Pakistan: MSF Forced to Reduce Emergency Activities in North-West

The international medical humanitarian organization Doctors Without
Borders/Medecins Sans Frontieres (MSF) has had to halt its emergency
medical services in the Swat region of Pakistan and reduce activities
in other areas affected by the current warfare. The organization was
the only one supporting the hospital in Mingora and providing ambulance
services in Swat. The reduction of MSF's activities is a result of the
general insecurity, in addition to a number of direct incidents against
MSF itself.

"Even before this new offensive, civilians in north-western Pakistan
were already struggling to survive a terrible situation," said Brice de
le Vingne, Brussels-based coordinator for MSF's programs in Pakistan
and Afghanistan. "Today, curfews, roadblocks, and intensely fierce
warfare make it virtually impossible for them to reach hospitals and
clinics. They are literally locked into this situation of extreme
violence. On top of that, it is largely impossible for our medical
teams to assist them."

Unknown numbers of people cannot escape the warfare. Trapped in
their homes, they cannot go out to buy food, obtain clean water, or
visit a doctor if they need to.

MSF calls on all parties to respect the rights of injured civilians
to medical treatment and to provide space for MSF to assist them
without being subjected to further violence, threats, and intimidation.
As a priority, MSF needs to be able to evacuate wounded people and
replenish Saidu Sharif Hospital in Mingora with urgently needed medical
supplies.

"This is a completely untenable situation," said De le Vingne. "It
has gone from dire to absolutely desperate. And there is every chance
that things will get even worse. Right now, exactly when the risks
facing people are radically increasing, we are simply not able to set
up much of the necessary lifesaving activities."

Hundreds of thousands of people are seeking refuge in less insecure
parts of Pakistan. They often stay with host families, putting extra
strain on local resources including health care, or in improvised camps.

In Lower Dir, MSF continues to provide clean water and basic health
care to displaced people in two camps. In Peshawar, MSF is preparing
for a possible arrival of more displaced, including injured civilians
who cannot find treatment closer to home. MSF has a team on standby in
Dargai to assist all those who need surgery.

From December 2007 to December 2008, during curfew hours, MSF
ambulances transferred approximately 1,300 war-wounded and other
patients from various parts of Swat to Saidu Sharif and hospitals in
Peshawar and Islamabad. In September, MSF treated nearly 4,000 cholera
patients during an outbreak of the disease. Such lifesaving assistance
is no longer possible.

Other MSF activities in Pakistan-in Baluchistan, Kurram Agency, and
in the Peshawar area-continue uninterrupted. MSF works in three basic
health structures in the Peshawar neighborhoods that are hosting
families displaced by the war, and has supported a camp in Charsadda
and distributed essential non-food items to over 30,000 displaced
people in Peshawar, Charsadda, and Mardan since August.