Since December 23, a sectarian clash has been underway in Kurram Agency, North West Frontier Province, Pakistan. Mortars have exploded within the vicinity of two hospitals in the towns of Alizai and Sadda, where the medical humanitarian organization Médecins Sans Frontières (MSF) provides assistance. The town of Alizai has been surrounded and blockaded by fighters. Five mortars landed near the MSF hospital compound on the December 25.

The following day, another three mortars shook the facility, damaging the MSF buildings and ambulance. Only a few wounded have so far made their way to the hospital for treatment.

MSF provided trauma medicines and materials, but has had to reduce the presence of its workers due to the insecurity. Fighting continues daily. On December 30, a mortar hit the second hospital in the nearby town of Sadda, damaging the hospital mosque. Over 100 wounded have come to the emergency room.

MSF teams have provided support and medical materials. While lowering staff numbers to the minimum MSF continues to provide basic maternal health services. Buildings in Sadda town have been subjected to daily fire of mortars and other heavy weapons since 23 December. People fleeing fighting in nearby towns are seeking refugee in Sadda, but they have now come under fire. MSF is trying to get additional supplies, including food and blankets to those most affected by the conflict.

This is the second time this year that sectarian clashes have resulted in prolonged insecurity and casualties. An isolated tribal area on the conflicted Afghan border, civilians in many parts of Kurram Agency - now enduring the coldest months of the year - face acute shortages of simple necessities like food and fuel.

Sectarian violence between Shia and Sunni supporters began in November. A Jirga - local peace talks - are underway to try and resolve the issue. Heavy weapons and small arms fire are still heard regularly in and around Alizai and Sadda towns.

MSF has been working in Pakistan since 2000 and is currently carrying out medical activities in the North West Frontier Province (NWFP) and Balochistan. It is the only international medical organisation present in Sadda and Alizai.