KAMPALA, 22 Aug 2005 (IRIN) - On 22 July 2005, the international medical relief agency, Médecins Sans Frontiéres (MSF), announced that it was halting all medical and humanitarian aid to an estimated 100,000 people, almost half of the population displaced by civil unrest in the northeastern Democratic Republic of Congo district of Ituri.
This decision followed the abduction, on 2 June, of two members of the MSF who were, however, released 10 days later.
MSF Head of Mission in DRC Jerome Souquet talked to IRIN about the plight of Iturians and the difficulties humanitarian agencies have to encounter to provide help to the needy. Here are excerpts of the interview on 17 August 2005.
QUESTION: MSF has withdrawn from Ituri citing security reasons, what exactly makes it feel insecure?
ANSWER: To clarify, MSF is still working in Ituri and we are still running the Bon Marché Hospital, which is a hospital of 300 beds and we are maintaining our presence in Bunia. The activities we stopped concern those outside Bunia and concern projects in remote areas.
Why we got out of those areas is obviously the security reason and the kidnapping of two members of staff of MSF which is a result of the violence in areas surrounding Bunia. We have been victims of this violence and currently accessibility is one of the major issues in Ituri.
Q: In which other areas of Ituri was MSF running activities?
A: In MSF we are always trying to reach as many communities as we can. It is part of our mandate. We had some activities north and south of Bunia, and specifically we were working in Tchomia, in Kakwa, in Jina and in Tchee where expatriates were permanently on the ground, and we were running a mobile clinic for woman. We were working in many of these locations outside Bunia.
This was our project but as you see security is more or less guaranteed in Bunia. We thought we could be safe in this small enclave guarded by MONUC, though it also does not have enough security guarantees. It is unacceptable for humanitarian workers to be targeted and to be victims.
Q: Which armed groups have made it impossible for MSF to carry out its mandate in Ituri?
A: We are working with all the different communities. We have some contacts with all the different groups; but regarding the responsibility for the violence and kidnapping, it is not the job of a humanitarian organisation to make that conclusion. We are a medical organisation, composed of nurses; we have doctors, we also have the support staff.
We don't want to assume the responsibility of giving advice to the military authorities, the political authorities and other civil authorities. Everyone in this [situation of] insecurity has to assume their own responsibilities.
Q: What is the humanitarian situation in Ituri and how are the living conditions of the people?
A: This is the main issue because an organisation like MSF cannot get a clear picture of what is happening. Why? Because accessibility is difficult. What we know is that when we had the possibility to work in different camps surrounding Bunia, we knew the situation was not good. Medically speaking, we had some mortality rates that were already two or three times higher than those that are acceptable as emergency situations. So, in many places we surpassed these emergency levels. Now that we have withdrawn, we can easily imagine that the situation is just getting worse, and what is worrying us the more is that not a single actor has accessed these areas to know what is taking place there.
For example in the area of Jina, the mortality rate was between four and six deaths per 10,000 per day, when we know that the figure is 2 percent per 10,000 per day for an emergency situation. We were still providing sanitation, water, as well as health care, and now that we have withdrawn we know that the situation is worse.
We are even worried because we do not even know what is happening in these areas. The only news we get from there is from the patients we see coming to Bon Marché. They are victims of armed violence, victims of rape and these are the few witnesses that are coming to be treated.
Q: What are the living conditions of Iturians, since some have been forced to abandon their homes and take refugee in forests for example?
A: All the people who have gathered around places secured by MONUC and other security services have the same fears. They are saying that their villages are not safe anymore that they can no longer stay in their homes safely, otherwise they will be attacked, they will be raped, and they will sometimes be killed.
They are looking for security by gathering in these camps of the displaced people. This poses a problem because you have a concentration of people who have lost everything. They have food problems; because they do not have access to their fields, and they have living condition problems because they abandoned their belongings.
In these camps, there is a potential of disease epidemics and when such diseases strike, it can be catastrophic. We witnessed this in April when cholera broke out in Camp Kakwa. MSF treated 1,600 cholera cases within Kakwa, Chomya and we had recently a few cases in Bunia, but it seems this is over. There were about five deaths.
Q: What are the main threats relief workers face in the field?
A: A relief worker faces the same danger as the locals. This means direct targeting, abduction, and some kind of racketeering. So we cannot go to [work under] these unacceptable conditions that are prevalent in these villages.
Some organisations are using other means to try to get access to some villages: using MONUC armed convoys to go to these places. MSF does not use these convoys because this goes against its principles. MSF believes that it has to work in acceptable conditions. To work under armed convoys and armed protection is not acceptable to MSF.
There is also confusion between the armed forces and non-governmental organisations and we refused to be part of this confusion. Part of the confusion between humanitarianism and militarism may have been one of the factors that led to the kidnapping. There was some confusion between MONUC and MSF and this could have been one of the factors that contributed to the kidnapping. We are very worried about this situation.
In Ituri there are three kinds of actors: the humanitarian, the military and civilian authorities. We have the same goal and aim, which is to provide acceptable living conditions to the population in Ituri; but each of us has to stay in his own domain. We don't want any confusion between these three main actors in the region.
Q: What are the needs of people in the camps?
A: What they need first and foremost is to go back to their places of origin and to access their fields, not to depend on external aid.
When MSF was still in the camps, we provided free health care to all the displaced people. We used to work in collaboration with other organisations to provide the minimum standard of sanitation like the provision of latrines. We also tried to achieve the global standards regarding access to water, in terms of quantity and quality.
We know that the water situation, for example in Jina, was a few liters per day per person before any organisation accessed Jina. The WHO standard is a minimum of 20 liters per day, per person. We are not in Jina at the moment, but we can imagine that the standard now is far, far below what is acceptable for humans in terms of accessibility.
Q: What should the international community do to correct this situation?
A: It is not the job of MSF to give advice to the international community as to what has to be done. However, MSF has a mandate of witnessing and our aim and job is to raise some alarm bells to alert anybody who can find a solution to the security situation in Ituri.
Q: When is MSF likely to resume its work throughout Ituri?
A: We have lived a very difficult situation and at the moment we are still trying to analyse and to make a conclusion as to how an independent organisation like MSF has been targeted and has been physically treated.
We have been victims of this violence and until we have clear conclusions, we cannot resume operations outside Bunia.
MSF, however, has a clear will to go back to serve the population in terms of health care; in terms of water and sanitation; and also to witness the situation and relay this to the international community.
We believe that we will eventually be able to resume our operations in Ituri as we have the support from a cross section of people in the entire district.
What we know is that we have been having access to 100,000 displaced people but these represent only half of the estimated 200,000 people who are affected by this endless conflict.