On December 27, 2021, Doctors Without Borders/Médecins Sans Frontières (MSF) nurse, Marguerite M., and ambulance driver, Ashu D., were arrested by Cameroonian authorities while providing neutral, independent, and impartial humanitarian aid to people in the South-West region of Cameroon. Just weeks after, two more MSF staff members were detained while providing humanitarian aid. Months later, all four staff members are still detained, and MSF is calling for their immediate release.
For almost five years, South-West Cameroon has been impacted by violence between separatist armed groups and state armed forces. MSF provided free health care to people in the region until March 29, 2022, when we took the difficult decision to suspend activities in South-West Cameroon to focus on obtaining the safe release of our colleagues. The details of the first incident and developments since are outlined below.
Impartial medical care in a volatile region
On the morning of December 26, 2021, Marguerite and Ashu were sent with an MSF ambulance to the Tinto area to pick up a man with a gunshot wound. It was rare for our teams to take care of people injured in the violence, as the majority of MSF ambulance movements are used to urgently transport children with malaria, women in labor, or people injured in road accidents. They reached the man at around 8 a.m., stabilized him, and put him in the ambulance before driving towards Kumba—the largest town in South West Cameroon—in case he needed to be transferred to a hospital for surgery.
As agreed with the authorities, MSF communicated all details of the movement: the departure point and destination of the ambulance, the type of patient, if the patient had identity document, and if they were accompanied by anyone. This is not standard MSF practice, but in this context it was important to ensure ambulances would not be blocked at checkpoints for long periods of time, which could be detrimental to patients. This procedure was formalized in October 2021, and since then, 132 MSF ambulance transfers involving patients with various medical emergencies have taken place without any problems.
The 27-year-old patient had no identification documents, which is not uncommon in Cameroon. Neither Marguerite nor Ashu knew who the patient was or what his role was within the separatist group. They only knew that he was a wounded man in need of emergency medical assistance. On the road, Marguerite began to fill in the transfer forms for the hospital in Kumba. While Marguerite was filling the form with the name the patient gave her, they were stopped at the Nguti checkpoint.
Despite explaining what they were doing, they were denied passage, ordered to turn around, and escorted back to Mamfe. The two MSF colleagues were later arrested and detained in Buea prison, where they remain four months later.
Detained while providing humanitarian aid
When they arrived in Mamfe later that day, the patient was guarded by military authorities and received medical care. Marguerite and Ashu were kept for questioning for a few hours. They were eventually released and ordered to return the next day to give their statements.
The following day, December 27, they were detained at the gendarmerie [armed police force]. They were publicly accused of collaborating with separatist rebels in the area, being involved in an operation to exfiltrate a terrorist, falsifying transfer documents, and giving the patient a false identity.
When informed of these charges and the detention, MSF teams in South-West thought there had been a misunderstanding that would be quickly resolved and contacted authorities to prove that they had followed the full administrative process agreed on. None of the explanations given by MSF or the legal service provided to Marguerite and Ashu—nor Marguerite and Ashu's own testimony of what happened—has secured their release.
MSF has reiterated that it followed the administrative process agreed with authorities for when a patient is not carrying identification. Treating and transferring the wounded and sick is the foundation of what humanitarian organizations do in situations of conflict and violence, no matter what side of the conflict the wounded person is on. Further, providing emergency assistance to people in life-threatening situations is protected under Cameroonian law.
Providing medical care to both sides of the conflict
MSF has specified that, as a neutral and impartial medical organization, it has supported wounded patients from both sides of the conflict in South-West Cameroon, including those from the state armed forces. MSF has reiterated that the transfer and care of patients wounded by gunshots is a minimal part of our work in the region. MSF representatives have explained that MSF’s contact numbers are known in the area to allow people to use them for emergencies and that MSF must talk to all parties to a conflict to ensure access to people who need medical care and to ensure the safety of our teams. By providing these clarifications and explanations to the Cameroonian authorities, MSF has continuously sought the immediate release of our colleagues.
As requested by the Ministry of Defense, the Mandela International Center, an independent Cameroonian organization, published a report exonerating Marguerite and Ashu of any wrongdoing, as well as MSF itself. The report demanded the immediate release of our two colleagues.
Forced to suspend vital medical care
Weeks after the arrest of Marguerite and Ashu, on January 19 and 20, 2022, two other MSF workers were also arrested in a different case. They are accused of collaborating with secessionism. As with Marguerite and Ashu, MSF stands by the legality of the tasks they performed for the medical organization. In both cases, MSF is following the Cameroonian legislative process.
MSF reiterates that its four colleagues were carrying out humanitarian tasks with the neutrality, independence, and impartiality with which humanitarian activities should be conducted, and again demands their immediate release.
MSF took the difficult decision to suspend activities in South-West Cameroon on March 29 to focus on securing the safe release of our colleagues. MSF is in a difficult position: Our medical activities are desperately needed, but providing medical care puts our staff at risk of being prosecuted for doing their work.
MSF has a duty to patients, but needs basic preconditions to be in place that would enable our teams to carry out medical activities in a safe and secure environment. It’s been clear that these preconditions are no longer there, and that medical care is not only unprotected but prosecuted. We can’t put our staff at risk.
Since the detention of our four colleagues, MSF representatives have engaged with the Cameroonian authorities at local and national levels by providing information related to our medical activities to facilitate our colleagues release—but to no avail. MSF remains available to continue the dialogue with the authorities and resolve this issue as soon as possible.