Freetown - The international humanitarian organisation Medecins Sans Frontieres (MSF) is deeply concerned that international attention in Sierra Leone - focused on the United Nations forces - has neglected the plight of the civilian population.

The renewed fighting in Sierra Leone and lack of humanitarian access to populations at risk has strained food supplies and led to the first reports of malnutrition, heightened the possibility of the outbreak of widespread disease, and has placed new burdens on camps for displaced persons. MSF urges that the parties to the conflict ensure that civilians have free and unhindered access to humanitarian assistance.

The renewed fighting has had a severe impact on the delivery of humanitarian assistance in the Northern Province and elsewhere in the country. A food shortage exists in Makeni, which is now cut off from supply from the capital Freetown, resulting in children under five years showing the first signs of malnutrition. Kabala has received an influx of over 2,000 displaced persons, straining the food supply.

MSF has, in the last two weeks, admitted 102 children to its feeding program there. At the MSF centre in Kambia, more than 60 children aged under-five (who were receiving treatment for severe malnourishment) and their caretakers were forced to flee during the recent crisis.

The food situation is likely to worsen during the so-called "hungry season," before the harvesting of the rainy season crop. Despite these increased needs, MSF has had to reduce its nutritional programs because of security concerns. The health situation in Sierra Leone, already precarious, could become desperate.

In Kambia, Bombali and Tonkolili districts in the Northern province, MSF has had to suspend its support for clinics, hospitals and nutritional programs. In Kambia district, MSF suspended medical care at an inpatient clinic treating 20 patients as well as support for several health centres. Measles epidemics are a serious concern.

Although an MSF measles vaccination campaign vaccinated 120,000 children in Bombali, Tonkalili and Mile 91, the program has had to be cancelled, leaving many children unprotected.

An MSF vaccination campaign in Kabala had reached only one-fourth of the targeted children under-five when insecurity halted the program. People fleeing the conflict in the Northern province is putting pressure on areas not directly affected by the fighting.

Existing camps for internally displaced persons in Lungi and the Western Peninsula are quickly becoming overcrowded. Reports suggest that over 10,000 persons have recently been displaced. The Geneva Conventions provide that international relief actions should be undertaken where the civilian population is suffering undue hardship owing to a lack of supplies essential for its survival.

MSF calls upon all parties to the conflict to facilitate the population's free and unhindered access to humanitarian assistance as provided under human rights and humanitarian law.

The parties must take steps to ensure the safety of the civilian population and humanitarian relief workers. Furthermore MSF insists that humanitarian assistance not be subjected to politicisation by governments, donors and regional institutions.