Growing insecurity forces MSF to leave its largest health centre in Somalia

MSF has worked in Somalia since 1991. Since January 2008 MSF's projects in South and Central Somalia have been run by dedicated Somali staff, supported by international staff based in Nairobi who visits whenever security allows. The commitment, hard work and bravery of these Somali staff meant that MSF was able to continue providing health care to hundreds of thousands of Somalis throughout 2008. In 2008 MSF teams provided 727,428 outpatient consultations, including 267,168 for children under five. Over 55,000 women received antenatal care consultations and more than 24,000 people were admitted as inpatients to MSF supported hospitals and health clinics. 3,878 surgeries were performed, 1,249 of which were injuries caused by violence. Medical teams treated 1,036 people suffering from the deadly neglected disease kala azar, more than 4,000 for malaria and started 1,556 people on tuberculosis treatment. Nearly 35,000 people suffering from malnutrition were provided with food and medical care and 82,174 vaccinations were given. Nairobi/Brussels - After nine years of providing health care for the population in Bakool region, Médecins Sans Frontières (MSF) has reached the regrettable conclusion that we do not have sufficient security to continue our work. This decision was MSF’s alone and we were not expelled by the authorities. Our medical activities elsewhere in Somalia continue. Somalia is a very difficult place to provide humanitarian assistance as was underlined by the abduction of two MSF medical staff in Bakool in April 2009. MSF is grateful that the incident was resolved positively with the help of the community. However, following the abduction and other serious incidents over the past year, MSF can no longer safely provide quality medical care to the people living in Bakool. For the past months, MSF has run the project from a distance, complemented by short visits of international technical support staff. With the abduction, the possibility of even this approach has been eroded. “Given the immense needs in Bakool and beyond we have continued to work under difficult circumstances, but unfortunately we now have to concede that the risks there have reached unacceptable levels,” said Jerome Oberreit, Director of Operations at MSF. MSF hopes that despite our departure the population of Bakool will find ways to mitigate the loss of services provided by MSF and that they will recognize the efforts by our Somali staff for the past nine years. MSF activities in Bakool include the Health Centre in Huddur – the largest in-patient facility in South and Central Somalia - and four outlying health posts in Labatan Jerow, El Garas, El Berde and Rabdure. During the nine years of the program, the Huddur Health Centre expanded from a single feeding centre for malnourished to a fully functional Health Centre with a capacity of 278 beds and 157 staff receiving continuous training. Since 2002 the Huddur Health Centre and the health posts have provided 272,700 outpatient consultations, while 11,075 have been admitted to the Health Centre. 3,314 of these were treated for Kala Azar and 945 for Tuberculosis. 1,913 children have been treated for severe malnutrition. In the past 14 months, MSF has been forced to close four projects due increasing insecurity including abductions and fatal attacks on our staff in Somalia. The continued free medical activities that MSF provides in the regions of Banadir, Bay, Galgaduud, Hiraan, Lower Juba, Middle Shabelle, Lower Shabelle and Mudug will depend on the communities and authorities providing conditions that prevent such incidents toward our staff and health facilities.