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In Darfur, two million people are still living in displaced persons' camps. While the health situation may be acceptable, living conditions are very precarious. In addition, the security situation has been worsening in the region for several months, making it impossible to gain access to certain populations in Northern and Central Darfur. Attacks against humanitarian organizations are hampering aid efforts.

An interview with Jean-Sébastien Matte, Doctors Without Borders/Médecins Sans Frontières (MSF) head of mission in western Darfur.

How would you describe the situation of the displaced persons in Darfur?
Their living conditions are better than they were three years ago, but have been worsening in the last year and a half. In late 2003 and early 2004, I was part of the team that launched MSF's operations in western Darfur. Compared to that time, there are lots of aid groups in Darfur now. The quantity of water and food distributions has increased and people have shelter. But extreme crowding has continued for three years and the basic supplies that were distributed (including jerry cans, blankets and plastic sheeting for shelters) have not been replaced in one and a half years.

The two million displaced persons remain entirely dependent on external aid. The camps where they are living—which may house up to 100,000 people—are like open-air prisons. It is very dangerous for women to leave the camp in search of firewood. Very few men risk leaving the camp, even to go to a government hospital, because they are afraid of being taken for supporters of a rebel group and being arrested. The displaced persons in Darfur are in an untenable situation.

Is the level of insecurity as high as in the past?
The situation has worsened significantly since May 2006. Instead of bringing peace, the agreement signed at that time between the Sudanese government and just one of the rebel groups has had the opposite effect. The factions that did not sign have splintered and are fighting among themselves. This has repercussions for the population and for us, humanitarian aid workers.

Incidents targeting aid organizations have increased during the last three months. We are increasingly targeted for attacks, beatings, and robberies. Since May, there have been more than 12 deadly incidents affecting all aid groups. That is more than the total number of incidents over the two previous years.

How has that affected our operations?
We carry out major operations on behalf of some 200,000 people in Niertiti, Zalingei, and Mornay. However, our activities have been cut back and that is certainly not optimal.

Today, because of growing insecurity we cannot travel on the roads between our three projects. Therefore, since the end of September, it's no longer possible to transport by car, patients from Mornay and Niertiti who need surgery to the Zalingei referral hospital.

The security situation has also made it impossible for us to reach the Jebel Marra, the mountainous region in Darfur's center, a rebel area where nearly 100,000 people live. In mid-September, while a six-week cholera epidemic raged, we had to evacuate from Kutrum, a village where we had been treating the sick. We left supplies on-site there and have been trying to monitor the situation. There must be several hundred cases and people are dying for lack of assistance. We cannot determine the mortality rates linked to cholera, but we think they are quite high.

All of northern Darfur is also off-limits to us as neither the government nor the various rebel groups will permit us access. Do the civilian populations have access to water, food and medical care? We don't know.

What is the outlook in the coming months for humanitarian aid organizations and the Darfur populations?
We are continuing our operations at the displaced persons' sites where we can still work. However, insecurity remains a real problem. Our teams are caught between two sets of conflicting statements. On the one hand, the international community is leading the displaced persons to believe that U.N. troops will make it possible to restore peace. On the other, the government responds with propaganda likening foreigners to "new crusaders." The result in the field is that our teams become targets. We need the warring parties to respect our aid work.