Darfor: Security and Hunanitarian Updates

Quote: Increased insecurity combined with decreased international aid in the troubled region of Darfur are adding to the misery of the population. Access to those in need is at an all time low, whilst disease and violence remain a daily fact of life for the millions who have been displaced since the beginning of the conflict in 2003. Today, most are entirely reliant on the dwindling external humanitarian aid and the threat of full-scale war is once again looming. Medecins Sans Frontieres (MSF) has been running projects in Darfur since early 2004 and today has five sections on the ground, with 123 international and 2233 national staff working across the three provinces. With a total budget in Darfur for 2006 of nearly 20 million Euros, it is one of the most significant operations in the world for MSF. North Darfur and the Jebel Mara In Kebkabiya, some 200 kilomteres to the north of the provincial capital, El Fasher, MSF is running three dispensaries in town and providing logistical support and medical supplies to the 67-bed hospital. In El Fasher itself, a cholera outbreak is currently being followed up by the MSF teams. 120 cases had been reported by 8 September, with 6-7 admissions daily. MSF is working to set up a cholera treatment centre in the hospital. A recent spate of insecurity is severely hampering operations in this area, with the projects in Kebkabiya only accessible by helicopter from El Fasher, due to a number of incidents against humanitarian agencies on the road. In Sarif Umra, following an attack by armed men, the project is being run by a skeleton team, whilst in Korma, the project has been closed due to security constraints. Ambulatory medical projects are particularly vulnerable to attack on the roads and an outreach project to Kaguro in the Jebel Mara region has also been put on hold. The Jebel Mara- a mountainous area in the centre of Darfur- has been especially affected by the increased insecurity. In June 2006, MSF began work in clinics in Killin and a month later in Gorni. However the project was evacuated for security reasons on 22 July when an MSF convoy was attacked on the Guildo-Golo-Killin road (only access road to Killin). The convoy was robbed and the staff beaten up. Niertiti is a town of around 3000 residents and as many as ten times that number of displaced in the foothills of the Jebel Mara. MSF has been running a hospital here since March 2004 and today is the only medical agency working in Niertiti.1128 hospital admissions were registered in the first six month of 2006. Mobile clinics from Niertiti for local nomadic populations were abandoned in the summer, once again due to insecurity. In the Jebel Mara itself, MSF has been running a healthcentre in rebel-held Kutrum since March 2006. However, this project was evacuated on 14th September. West Darfur In Zalengei which today counts a population of around 20,000 residents and 95,000 displaced, MSF deals with pediatric care (around 180 admissions per month), a surgical block and post-operatory care (including an influx of 52 injured during several days in December). In Mornay, the vast camp for the displaced houses around 80,000 people and the population is virtually cut off from external aid. MSF has been working here since 2004 and has constructed a hospital and a health centre. In the first half of 2006, an average of nearly 4900 medical consultations were carried out every month and 293 children were admitted into the MSF nutritional centre between April and July. Bordering Chad, in Um Dukhun MSF offers surgical care, in-patient care, laboratory services and general out-patient care including basic health, antenatal and nutrition. Outreach workers assist with health education and referrals. Following a recent influx of 12,000 refugees and displaced people, MSF assisted with medical care, a measles vaccination and provision of non-food items. In Shangil Tobaya, MSF provides healthcare services for the displaced people living in the Shangil and Shadat camps, as well as in Shangil Tobaya village. This project was evacuated on 23 July after a security incident and due to the overall deterioration of the security situation in the area. It officially re-opened on 20 August but with reduced activities and international staff. In Habilah, which houses over 22,000 displaced and a 7,000 resident population, MSF runs a medical clinic with 20-bed inpatient ward. This includes therapeutic feeding for severely malnourished children and ante-natal care and delivery. Outreach workers assist with health education and referrals. In Kerenek, with over 22,000 displaced, MSF runs a clinic with a 30-bed ward. Combined, these two projects carry out over 4,500 consultations per month. Mobile clinics provide medical care for mostly nomadic populations around these two areas. In October 2006, a new project will open in the northern corridor of West Darfur, in the town of Seleah, where about 160,000 people live with very little assistance and access to medical care. South Darfur With around 90,000 people, Kalma remains one of the largest displacement camps in the world. MSF is running a primary health clinic with almost 1000 consultations per week, a women’s health centre with ante- and postnatal care, delivery assistance and treatment for sexual-gender based violence. The project is complemented by community outreach activities and a mental health programme addressing the profound psycho-social stress and trauma experienced as a result of the current living conditions and uncertainty, as well as past and continuing conflictrelated psychological trauma. In Muhajariya, a town with a population of more than 45,000, MSF offers surgical care to war-wounded, emergency obstetric services and inpatient and outpatient departments. Mobile clinic teams provide basic health care services weekly to the towns of Labado and Angabo, as well as assisting displaced communities in the countryside. In Shariya, despite numerous evacuations due to insecurity, MSF manages to support the local primary health clinic and has mobile teams visiting the displaced around the region, including weekly clinics to Khazan Jedid, Um Shegera and Teisha when possible. Emergency preparedness A primary focus for MSF is to be able to react quickly to outbreaks of disease, fighting or new displacement throughout the whole region. In the past months, emergency teams have responded to an outbreak of watery diarrhea and cholera in Kalma camp, organised measles and meningitis vaccinations, and distributed plastic sheeting and emergency food rations to new groups of displaced. Currently, MSF is also working in Mornay to combat a cholera outbreak which has already claimed eight lives. MSF is also continuously lobbying for increased aid and improved access in the region

Quote: Now it is not about politics, races or selfishness it is about lives of innocent people found themselves in the middle of the worst human crisis in the world…. our people, our brother and sister in Darfor…

Quote: : In Mornay, cholera follows reduction in aid Eight people — including a child under five — have died from cholera in Mornay, western Darfur, in the last two weeks. Médecins Sans Frontières (MSF) team has already treated more than 60 patients. This situation occurred after various aid agencies withdrew assistance to people living in the Darfur displaced persons' camps. All the conditions contributing to cholera's appearance are present in Mornay. In 2003, it was a small village of 5,000 inhabitants. Today, more than 75,000 people have taken refuge there, fleeing killings and violence. For more than two years, people have been crammed into makeshift shelters. The crowding, lack of latrines, poor waste management, and inadequate drainage combine to make the displaced persons particularly vulnerable. MSF set up the water distribution system in 2004. It was later managed by Oxfam and is now overseen by WES, a local organisation funded by UNICEF. Today, that system is failing—both in terms of quantity and quality. While a minimum of 20 liters of water per person per day is required to meet daily needs, the displaced persons receive only 12. In addition, two water boreholes were replaced by a system that pumped water from a well that proved to be muddy and contaminated by bacteria (fecal coliform). The muddiness makes it difficult to chlorinate the water. Several broken water taps have not been replaced. Funding in free fall - aid dropping "Cholera has appeared and eight people are already dead," says Hiam El Zein, head of MSF's mission in western Darfur. "These deaths are the result of inadequate aid to the displaced persons. In Mornay, as at other sites where tens of thousands of displaced persons have assembled, some organisations are pulling back from vital services. That may be because donors governments and institutions have stopped or reduced their funding or because these groups have become involved in development activities. In Mornay, UNICEF has not kept its promises because of lack of financing." Indeed, in June 2006, UNICEF announced that it had received only 3.1 percent of the funding required from donors (primarily Western governments). Of the $89 million necessary, only $2.81 million had been paid. As a result, in Mornay, WES is not receiving sufficient UNICEF funding. The lack of proper and regular maintenance of the water supply system—along with the poor health conditions in which the displaced persons have been forced to live for more than two years—is crucial to explaining why cholera has appeared in the camp. The MSF team in Mornay treated the patients quickly and set up a cholera treatment center in tents next to the hospital. Eight satellite rehydration centers were also set up. In a camp like Mornay, more than 2,000 cases may be expected. Everything is ready in case the treatment center needs to increase its capacity to 180 beds if the number of patients rises significantly. Tragic consequences for the displaced persons "We also have to invest in the water distribution system again because WES does not have the staff or all the necessary UNICEF funding to do it," El Zein added. "We are going to set up a system that will allow us to use surface water, which is clear, and then decontaminate and chlorinate it. Our teams have also helped to apply chlorine spray to the contaminated areas." In 2005, when many aid organisations arrived in Darfur, MSF pulled back from managing the water distribution system to refocus on medical activities and remain responsive to new emergencies. The need for assistance was, and remains, very high for the populations who must live in these camps. They are totally dependent on external aid for their survival. Although the Darfur situation is now of a more chronic nature, punctuated by violent episodes, there is still a state of emergency. The people have the same assistance needs and reduced aid can have tragic impacts on their living conditions. Last May, MSF was troubled by the effects of reduced World Food Program (WFP) food distributions during the most critical period of the year, resulting from lack of funds. Today in Mornay, MSF is witnessing the tangible effects of aid agencies' withdrawal on the health of displaced persons.