In the second half of 2011, Médecins Sans Frontières (MSF) witnessed increased insecurity in the camps located near Dadaab, Kenya. The kidnapping of two MSF international staff members in October forced the organisation to halt activities in Ifo camp and to temporarily reduce services in Dagahaley camp to life-saving activities in the hospital only.
Despite the situation, MSF medical teams never stopped providing medical care in the biggest refugee camp in the world, and MSF has now resumed all medical activities in Dagahaley.
MSF teams are working to ensure quality medical care for the refugees. The 300-bed hospital in Dagahaley is running at full capacity, and four health posts out of five have been reopened. More than 2,100 children are being treated in nutritional programmes, and 200 were admitted to hospital with medical complications.
Teams are holding more than 5,500 consultations per week in the health posts, and there have been more than 400 weekly hospital admissions.
Yet another year of war and reduced humanitarian assistance in Somalia has meant the forced internal displacement of hundreds of thousands of people, and many have left to look for a safe place in neighbouring countries.
The health needs of the population were already huge before the nutritional emergency currently affecting the horn of Africa. It is in this situation that MSF is struggling to provide care.
MSF medical teams are particularly worried about the refugees. “Now, almost all aid agencies have reduced their activities. We fear we may go back to how it was last summer, when the health status of the refugees was actually worsening in the camps," says Dr. Jean-Clément Cabrol, MSF’s Director of Operations.
"The people’s situation had finally been improving when the security incident happened. The current reduction of activities could make for a dramatic impact on the refugees. For example, today, those who can make it to cross the border and seek refuge in Dadaab have no access to shelter, food and non-food items.”
The situation remains very fragile indeed. In recent months, MSF teams had to deal with a measles outbreak that affected the entire refugee camp complex. More than 380 cases have been treated in MSF medical structures since August, and nearly 113,800 people have been vaccinated.
Watery diarrhoea is currently posing a serious health risk and cases of cholera have been confirmed in all three camps. MSF is running a 50-bed cholera treatment centre in Dagahaley, and 45 patients have been admitted in the last 10 days.
But health is not the only concern for MSF teams responding to the Somali crisis in Kenya and in Somalia.
The Kenyan military intervention in southern Somalia, the conflict in Somalia opposing TFG troops and Al-Shebab militias, and the lack of access to large areas of Somalia, are putting the Somali population in a dramatic situation.
Given the current situation, MSF is concerned about its ability to access the Somali population and to implement independent assistance.