Dr. Christophe Fournier, MSF's International Council president, recently returned from an assessment mission to Darfur, Sudan, and describes the humanitarian situation there as well as the work and the challenges faced by MSF. He also shares his concerns over proposals to create military-protected corridors for the delivery of humanitarian aid to the region.
– Christophe Fournier
How would you describe the situation for civilians in Darfur today?
Over a two-week period, I visited three regions of Darfur and what struck me most was the everyday insecurity faced by people living there. Although the violence may not be as intense as it was in 2003 and early 2004, civilians continue to be killed. The two million displaced people living in camps or settlement areas risk attack whenever they venture to collect firewood or water; effectively turning these areas into prisons, with violence both inside and out. Hundreds of thousands of more people remain out of reach, cut off from humanitarian assistance by the ongoing conflict.
Is this insecurity also affecting humanitarian organizations?
Yes indeed. It also affects humanitarian aid workers. Over the last year we have had to reduce our number of projects, either because fighting forced us to evacuate; or because we were attacked in our compounds; or because of insecurity on the roads. The only way to reach some facilities or run mobile clinics is by car, but there have been an increasing number of attacks against both humanitarian aid workers and their vehicles. Over the course of the last year, more than 100 agency vehicles were stolen and already this year the figure has exceeded 50. This is quite considerable given there are fewer and fewer humanitarian organizations on the roads.
What can we say about the health status of the population? Are they getting basic health assistance?
In the biggest settlements and displaced camps, people are receiving food, water, shelter, and basic health care, but only because of the unprecedented relief activities in Darfur. In our health facilities we provide assistance to around 500,000 displaced people, among whom diarrhea and respiratory infections (mostly in children under 5) are the main problems seen by our medical staff. In places further from the main towns, where MSF has recently been able to assess the health situation, we continue to find measles, meningitis, and malnutrition. People are completely dependent on humanitarian assistance for their survival. For the people who remain out of reach because they were displaced by the conflict or cannot reach cities or camps, it is difficult to say. We have almost no access to these populations so it's hard to comment on their health status. This lack of information is clearly very worrying.
Can you give us the picture of what are the main activities of MSF in Darfur in response to the needs of the population?
The presence of other humanitarian organizations on the ground (there are more than 80 organizations in Darfur staffed by approximately 13,000 humanitarian aid workers) has enabled MSF to focus almost exclusively on medical activities. These programs represent MSF's biggest operation in the world today. Up to 2,000 MSF personnel are providing access to primary health care in towns and displaced camps as well as using mobile clinics to reach other, more isolated populations. In a number of referral hospitals, MSF medical teams also provide emergency care and surgical expertise for the most severe cases, as well as specific health services for people victims of sexual violence.
What are the main challenges for MSF in Darfur today?
Today the main challenge is to reach people in areas without access to aid: the places we had to evacuate due to ongoing fighting and other locations outside the camps. We know that there are scattered populations totally deprived from any humanitarian assistance. Reaching these people is our main objective.
There are a number of actors that are calling for a military intervention in order to facilitate a solution to the conflict. What do you think?
We have to be very clear: MSF is a humanitarian organization. We are in Darfur to provide humanitarian relief and not to find some solution to the conflict. However it's true that a number of solutions are being proposed. We are always concerned to hear other humanitarian actors calling for military interventions. For humanitarian organizations to work in conflict areas it is essential to be neutral and independent. Being perceived as supporting one side over another jeopardizes the security of our teams and restricts access to certain areas and populations.
What strikes me about some of the other solutions being proposed is that they seem to be coming from an overly simplistic analysis of the situation. Since the signature of the Darfur Peace Agreement in May 2006, we have seen a fragmentation of armed actors with dozens of groups involved in the conflict. In some places, factions that used to control their areas are not in control of their people anymore and in others you have renewed fighting between different factions. This is compounded by widespread banditry. The situation is very complex and providing any kind of simplistic solution is questionable.
What about the proposal of military protected humanitarian corridors?
We are talking about an extremely complex situation with widespread violence committed by number of different groups in a region the size of France. I don't see how realistic it is to talk about humanitarian corridors in such a context. In fact, such a humanitarian corridor means that you will see convoys of humanitarian vehicles and goods being escorted by soldiers. In Darfur, if you are using an armed escort or soldiers then you will be perceived by certain warring parties as the enemy. You will lose the neutrality and independence you need to access populations in need. We already find it difficult to reach some areas and certain groups of people. The way we overcome this is by talking to all actors involved to make sure they understand who we are, what we are doing, who we want to help and how neutral and independent we are. Humanitarian corridors could jeopardize this and would do little to help us reach those who need aid most; the dispersed populations outside the camps and cities. Providing aid to these people remains our main objective.