MSF tentative return to Somalia

MSF is striving to return to work at full capacity in all of its projects, but the renewed instability in the country means that this is far from assured.

Over the past weeks, conflict has once again ravished the stricken East African state of Somalia and the consequences on the population and delivery of humanitarian aid are severe. While full MSF teams are quickly returning to projects across the area, providing security for staff is extremely problematic.

For instance, on 27 December, representatives of military forces entered the MSF medical facility in Dinsor, pressured the Somali medical staff employed by MSF, and confiscated all in-patient confidential medical files.

Somalia has been without an effective central government since the fall of Siad Barre in 1991. Since then, continuous clan inter-fighting and shifting alliances has made the country one of the most difficult in the world in terms of providing humanitarian assistance. It has also left Somalia with some of the worst health indicators on the planet. According to available UN statistics, more than one quarter of Somali children die before their fifth birthday and those who survive have a life expectancy of just 47 years.

The Islamic Courts, who by September last year controlled most major towns in the country, provided a degree of stability in areas of Somalia which had been completely inaccessible to international aid workers for over a decade. In early 2006, MSF was able to open two major projects in the province of Galgaduud, a region almost devoid of healthcare since the early 1990s.

"The almost total defeat of the Islamic Courts has thrown the country back into a state of confusion," explains MSF head of mission Colin Mcllreavy. "For example, we are currently assessing options to return to the town of Marere, but the lack of a settled administration means that we have no reliable partners to work with. Until this changes, we are unable to send our medical teams back in to the area."

By December 23, full-scale war had forced MSF to withdraw international staff from seven locations across south and central Somalia. While projects were maintained by national staff, this temporary withdrawal caused a significant loss of oversight and expertise.

Teams were returning to the country by early January, but security remains extremely uncertain than ever. Among the first areas to return were those such as Huddur and Dinsor, respectively in the Bakool and Bay Provinces, which were always under the sway of the Transitional Federal Government (TFG), the entity which now ostensibly runs the whole of Somalia with support from the military intervention of neighbouring Ethiopia.

A four-person team has also returned to the hospital in Galkayo, a reduced team returned to Galgaduud on 10 January and MSF hopes to be able to re-start in Beledweyne and Jowhar in the coming week. MSF representatives have traveled to Marere, an area formerly under control of the Islamic Courts, to establish links with the new administration. This region on the Jubba River is of particular concern as it recently suffered severe flooding which forced thousands of people from their homes.

MSF is striving to return to work at full capacity in all of its projects, but the renewed instability in the country means that this is far from assured.