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The situation in the three republics of the North Caucasus region of the Russian Federation remains volatile. Nearly every day there are attacks and violent incidents, and the insecurity worsened during the latter half of the year when the number of suicide bomber attacks increased alarmingly. MSF has been providing support to hospitals and through clinics and has been raising awareness of the mental health problems caused by the conflict.

Medical situation and priorities

Healthcare needs vary across the North Caucasus regions in Russia. For MSF, the priorities are to provide treatment for tuberculosis (TB), to offer psychosocial support, and help vulnerable groups such as displaced people and illegal migrant workers who have experienced neglect or violence. Prevalence of all strains of TB remains high, particularly in Chechnya where the entire health infrastructure was ruined during the war. Furthermore, there is an irregular supply of TB drugs, the necessary diagnostic tools are not yet in place, and infection control measures are unsatisfactory. In the region of Ingushetia in the south of the country, the mental health of the population is also becoming a serious concern. Intense insecurity coupled with political instability has exacerbated chronic psychological problems.

Throughout 2009, MSF doctors continued to offer free paediatric care in two clinics in Grozny in the south, and to provide women with free healthcare in two clinics in the nearby Staropromyslovsky district. Together these clinics gave consultations to more than 1,500 women every month, many of whom were displaced or from low-income, rural families. MSF also supplied drugs and medicines to a hospital in Grozny and to regional health centres in three mountainous villages.

After several years’ absence, MSF returned to Dagestan, again in the south, to provide treatment for migrant workers and internally displaced people in a health centre there.

MSF has started to hand over its support for the TB programmes in the more stable northern area of Chechnya as mental health activities respond to acute psychosocial needs and support patients with chronic conditions. In July 2009, MSF also ended its surgery and physiotherapy programme in the main hospital in Grozny, since fewer patients required treatment for injuries and chronic disabilities that occurred during the war.

Access to the mountainous southern region remains a tough challenge due to the remote location of the communities. MSF’s priority is to improve the treatment for TB, including drug-resistant forms of the disease.

MSF has worked in Russian since 1988 and the North Caucasus since 1995.

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