Afghanistan: MSF leaves country following staff killings and threats

ALT Carl De Keyzer/Magnum

The people of Afghanistan today face a harsh and desperate reality as a result of more than 25 years of war, shifting political leadership and years of drought. To help alleviate their suffering, MSF has been providing Afghans with medical care for almost 24 years.

Tragically, on June 2, 2004, five MSF staff members were shot and killed on the road between Khairkhana and Qala-i-Naw in northwestern Badghis province. After weighing the options, MSF sadly decided to close all of its medical projects in Afghanistan by the end of August 2004. Most activities were handed over to local groups, international NGOs or the ministry of health.

Although Afghan officials presented MSF with credible evidence that local commanders conducted the attack against the three international volunteers and two NATIONAL STAFF: members, these officials had done little to bring the perpetrators to justice. In addition, after the killings, a Taliban spokesperson claimed responsibility for the murders and later stated that organizations like MSF work for US interests and are therefore targets for future attacks.

MSF believes that humanitarian assistance is only possible when armed actors respect the safety of humanitarian workers, more than 30 of whom have been killed in Afghanistan since the beginning of 2003. The targeted killing of MSF staff, the government's failure to arrest the culprits and the false allegations made by the Taliban made it impossible for MSF to continue providing assistance, despite the great needs.

The violence directed at humanitarian aid workers in Afghanistan comes amid consistent efforts by the US-led coalition to use humanitarian aid to build support for its military and political aims. MSF has repeatedly denounced the coalition's attempts to do so. The organization has also spoken out against the military's attempt to usurp humanitarian aid.

In May 2004, MSF publicly condemned the coalition's decision to distribute leaflets in southern Afghanistan that conditioned the continued delivery of aid on local people's willingness to provide information about the Taliban and Al-Qaeda.

MSF's activities in Afghanistan

Before the murders of five of its staff, MSF had been providing health care in 13
provinces of Afghanistan, performing tens of thousands of medical consultations each month. Teams gave basic and hospital-based care, treated people with malaria and tuberculosis and worked to reduce maternal mortality. MSF staff also provided safe drinking water and sanitation facilities.

When a malaria epidemic started in October 2003 in Badghis province, MSF teams treated 1,300 patients within the space of a month. In the same year, MSF carried out a study to test the efficacy of chloroquine, the conventional malaria treatment in Afghanistan, because of growing concerns about resistance to the treatment. In its projects, MSF had made a more effective medicine, artemisinin-based combination therapy (ACT), the standard treatment.

In addition, staff members vaccinated tens of thousands of children across the southern region between the ages of six months and 12 years old in response to repeated measles epidemics there. In five districts of Bamiyan province, teams were working to improve access to primary health care and maternal and child care.

At the beginning of 2004, a surgical unit was opened in the Panjab district to help pregnant women in need of emergency obstetrical care.
Afghanistan's wars and natural disasters have caused massive population movements in recent years.

Before the killings took place in June, MSF was helping displaced people living in various camps inside Afghanistan as well as assisting Afghan refugees living in neighboring Pakistan and Iran. In 2003, under government pressure, many of the displaced returned to their homes or moved to new locations. In response, MSF was gradually reducing its medical activities in the camps. Yet MSF continued to provide basic health care to 40,000 displaced people

living in Kandahar province's Zhare Dasht camp and to 22,500 displaced people in the camps near Spin Boldak across the Pakistani border. In the Afghan capital, Kabul, MSF assisted returnees and provided clean water to squatters living in tents in the city's Jangalak and Shahrak-
I-Police areas.

MSF worked in Afghanistan from 1980 until August 2004.

INTERNATIONAL STAFF: 67
NATIONAL STAFF: 658
(before 2 June 2004)