Access To Medical Care Dangerously Scarce In and Around Mogadishu, Somalia

Nairobi, 20 August 2007 — Access to medical care and assistance for civilians and displaced persons in and around the Somali capital of Mogadishu has decreased alarmingly in the past months, according to the international medical humanitarian organization Médecins Sans Frontières (MSF). MSF is urgently calling upon all parties to the conflict to respect the need for medical staff to work unimpeded and for residents and displaced people in and around Mogadishu to have safe access to medical care.

MSF medical teams have found a severe decrease in the level of medical care available in Mogadishu over the past six months. According to estimates gathered by MSF international staff, as of today, less than 250 out of the 800 hospital beds available in Mogadishu in January are still in service. Since then, three quarters of the staff in several of these hospitals have also left.

"With bombings and shootings nearly daily occurrences in Mogadishu, people in need of medical care are terrified to leave their homes, medical personnel are fleeing the city, and hospitals are closed or barely functioning," said Dr. Christophe Fournier, MSF International Council President, who has just returned from Mogadishu. "People are not being treated for basic ailments, let alone emergency needs. The lack of respect for allowing doctors to work and for the sick and wounded to receive treatment is shocking and absolutely unacceptable."

MSF has treated nearly 60,000 people in its out-patient facilities in and around the city since January, but insecurity has prevented the organization from opening desperately needed medical services for more severe and surgical cases. MSF is angered and deeply unsatisfied with the level and quality of care it is currently able to provide for civilians in Mogadishu and for displaced people around the city.

"We should be able to open emergency and surgical services in Mogadishu, send out ambulances to reach the sick and wounded, and bring them back for treatment," said Dr. Fournier. "But, after months of trying, we still can't even move about the city freely to assess the needs and provide the quantity and quality of care that we know is needed. We want to do more, as do the Somali doctors remaining in the city, but we are increasingly frustrated and outraged that not enough is being done by all parties to ensure safe access to medical care in Mogadishu."

Violence in Mogadishu has also caused hundreds of thousands of people to flee the city since January. Since the beginning of the exodus, a total of 20,800 families (approximately 120,000 people) arrived in the Afgooye region west of Mogadishu, including approximately 5000 new families (approximately 30,000 people) in July alone. Many are living in miserable conditions with little assistance, inadequate water and shelter, and no stable source of food. In Hawa Abdi, 17 kilometers west of Mogadishu, a rapid health assessment carried out by MSF in June of 641 children living with their displaced families indicated a global malnutrition rate of 21.5 percent among children under the age of five and a severe acute malnutrition rate of 3 percent — a nutritional emergency, according to World Health Organization standards. More than 60 percent of these families had no source of income, while 93 percent said they had either already run out of food or had little left. In July, nearly 38 percent of the 1424 children under five who visited our clinics for the displaced in Afgooye and Hawa Abdi presented signs of acute malnutrition and nearly 12 percent were severely malnourished and at immediate risk of dying.

"The increasing rates of malnutrition and a clear deteriorating trend in the nutritional status that we are finding in children among families who have fled Mogadishu is of extreme concern," said Dr. Fournier. "This is a warning sign that without a dramatic increase in humanitarian assistance and access to medical care for residents of Mogadishu and the displaced in the surrounding regions, the health situation will further deteriorate. Immediate action must be taken to assure that children, the sick, and the wounded do not suffer or die needlessly because they cannot receive medical care."

MSF has been present in Mogadishu since 1991 and is now working in three locations in the Somali capital, providing different medical services. Since April 2007, MSF has been providing primary health care, water, and non-food items to displaced persons from Mogadishu in the Afgooye and Hawa Abdi region. MSF has worked continuously in southern and central Somalia for more than 16 years and is currently providing medical care in ten regions.