Top Ten Humanitarian Crises reveal growing insecurity, neglected health needs

Médecins Sans Frontières Releases 11th Annual List

Massive forced civilian displacements, violence, and unmet medical needs in the Democratic Republic of Congo, Somalia, Iraq, Sudan, and Pakistan, along with neglected medical emergencies in Myanmar and Zimbabwe, are some of the worst humanitarian and medical emergencies in the world, the international medical humanitarian organisation Médecins Sans Frontières (MSF) reported today in its annual list of the "Top Ten" humanitarian crises.

The report underscores major difficulties in bringing assistance to people affected by conflict.  The lack of global attention to the growing prevalence of HIV-tuberculosis co-infection and the critical need for increased global efforts to prevent and treat childhood malnutrition—the underlying cause of death for up to five million children per year—are also included in the list.

"The worldwide financial crisis is hitting our community hard. But elsewhere, millions of people are confronted with crisis of a totally different order," says Dick VAN DER TAK, the Executive Director of MSF Hong Kong. "With the release of this Top Ten, MSF aims to highlight the plight of millions of people who struggle every day for their survival. They are trapped in violence or conflict, affected by epidemics and disease, and their stories often go untold.  By raising their plight MSF hopes that they will not be forgotten."

"In some of these places, it is extremely difficult for aid groups to access populations requiring help.  Where we are able to provide assistance, we have a special responsibility to bear witness and speak out about intolerable suffering and draw attention to basic humanitarian needs—needs that are often largely ignored," says Dr. Christophe FOURNIER, MSF International Council President.

Many of the countries on this year's list illustrate the ever-shrinking space for impartial humanitarian action, making it extremely difficult to deliver aid to those most affected and vulnerable.  Aid organisations now operate with increased security risks and in generally more hazardous and threatening environments. In highly politicized and volatile conflicts such as those in Somalia, Pakistan, Sudan, and Iraq, MSF - despite its neutrality and independence - is limited in its ability to directly address immense medical needs.

In Somalia, intensified violence, including direct attacks and threats against aid workers, meant that MSF had to curtail some of its operations in 2008, including the withdrawal of its international staff, significantly reducing the quality of assistance provided to an already weakened population. In Pakistan, hundreds of thousands of people fled air attacks and bombings from a counter-insurgency campaign in the northwest area earlier in the year. After aid workers in the country were threatened, attacked, and kidnapped, MSF restricted the number of international staff in its projects.

In places such as Myanmar and Zimbabwe - where governments fail to make health care a priority or view NGO interventions with suspicion - humanitarian organisations are either limited in the type of assistance they can provide or are left to deal with overwhelming health crises on their own. In Myanmar, where MSF is the main provider of HIV care, hundreds of thousands of people are needlessly dying due to a severe lack of HIV/AIDS treatment while the government does far too little to help its own people.

Governments are also ignoring the crisis of childhood malnutrition. In Niger, the government in 2008 forced the termination of MSF's child nutrition program in the region of Maradi, where tens of thousands of children were suffering from acute malnutrition.  As a result, they have not received proven and highly effective treatment.  The closure came at a time when efforts to make progress in the fight against malnutrition globally are more possible - and more necessary - than ever.

"The reality on the ground is that the humanitarian community is unable to do nearly enough for populations in grave need of medical assistance," Dr. Fournier says. "With the release of this list, we hope to focus much needed attention on the millions of people who are trapped in conflict and war, affected by medical crises, whose immediate and essential health needs are neglected, and whose plight often goes unnoticed."

MSF began producing the "Top Ten" list in 1998, when a devastating famine in southern Sudan went largely unreported in U.S. media. Drawing on MSF's emergency medical work, the list seeks to generate greater awareness of the magnitude and severity of crises that may or may not be reflected in media accounts.

"Top Ten" Humanitarian Crises of 2008