Philip Humphris is Doctors Without Borders/Médecins Sans Frontières' (MSF) head of mission for West Darfur state in Sudan. He has returned from western Darfur and, as the number of aid agencies in Darfur continues to decrease, explains what MSF is doing in this region.
What programs is MSF running in the far western areas of Darfur?
Our work in western Darfur focuses on three major areas. First, our medical teams are working with people affected by the major wave of violence that occurred in 2003-2004. In the town of Habila, our health center offers primary and secondary care to 7,000 local residents, as well as to the 22,000 people who were displaced more than three years ago. The displaced persons are completely dependent on outside aid to survive. Our health center treats primarily infectious illnesses. We also offer labor and delivery services for pregnant women, particularly for complicated births. On average, we handle 35 births every month.
Most of the displaced persons suffer from psychological distress. In Habila, many of our patients complain of muscle pain, headaches, and sleeping problems. This represents approximately 15 percent of our patient visits. In a war setting, these symptoms suggest mental health-related problems. A psychiatrist is currently on site to evaluate needs and establish a possible mental health program.
Second, we treat victims of the current conflict by supporting the emergency department of the general hospital in El Geneina, the provincial capital. This government hospital admits most of the wounded in the province. Our support involves providing medical equipment and medications as well as technical support (including hygiene and pharmacy management).
– Philip Humphris
In addition, we try to respond to new medical and humanitarian needs that arise regularly. These needs are related directly to attacks on villages and to violence. A four-person team is currently based in Seleia, a city of 20,000 residents located north of El Geneina. The team is setting up an operating room to treat the wounded.
Recently, in January 2007, more than 5,000 people arrived at the Aradmata and Dorti camps. The team immediately evaluated the health status of these individuals, who had fled violence, and treated the most urgent cases. We also distributed basic supplies to the families.
MSF regularly talks about the difficulties in accessing populations. In concrete terms, what do those problems involve?
In each of these three areas, we regularly face problems gaining access to the most weakened populations–those most directly affected by the violence–and in setting up appropriate activities. Likewise, patients find it difficult, and sometimes impossible, to reach our health centers. All of these access problems, both for the populations and for humanitarian aid workers, are related to the threat of violence. Twelve humanitarian aid workers have been killed in Darfur since May 2006. Traveling on the roads in Darfur today means risking assault or even death.
During our emergency efforts on behalf of the 5,000 newly displaced people in the Aradmata and Dorti camps, we learned that many people were blocked in the village of Tanjeke, 30 kilometers north of El Geneina, which they could not reach because of poor security conditions on the road. Some arrived sporadically, in small groups, traveling at night to avoid attacks. After making all the necessary contacts, I left with a team to evaluate the medical situation and living conditions in Tanjeke. People there had a tremendous need for basic supplies like jerry cans, blankets, and plastic tarps for shelters. On the way back, we were stopped by armed men. Although we managed to continue unharmed after talking with them, this event illustrates the volatile nature of the situation. It is still difficult to return regularly, by road, to Tanjeke to set up activities.
Similarly, in Habila, we are confined to the town itself. We had to stop our mobile medical visits in neighboring villages and encampments because we felt that our safety could not be guaranteed on the road.
For the last eight months, our teams have experienced many security incidents, including three ambushes by armed men along the roads. During these incidents, our team members' lives have been put at risk. They have been beaten, shots have been fired in their direction, and they have been robbed. Since July, our teams have barely traveled on the roads in the province and we must rely on air transport, which is expensive and limits our scope of operations. It is impossible to conduct medical visits in the villages by airplane and helicopter. The insecurity in Darfur seriously limits our action and leaves a large part of the rural populations and those in surrounding areas largely inaccessible. However, I should emphasize that the situation in Darfur is not homogeneous. Some areas are more unstable than others. That is particularly true in the area where we are.
You've just come back from Tanjeke and El Geneina. Would you tell us about the daily lives of recently displaced people?
In talking with the newly displaced persons, I was particularly struck by their total lack of hope for their future. Their daily lives are governed by fear of attack by armed groups. These are the same armed groups that told them to leave their village. Others describe fleeing in the midst of an attack. They describe major population displacements of nearly 10,000 people from several villages, who they say have fled recently. We have not gone to these villages because the security conditions prohibit travel there, so we do not know if villagers are still there or even if the villages have been destroyed. Some people had no other choice but to flee again, after experiencing yet another round of violence.
Growing numbers of aid agencies are leaving Darfur, saying that the insecurity is making it impossible for them to do their work. What about MSF?
Despite the problems, our presence in Darfur, with these populations, is still important. Many people are completely dependent on humanitarian aid. Over the last several months, we have faced the limits of our work as a medical humanitarian group on a daily basis. Our work, which focuses on assisting victims of the conflict, is constantly being called into question for reasons of lack of security. To complicate things, the administrative procedures are particularly long and tiresome. They slow our responsiveness. To improve our ability to respond and ensure our independence, MSF asked the Khartoum authorities for permission to fly its own plane in Darfur. It's been four months and we still have not received an answer.