Expulsion of 13 relief agencies from Darfur could devastate health care

BMJ 2009; 338 doi: (Published 10 March 2009) Cite this as: BMJ 2009;338:b985
  1.  John Zarocostas
  1. 1 Geneva

     Sudan’s decision last week to expel 13 major voluntary relief agencies that provide humanitarian aid to many of the 4.7 million people in the Darfur region threatens the delivery of essential health care, UN officials and aid experts have warned.

    The decision to expel the agencies from Darfur and other areas in Sudan “will have immediate important repercussions in the immediate term, because in several locations in Darfur they have been the only health providers,” said Fadela Chaib, a spokeswoman for the World Health Organization.

    “Hundreds of thousands of people [will be] without access to any health services,” she told reporters on 6 March. “We are discussing and seeing how we can contain and fill the major gaps.”

    WHO has 10 international staff and 100 Sudanese staff in the region.

    The United Nations secretary general, Ban Ki-moon, and the chiefs of the affected relief agencies have urged Sudan’s president, Omar al-Bashir, urgently to reconsider his decision. It was triggered by his indictment by the International Criminal Court on 4 March for war crimes and crimes against humanity.

    The agencies say they have nothing to do with the court’s decision and are urging Khartoum to allow them to restart operations.

    Rupert Colville, spokesman for the UN Commissioner for Human Rights, Navanethem Pillay, said, “To knowingly and deliberately deprive such a huge group of civilians of means to survive is a deplorable act.

    “Humanitarian assistance has nothing to with the ICC [International Criminal Court ] proceedings. To punish civilians because of a decision by the ICC is a grievous dereliction of the government’s duty to protect its own people.”

    The agencies affected include Médecins Sans Frontières (MSF), Save the Children, Care International, Oxfam, the International Rescue Committee, the Norwegian Refugee Council, Mercy Corps, CHF International, Solidarité,  and Action Contre la Faim.

    The decision, if implemented, “will cause irrevocable damage to humanitarian operations,” said a spokesperson for Mr Ban. The UN chief said that the confiscation of equipment, money, and other materials “is unacceptable and must end immediately.”

    Christophe Fournier, international president of MSF, said, “The sudden halt of our medical programmes, including vital surgical, nutrition, and basic healthcare programmes, in large areas of Darfur will have an immediate and devastating impact on the population.”

     More than 400 000 people were getting medical care through MSF, said Philipe Ribeiro, general director of MSF France. He said that last year MSF treated more than 200<thing>000 people in the region, carried out more than 8000 surgical interventions, and treated more than 20 000 pregnant women.

    Until the expulsion MSF had more than 100 international staff and about 1625 Sudanese staff delivering essential medical aid in Darfur. However, since the decision it has closed down six of its 13 projects and lost at least half of its operational capacity, MSF officials told reporters on 6 March.

    Now MSF has only about 900 staff remaining, a third of whom are medical staff.

    MSF says that many basic needs of hundreds of thousands of people will go unmet. Outbreaks of meningitis in Kalma camp and Niertiti, where 130 000 people are in urgent need of vaccination, “risk going unchecked,” it said. 

    Save the Children UK said that the decision to suspend its operations “has very worrying implications for 50 000 children we are currently supporting in Khartoum and the north east of the country. These are some of Sudan’s most vulnerable children.”

    Care International said it is assessing what the revoking of its licence means for the 1.5 million people who receive health, food, water, sanitation, and livelihood assistance from the agency.


    Cite this as: BMJ 2009;338:b985

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