MSF calls for all parties to the conflict to respect safety of civilians The resumption of fighting in Mogadishu, Somalia’s capital, has forced the majority of people living in the Yaqshid, Karan and Abdul Azziz districts in the north of the city to flee, according to the medical humanitarian organization Médecins Sans Frontières (MSF). Continuous shelling, explosions, and open combat among various armed groups have claimed the lives of dozens of civilians and plunged the city into chaos. As a consequence, MSF has been forced to close its medical centres in the area. Last week, MSF closed a pediatric hospital and three health clinics in the north of Mogadishu. MSF staff – like the rest of the population – have had to flee to safeguard their own lives and those of their families. This is the first time in the 17 years that MSF staff working in north Mogadishu have had to flee for their lives. The MSF teams were performing an average of 2,500 outpatient consultations per week, and were treating nearly 400 malnourished children when they were forced to cease operations. In Daynile Hospital, located on the western edge of Mogadishu, MSF medical teams have treated 869 wounded people and performed 49 operations since the beginning of May. Among those receiving emergency treatment, 162 were children under the age of 14, and 156 were women. Twelve patients have died from their wounds.  “In the past two months, an estimated 200,000 people have had to flee towards Afgooye and Jowhar,” said Monica Camacho, general coordinator of the MSF mission in Somalia, based in Nairobi. “The population is terrorized, and in the past two weeks the number of dead and wounded has drastically increased. It has become impossible to provide medical and humanitarian assistance to those in need,” added Camacho.   Along the road to Afgooye, west of Mogadishu, half a million people are living in temporary shelters made from sticks and plastic sheeting and there is very limited access to healthcare. There is a desperate shortage of food and water, and settlements of internally displaced people are overcrowded, posing a serious risk for epidemics, such as measles or cholera.  MSF calls on all parties to the conflict to respect the organization’s medical structures and the work of Somali staff – health professionals who have managed to provide vital medical and humanitarian aid in some of the worst conditions imaginable.   “Some of the medical structures in the north of Mogadishu had been taken over by armed men,” said Alfonso Verdu, operations manager for MSF in Somalia. “All the patients who were being treated in MSF medical structures in the past two weeks have fled or have had to be evacuated. Many of them have had to interrupt their treatment, which is extremely worrying. Practically no one remains on the streets of north Mogadishu.”  In the past three months, MSF has experienced numerous security incidents.  In April, two staff members were kidnapped in Huddur, in the Bakool region in the space of one week. On June 18, an MSF employee died in an explosion which killed 30 other people. Later in June, an MSF vehicle in North Galcayo was attacked, resulting in death of the mother of a patient. These recent incidents and the general deteriorating security environment of the past two years have made the work of MSF in Somalia increasingly difficult.   “Despite all that has happened, we want to continue working in the country. The needs are huge and the main victims of this conflict are civilians,” said Benoit Leduc, head of operations for MSF in Somalia. “We can see it in our hospital in Daynile, where most of the patients are women and children. We are again calling on all the parties to the conflict to respect the safety of civilians and guarantee the humanitarian space necessary to treat the wounded.”  MSF has worked continuously in Somalia for more than 17 years and is providing medical care in nine regions in the country. In 2008 alone, 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 were 3,878 surgeries, 1,249 of which were injuries due to 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.