After Kurram, MSF banned from working in Bajaur

PESHAWAR: After ban on its working in the Kurram Agency, the authorities on Thursday stopped the Médecins Sans Frontières (MSF), also known as Doctors Without Borders, from operating in Bajaur tribal region.

With closure of MSF operations in Bajaur, the international humanitarian charity organisation will have no presence in the Federally Administered Tribal Areas (Fata). The organisation said it was offering services to thousands of people in Fata.

A senior government official in Peshawar told The News that MSF was on negative list and was, therefore, denied an NOC by the Ministry of Interior in Islamabad.

“Actually, the MSF is on negative list as per notification of the Ministry of Interior as well as Corps Headquarters Peshawar. Therefore, their activities were stopped,” said the official. He added that they would also stop its activities in Khyber Pakhtunkhwa.

On September 13 this year, the Directorate of Health Services in Fata Secretariat, Peshawar, stopped the MSF from working in Kurram Agency.

The security agencies refused to give the ‘no objection certificate’ (NOC) to the MSF.

According to MSF officials, all the staff members working in their two health centres were Pakistani nationals.

Director General Health Services for Fata Dr Jawad Habib as usual avoided comment on the issue.

Dr Jawad Habib is the nephew of Khyber Pakhtunkhwa Governor Iqbal Zafar Jhagra.

According to MSF, it was providing services in Fata since 2004 and was never denied an NOC in the past.

The MSF said closure of its services in Bajaur will leave thousands of people without vital healthcare.

“The international medical humanitarian association Médecins Sans Frontières has been told by the Pakistani authorities to close its medical activities in Bajaur Agency in north-western Pakistan,” it said. It added that MSF will now have no presence in the Fata, one of the areas of the country where the need for emergency, maternal and child healthcare is most acute.

“We are extremely disappointed by the authorities’ decision to refuse permission for MSF to continue providing urgently needed medical care in Bajaur Agency,” said Azaad Alessandro Alocco, MSF’s Country Representative in Pakistan.

He said healthcare services are very limited in the area and most of their patients cannot afford to pay even for basic medical care.

“As the only major hospital providing free, quality healthcare in the area, the closure of MSF’s activities will leave a major gap and have serious negative implications for the health of people living in Bajaur and the surrounding areas such as Mohmand Agency,” the MSF country representative noted.

According to MSF officials, Pakistani authorities have informed them that the NOC required for carrying out medical activities in Bajaur will not be renewed, although no explanation has been given.

Without a valid NOC, they said, MSF is not allowed to continue providing medical services.

“MSF has informed its team and the local community in Bajaur Agency about the decision and will complete the closure process within two weeks,” the MSF statement explained.

According to MSF, it has been supporting regional health authorities at the Tehsil Headquarters Hospital of Nawagai since 2013, providing medical care in the outpatient, emergency room, and mother and child health departments.

It said that as the authorities have not permitted MSF international staff members to access Bajaur Agency, the project is run by 120 Pakistani employees with support from international staff based in Timergara, the headquarters of Lower Dir district, and in Islamabad.

“The number of people seeking healthcare at Nawagai hospital has continued to increase, illustrating the enormous need for medical care in the area,” Azaad Alocco said.

The MSF country representative said that after extending the emergency services at the hospital in February 2017 to be open 24 hours, seven days a week, they have seen the number of patients treated in the stabilisation room more than double.

“The end of MSF support will likely mean that people in need of life-saving emergency, maternal and paediatric care will face challenges accessing it, especially at night time when travelling is more difficult,” the MSF head feared.

The statement said MSF teams in the first nine months of 2017 provided care to 41,029 patients in the hospital, compared to 38,865 in all of 2016.

It said more than 14,400 patients were seen in the stabilisation room between January and September 2017, compared to around 8,200 in all of 2016.

About 1,152 deliveries were assisted by skilled MSF medical staff between January and September 2017, compared to 1,291 in all of 2016.

In 2016, the MSF teams at Nawagai hospital conducted more than 31,000 outpatient consultations and treated 167 children for malnutrition.

The teams also treated more than 800 patients infected with Leishmaniasis, which is an endemic disease in Bajaur. The MSF also manages support services in the hospital such as the laundry and infection control.

It claimed that MSF also provided support including medical supplies and training to the Ministry of Health and Khar Agency Headquarter Hospital for responding to mass casualty events. For severely ill patients in need of more intensive medical care than what can be provided at Nawagai hospital, the MSF ensured their referral to Khar hospital or to the MSF-supported district hospital at Timergara.

The MSF said it has been working with Pakistani communities affected by natural disasters, conflict or lack of access to healthcare since 1986.

The security agencies have made it mandatory for all the national and international NGOs and other social welfare organisations to seek NOC from the concerned authorities before working in Fata.