The international humanitarian medical organisation Médecins sans Frontières (MSF) is extremely concerned about the deteriorating security and health situation in Mile 91, a town 50 kilometers south west of Makeni in northern Sierra Leone. Beginning in May, tens of thousands of people were forcibly displaced to Mile 91 and its environs from the towns of Makeni, Magburuka and other surrounding villages.

The steady influx of people has resulted in a health crisis because access for aid workers and supplies has been restricted by the extreme insecurity in the area. One of the indicators of the health crisis is the large caseload of over 9.000 people in the first two weeks of July monitored in just two health clinics. MSF has seen a rise in the number of patients with bloody diarrhoea, many of whom are severely dehydrated.

Five of the 10 samples tested are Shigella type 1, which is the most contagious form of diarrhoea and can lead to epidemics. Malnutrition is a serious problem. A feeding center run by another international aid organisation has, in the last two weeks, received 500 malnurished children and another 170 who are severely malnourished.

Interviews with mothers revealed that the children had become malnourished since arriving in Mile 91. MSF research has established that most of the recently displaced people fled because of attacks by government helicopter gunships on their home areas. Atrocities committed by the rebel Revolutionary United Front have also continued to terrorise large numbers of people.

Security in Mile 91 remains a major constraint and concern. The town is on the dividing line between opposing forces and close to the Sierra Leone Army base Camp Charlie. Fighting in the surrounding area, sometimes among militias linked to the government, threatens the people seeking refuge and reduces the aid that can be provided.

In June MSF began supporting two clinics in Mile 91 and ran a mobile clinic to reach the surrounding villages. Their work has been periodically interrupted by violence around the town and the team has to make a four hour journey each day from its permanent base in Moyamba to work in Mile 91.