Growing Insecurity Forces MSF to Leave its Largest Health Center in Somalia

After nine years of providing health care for the population in
Bakool region, Doctors Without Borders/Medecins Sans Frontieres (MSF)
has reached the regrettable conclusion that it does not have sufficient
security to continue its work. This decision was MSF's alone and the
organization was not expelled by the authorities. MSF 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 several 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 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 Center 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 Center
expanded from a single feeding center for malnourished to a fully
functional Health Center with a capacity of 278 beds and 157 staff
receiving continuous training.

Since 2002 the Huddur Health Center and the health posts have
provided 272,700 outpatient consultations, while 11,075 have been
admitted to the Health Center. Of these, 3,314 were treated for Kala
Azar and 945 for Tuberculosis. Additionally, 1,913 children have been
treated for severe malnutrition.

In the past 14 months, MSF has been forced to close four projects
due to 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.

The international medical organization Doctors Without
Borders/Medecins Sans Frontieres (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 visit 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. There was
a total of 3,878 surgeries 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.