MSF halts humanitarian programs in Somalia

International medical charity Medicines Sans Frontieres said on Wednesday that it has closed its humanitarian activities in Somalia due to increased insecurity on its staff. MSF's international president Dr. Unni Karunakara told a news conference in Nairobi that the medical charity has informed the Somali government of the drastic decision which comes after 22 years of provision of humanitarian aid in the Horn of Africa nation. "We are ending our programs 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," Karunakara told journalists. The charity will be closing its medical programs in the capital Mogadishu and the suburbs of Afgooye and Daynille, as well as in Balad, Dinsor, Galkayo, Jilib, Jowhar, Kismayo, Marere, and Burao where over 1,500 staff provided a range of services. "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," he said. Karunakara said MSF was forced to take this drastic decision due to extreme attacks on its staff in an environment where armed groups and civilian leaders increasingly support, tolerate, or condone violence against humanitarian aid workers. During MSF's 22-year history of working in Somalia, 16 MSF staff members have been killed and the charity has experienced dozens of attacks on its staff, ambulances, and medical facilities since 1991. The closure effectively cuts off hundred of thousands of Somali civilians from humanitarian aid and has been one of the hardest decisions MSF has had to make in its history. Karunakara said civilians in Somalia will ultimately pay the highest cost, adding that 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," he said. According to Karunakara, 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. "Over its 22-year history in Somalia, MSF has negotiated with armed actors and authorities on all sides," Karunakara said. 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. He said the exceptional humanitarian needs in the country have pushed the organization and its staff to tolerate unparalleled levels of risk -- much of it borne by MSF's Somali colleagues -- and to accept serious compromises to its operational principles of independence and impartiality. The most recent incidents included 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. In 2011, Al-Shabaab abducted the two Spanish women, Serra from Girona (Palafrugell) and Thiebaut from Madrid, both working as logisticians for MSF and took them across the border into Somalia. The abduction was the third incident of foreigners being abducted in the East African nation which neighbors the lawless Horn of Africa nation in just over a month in October 2011. "These two incidents are just the latest in a series of extreme abuses. Fourteen other MSF staff members have been killed, and the organization has experienced dozens of attacks on its staff, ambulances, and medical facilities since 1991," Karunakara said. He said beyond the killings, abductions, and abuses against its staff, operating in Somalia meant MSF had to take the exceptional measure of utilizing 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. Karunakara said humanitarian action requires a minimum level of recognition of the value of medical humanitarian work, and therefore the acceptance by all warring parties and communities to allow the provision of medical assistance, as well as the operational principles of independence and impartiality. "Furthermore, these actors must demonstrate the capacity and willingness to uphold negotiated minimum security guarantees for patients and staff," he said.