November 1, 2011
© Pierre Boyer/MSF
On May 26, a suicide bomber killed 36 people and wounded approximately 60 more near a police station in northwestern Pakistan’s Hangu district, just a few blocks from the hospital where MSF’s team lives and works. Hospital staff and MSF’s team together treated 58 people in the immediate aftermath.
MSF has been operating an emergency room and a surgical department in Hangu since May 2010, serving a population battered by years of armed conflict between militant groups and government forces. Most of the surgeries in Hangu are performed on victims of violence, including people wounded by bullets, mortars, and knives
On May 18, MSF also opened a 30-bed obstetric and gynecological hospital in nearby Peshawar, another area where pervasive violence limits access to health care, particularly for women. Pakistan has one of the highest rates of infant and maternal mortality in Central Asia. MSF’s hospital provides free, emergency OB-GYN care, including consultations, labor and delivery, surgery, and hospitalization.
The health care system in Bahrain has functioned effectively for many years, its performance boosted by well-trained professionals working in well-developed facilities. When demonstrations began in the tiny nation, however, and the state’s security apparatus started cracking down on protestors, those same health facilities became places to be feared.
SalmaniyaHospital in the capital of Manama, the country’s only public referral hospital, was occupied by the military in March. MSF also received reports that the military attacked health centers in other villages, shot tear gas into clinics, beat patients and staff, and shot at ambulances.
“Health facilities are used as bait to identify and arrest those who dare seek treatment,” said Latifa Ayada, MSF medical coordinator. “Wounds, especially those inflicted by distinctive police and military gunfire, are used to identify people for arrest, and the denial of medical care is being used by Bahraini authorities to deter people from protesting.”
Furthermore, MSF staff member Saeed Mahdi was arrested in May and held for more than a month, until he was finally released.
MSF visited patients who feared seeking treatment and made several public statements and released a report—“Health Services Paralyzed: Bahrain’s Military Crackdown on Patients”—calling on Bahrain to respect humanitarian space and the neutrality of hospitals, and to allow wounded people access to medical assistance, regardless of their religious sect or political beliefs.
MSF has been responding to frequent outbursts of violence in southern Sudan. This comes in the aftermath of last January’s overwhelming vote for independence and the subsequent struggle to define borders and claim territory, particularly in the oil-rich region around the city of Abyei.
Fighting broke out in the area on May 20, driving tens of thousands of people from their homes. MSF was forced to suspend all primary activities in Abyei and instead set up mobile teams along the roads to provide the displaced with medical assistance, food, and relief items like plastic sheeting, mosquito nets, and shelter. And an MSF hospital in Agok, 24 miles south of Abyei Town, treated 50 victims of the violence in the days that followed.
“We have seen thousands of people—mainly women and children—carrying bags on their heads, or sitting on mats on the side of the road, exhausted by hours of walking,” said MSF head of mission Raphael Gorgeu. “We are very concerned about the harsh conditions the displaced population has to endure on the roads.”
© Eric Bouvet
The conflict in Libya has forced MSF to adapt and interrupt its work in the country on several occasions. On March 15, teams were forced to withdraw from the eastern city of Benghazi, where staff had been delivering supplies and performing surgeries in three city hospitals. MSF then returned to Benghazi on March 24.
Blocked from entering the besieged city of Misrata, MSF first sent surgical kits to Libya’s third largest city. After staging two boat evacuations of patients, MSF finally entered Misrata on April 18, providing surgical expertise and trauma training in a number of Misrata hospitals.
Teams also worked along the western border with Tunisia, providing medical care and psychological counseling to people displaced by conflict. Additionally, MSF began working in Zintan, southwest of Tripoli, on April 30, assisting the local emergency unit with large influxes of war-wounded patients. Shelling in the city—some of it very near the hospital where MSF was working—forced a temporary suspension of activities. But a smaller, scaled-down team returned to the city just days later.
Refugees and asylum seekers fleeing the conflict have also reached the Italian island of Lampedusa. MSF has been providing medical aid, psychological counseling and basic supplies since February, and has issued several calls for the Italian government, and other European nations, to take responsibility for the people fleeing the war, since those same nations support the NATO actions in Libya that are driving people out in the first place.
© 2013 Doctors Without Borders/Médecins Sans Frontières (MSF)