Has MSF interrupted its activities in Somalia?

"This incident was a severe and extremely violent act and it is causing a significant disruption in the services we are able to provide in the country. The absence of international staff on the ground has affected, for example, our surgical programme in Kismayo: we currently do not have any staff there who can perform emergency surgical interventions in the hospital where we were working.

"However, we have not suspended our activities altogether; we actually continue to send medical supplies to our project locations in Somalia where our local staff continue to run the medical programmes at the best of their capacity.

"I would like to emphasise that all our activities rely heavily on our 800 national staff who provide medical care to our patients in all project locations. Since we have withdrawn our international staff, our team in Galcayo has been able to provide medical care to 1,164 people in our hospital and 1,110 patients in our hospital in Marere. More medical activities continue to be carried out in the other MSF project locations across Somalia."

Has MSF withdrawn international staff from Somalia before?

"Due to the fragile security situation in Somalia, evacuations of project teams have been common. That all sections have now withdrawn all international staff from all project locations in Somalia reflects the exceptional circumstances and the severity of the attack, however the withdrawal of our international staff is part of our regular operational procedures for our missions in Somalia.

"Our presence in Somalia has always been based on careful and continuous review of the security situation. Evacuations of our international staff - particularly preventive evacuations - have regularly taken place in the past.

"Since we started working in the town of South Galcayo in 2003 for example, there have been about 50 evacuations of different durations and for different reasons. The instability of the Somalia context has also made it necessary to have all coordination teams based in Nairobi, Kenya."

What are the consequences for the Somali people during those periods?

"Our dedicated Somali colleagues do their best to continue life-saving medical activities and to cover during those periods when international staff is not present. The presence of our international staff together with our Somali colleagues ensures that we can provide free quality health care and highly specialized treatment such as surgical interventions. As a result of the conflict most people have the greatest difficulties to access free healthcare and specialized treatment of the kind MSF provides.

"The humanitarian situation in Somalia is exceedingly concerning. Mortality rates in several areas of the country are far beyond emergency thresholds and existing medical assistance is insufficient to cover the needs. Hundreds of thousands of Somalis are struggling to survive and are in urgent need of immediate assistance. Subsequently the attack on our team in Kismayo has been an attack on the very idea of humanitarianism and our ability to alleviate the suffering in Somalia."

What do you foresee for the immediate future of MSF in Somalia?

"We have worked in Somalia for over 17 years and particularly over the past year the country has been facing a critical emergency with escalating violence, massive displacement and acute unmet medical needs. We are deeply concerned for the people that we are now unable to help.

"Despite the fact that most activities continue in the absence of international staff, this attack has been a set back. We should do more during this time when the people in Somalia are in such desperate need and yet we cannot just carry on and ignore the murder of our colleagues.

"We know that our presence in Somalia is relevant and we have received much support and solidarity from our national staff, the local counterparts and the local population in the aftermath of the brutal attack on our team in Kismayo.

"In Kismayo people have taken to the streets and condemned the attack in solidarity with MSF. We are determined to provide assistance in Somalia, but what happened to our colleagues two weeks ago needs to be clarified and analyzed before we can take decisions about returning with international staff."