Darfur: The crisis continues

Last year's scorched-earth campaign has been replaced by less overt, but equally devastating, forms of violence and intimidation against civilians, which still include sporadic fighting, beatings and sexual violence.

Not only do they struggle with physical ailments but many suffer from mental trauma related to both the violence that drove them to these camps and the uncertainty that keeps them there.

By mid-2005 more than two million people had been displaced by the ongoing violence plaguing the region. This number includes more than 200,000 people who have fled to neighboring Chad.

However, last year's scorched-earth campaign has been replaced by less overt, but equally devastating, forms of violence and intimidation against civilians, which still include sporadic fighting, beatings and sexual violence. In all locations where MSF provides medical care, teams continue to see a significant number of victims of direct violence.

From January to May 2005, MSF staff treated more than 500 people for violence-related injuries and 278 women for rape. Rape and sexual violence remain pervasive, inflicted on women and girls who must venture beyond the borders of camps to find firewood, water and food for their families.

Although late to arrive, humanitarian assistance has increased significantly during the past year. Faced with high rates of diarrhea, respiratory infections, and malaria; appalling water and sanitation conditions in many areas; and outbreaks of meningitis and hepatitis, MSF has worked to provide medical care, nutritional help and safe water.

Despite these improvements, the living conditions of the people in Darfur remain precarious. And while health indicators in some of the biggest camps and settlements have improved, aid has not reached some remote areas or parts of rebel-held territory.

Obstacles to giving aid

Security remains a limiting factor for the adequate provision of medical assistance in Darfur. Given the size of the region and the dispersed population, access is highly dependent on road transportation, which is sometimes interrupted by logistical problems and weather, but mostly by insecurity. With hundreds of international staff and more than 4,000 national staff operating in 32 locations across the region in July 2005, MSF continues to make a priority of providing aid in Darfur.

In the past year, teams throughout the region conducted more than a million medical consultations and treated more than 50,000 children suffering from malnutrition. MSF has also spoken out on a number of occasions, including before the UN Security Council, on what its teams have witnessed and called on other actors to provide more help to the region's civilians.

For the majority of the displaced people with whom MSF teams have spoken, returning home now is not an option. Some have started to buy land or construct homes with more permanent materials. Many have found ways to earn money, and others, who have become accustomed to living near medical services and schools, now prefer to stay in a more urban environment.

Some of those who do attempt to leave the camps face continued intimidation and direct violence, and many end up returning to refuges that pose similar dangers but offer security in numbers and the limited, daytime presence of humanitarian aid organizations.