict zones have been significantly calmer than in previous years?


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