The worsening humanitarian situation in Idlib, Syria
by OCHA, Mercycorps, NRC, OHCHR, Unicef, agencies
18 June 2019
Briefing to the UN Security Council on the humanitarian situation in Idlib by Emergency Relief Coordinator, Mark Lowcock - UN Office for the Coordination of Humanitarian Affairs:
''I briefed this Council one month ago on the worsening humanitarian situation in Idlib. Ten days later, my deputy alerted you to further violence and destruction. Violence, involving Syrian Government forces and their allies, armed opposition forces, and the Security Council-listed terrorist organization Hayat Tahrir al-Sham, continued throughout the holy Eid al-Fitr period.
It has still not stopped despite the announcement of a truce on 12 June.
Over the last six weeks, the conduct of hostilities has resulted in more than 230 civilian deaths, including 69 women and 81 children. Hundreds more have been injured.
Since 1 May, an estimated 330,000 people have been forced to flee their homes, moving northwards towards the border with Turkey. That''s almost double Mr. President the number of newly displaced people since my last briefing to you.
A recent rapid assessment found that many of them have moved multiple times since the start of the conflict, some of them have moved as often as ten times. This is a particular feature of the Idlib area. People fled initially from other parts of Syria, then people moved again and again and again, constantly searching for safety.
Camps for the displaced people are overcrowded, with many people forced to stay in the open. Those who remain in towns and villages close to the fighting live in constant fear of the next attack. Many are crowding into basements, seeking refuge from air strikes, volleys of shells and mortar rounds, from fighting which continue to threaten what is left of their homes.
Hospitals, schools and markets have been hit. Power stations have been affected. Crops have been burned. Children are forced out of school.
We have had reports this morning of another 19 people killed yesterday by airstrikes and artillery shelling. And this past weekend, civilians were killed by mortar and rocket attacks in the Al-Wadehy area to the south of Aleppo city.
In short, we are facing a humanitarian disaster unfolding before our eyes. There is no denying the facts.
The UN and its partners have been responding with emergency food assistance through ready-to-eat rations, reaching more than 190,000 people in May. In addition, the UN and its partners have been reaching nearly 800,000 people with general food assistance.
Water, health and sanitation supplies have been distributed to some 180,000 displaced people, and water trucking has been made available to people in some 342 camps and informal settlements.
None of this, incidentally, would have been possible if this Council had not renewed resolution 2165. Cross-border assistance remains the only means of reaching people in and around Idlib.
The UN and the brave humanitarian workers on the ground are doing all they can. They are risking their lives to help others.
But the response is stretched and a further increase in need brought on by additional fighting would risk seeing it overwhelmed.
To this day, we continue to receive reports of attacks impacting civilian infrastructure, including schools and hospitals. Since April, according to reports, 37 schools have been affected.
More than 250,000 children are out of school. Some 400,000 students have had their exams cancelled. And 94 schools are currently being used as shelters. As UNICEF said last week, no parent should fear sending their child to a school that may be bombed later that day.
I need to remind you again Mr. President of the incidents affecting health facilities. 26 incidents affecting healthcare facilities in northwestern Syria have been confirmed by the World Health Organization since late April. Eight more than when I last briefed you. Two of those facilities were located in an area controlled by the Government of Syria.
Many other hospitals have closed out of fear of being attacked. These attacks don''t just claim innocent lives. They also deprive thousands of civilians of basic health services, even as fighting intensifies around them.
As you know, some of these hospitals had been deconflicted through the UN''s de-confliction mechanism. All parties have specific obligations to refrain from attacking protected sites under international humanitarian law, regardless of whether they have been de-conflicted or not. It is appalling that these sites were hit in the first place. But hitting a facility whose coordinates were shared as part of the UN''s de-confliction system is simply intolerable.
A number of partners now feel that supplying geographical coordinates to be given to the warring parties effectively paints a target on their backs. Some have drawn the conclusion that hospital bombings are a deliberate tactic aimed at terrorizing people. This whole episode raises deep questions about the de-confliction system. We are discussing this internally, and I will tell you what our conclusions are at the regular monthly humanitarian briefing that we are due to give you next week.
UN Security Council-listed terrorist group Hayat Tahrir al-Sham (HTS) has a significant presence in Idlib and is responsible for its own share of the suffering there. Countering HTS is plainly a major challenge.
But counter-terrorism efforts cannot in any way absolve States of their obligations to uphold international humanitarian law. And that is the bottom line, Mr President, just as the Secretary-General said earlier, international humanitarian law must be upheld and attacks on civilians and civilian infrastructure need to stop and they need to stop immediately''.
May 24, 2019
44 Syrian and International NGOs Call for Immediate End to Attacks on Civilians and Hospitals in Idlib, Syria
Three million civilians in northwest Syria are scared and many are homeless. With no concrete actions taken beyond political statements and promises, Syria and the world may soon be witnessing the “worst humanitarian tragedy of the 21st century”. Rescue and medical workers on the ground are warning that they have not seen such ferocious attacks in eight years in Idlib. If the conflict continues to escalate, as many as 700,000 people could be displaced from their homes in Syria’s last opposition stronghold.
According to the United Nations, over 200,000 people were forced to flee the continuous bombing and shelling of towns in southern Idlib and northern Hama and have few options to seek safety. Up to 80,000 of those who have fled are sleeping rough with no shelter, and many others are crammed into overcrowded homes.
Since the beginning of the escalation at the end of April, the United Nations confirmed at least 105 have been killed, 3 IDP sites were impacted, and 17 schools have been damaged or destroyed. The United Nations has counted 23 attacks on 20 health facilities, some of them hit twice. 49 have had to suspend their operations due to attacks or insecurity.
Some of the health facilities that were attacked were on the de-conflicted list provided to the United Nations Office for the Coordination of Humanitarian Affairs.
“Attacks on community hospitals, including specialized maternity centers left thousands without medical care in Aleppo and East Ghouta,” said Dr. Ahmad Tarakji, SAMS President.
“Last year, our medical staff on the ground agreed to share hospital coordinates as part of the UN de-confliction mechanism: The United Nations has a responsibility to protect these hospitals and present a tangible plan to deter such attacks. The people of Syria have the right to know who is attacking and destroying their hospitals.”
Half of the three million people living in Idlib are internally displaced already and have experienced this violence time and again over the course of this conflict. The memory of Aleppo, East Ghouta, and Daraa, is still fresh in their minds, as they fear the latest offensive is only an indicator to the full-scale assault to come.
“Half of Syria’s population has already been displaced by eight years of war, yet the worst may still come,” said Arnaud Quemin, Mercy Corps’ Syria Country Director. “While entire communities were forced to flee and sought shelter in Idlib, three million people there, half of whom are internally displaced already, now fear they will have nowhere to go if war comes again to their doorsteps.”
There is no justification for ongoing attacks on civilians and civilian infrastructure. Parties to the conflict have a legal obligation to protect civilians and spare them from the worst effects of the fighting and to avoid attacking schools, hospitals and homes. Clearly these rules are being violated in northwest Syria today.
In response to the recent alarming chapters of military escalation, we, the undersigned Syrian and international human rights, humanitarian and solidarity organizations, urge all parties to act quickly to ensure the protection of civilians in northwest Syria and compliance with international humanitarian law:
The United Nations Security Council members have a mandate to ensure the protection of civilians and maintain international peace and security. They cannot keep hiding behind divisions in the Council to allow the worst to happen in Idlib, and should exercise all the pressure they can on warring parties to end the hostilities, stop the systematic attacks on civilian infrastructure, and ensure that cross-border and cross-line humanitarian access is facilitated to allow aid agencies to reach all communities in need, in compliance with UNSC resolution 2393.
We also call on UNSC members to work with Turkey and Russia to honor their commitments to the so-called demilitarized zone agreement signed by both parties in September 2018 and implement an immediate ceasefire over the entirety of northwest Syria.
Members of the Security Council should support the Secretary General’s Special Envoy for Syria Geir Pedersen to engage parties and broker a peaceful resolution of the security situation in Idlib to avert further bloodshed and urge all parties to return to the table to negotiate a political settlement to the conflict.
May 2019 (OCHA, agencies)
Since 28 April, ongoing conflict in northwest Syria between Government of Syria (GoS) forces and its allies and nonstate armed groups (NSAGs) has continued to escalate. On the morning of 8 May, GoS forces began ground operations against NSAGs, impacting on civilian populations, infrastructure and service provision in northern Hama and southern Idleb governorates. There are reports of people being killed and injured as a result of the recent escalation. While information is difficult to verify, unconfirmed reports indicate that more than 120 civilians, including women and children, have been killed, while many others have been injured.
Between 29 April and 9 May, approximately 180,000 individuals fled the fighting, some 164,000 people fled to northern and eastern Idleb Governorate and around 16,000 people to northern and western Aleppo. Of note, there are reports of many communities that have been abandoned as their populations have fled. However, some people have stayed behind, many of whom are vulnerable. Many are dependent on humanitarian services for their daily needs.
There are an estimated 3 million people in the de-escalation zone in Idleb, of these 1.3 million are internally displaced people (IDPs). In the area impacted to date, there are an estimated 2.1 million people (Humanitarian Needs Overview, August 2018).
Many of the population affected have been displaced in the past, for some this has been multiple displacements. As such, their ability to cope is reduced or compromised. The areas that recently displaced people are moving towards are already densely populated – often to areas with camps at full or excess capacity, putting additional strain on services. Reports indicate that rents have increased fivefold - where housing is available - since 1 May.
Impact on civilians and civilian infrastructure
Since the escalation of conflict on 28 April, many civilian structures have been impacted by airstrikes and/or shelling. On 7 May, two primary health care centres in Kafr Nabutha and Algab, both in Madiq Castle Sub-district in Hama Governorate were damaged. On 8 May, the Kafr Zeita Primary Health Centre in Hama Governorate was also damaged, bringing the total number of health facilities reported to be damaged or destroyed to 15 in this period.
Suspension of humanitarian activities
The impact of the recent increase in conflict on the civilian population, civilian infrastructure and the provision of basic service is deeply worrying. Many humanitarian responders have been forced to suspend their activities in the conflict area. Some organizations suspended activities as their premises were damaged, destroyed or rendered unsafe by the violence.
Others have suspended activities in order to keep their staff and beneficiaries safe, or because the beneficiary population has left. As of 8 May, at least 16 humanitarian partners have suspended their operations in areas impacted by conflict.
http://bit.ly/2VDfsrL http://reliefweb.int/report/syrian-arab-republic/44-syrian-and-international-ngos-call-immediate-end-attacks-civilians http://www.unicef.org/press-releases/tens-thousands-children-grave-danger-violence-escalates-northwest-syria http://reliefweb.int/report/syrian-arab-republic/idlib-children-show-signs-severe-distress-after-being-forced-flee-again http://reliefweb.int/report/syrian-arab-republic/statement-dr-kerem-kinik-president-turkish-red-crescent-and-vice
Syria: Office of the High Commissioner for Human Rights alarmed by upsurge in attacks and civilian casualties in Idlib.
The intensified ground-based bombardment of Idlib and surrounding areas by government forces and their allies in recent weeks, coupled with a series of attacks by non-State actors, has led to numerous civilian casualties and left some one million people, including hundreds of thousands of displaced people, in an extremely vulnerable situation, the UN Human Rights Chief said on Tuesday.
UN High Commissioner for Human Rights Michelle Bachelet called on all parties involved, as well as external governments with influence, to ensure that the protection of civilians is held paramount in the planning and execution of all military operations in accordance with international law.
The bombardment of the "demilitarized buffer zone" that includes Idlib and areas of northern Hama and western Aleppo Governorates started to escalate in December 2018 and has further intensified in recent days. At the same time, there has been an increase of infighting amongst non-State actors and in the use of improvised explosive devices (IEDs) in areas they control, including by the extremist group, Hay’at Tahrir Al-Sham (HTS).
"Large numbers of civilians, including hundreds of thousands of displaced people, in Idlib and northern Aleppo are living an intolerable existence," said Bachelet. "They are trapped between the escalation of hostilities and bombardment on the one hand, and, on the other, are forced to live under the extremist rule of Hay’at Tahrir Al-Sham and other extremist fighters who regularly carry out targeted killings, abductions and arbitrary detention."
"I urge all the parties involved to, first and foremost, ensure that civilians themselves, and civilian infrastructure, are protected as required by international humanitarian and international human rights law," the High Commissioner said. "The principles of distinction, proportionality and precaution must be fully respected, and military objects must not be placed in the vicinity of civilians." http://bit.ly/2ICJcin
Nov. 2018 (UN News)
A fragile ceasefire between Government forces and opposition fighters has held in Idlib for 10 weeks, guaranteed by Russia, Turkey and Iran, who re-committed to the deal at talks in Astana, Kazakhstan, this week said Jan Egeland, co-chair of the International Syria Support Group''s Humanitarian Access Task Force and Senior Advisor of the UN Special Envoy for Syria.
Mr. Egeland, who welcomed the original deal, warned at the time that the alternative – clashes between opposition and Government forces – would cause massive bloodshed and destruction similar to that inflicted on other major cities, including Homs, Aleppo, and Raqqa.
In his last press encounter as co-chair of the humanitarian task force before stepping down, Mr. Egeland offered insight into the difficulties of achieving the mechanism’s two main aims since it was established in early 2016: securing aid access and protecting civilians.
Among its challenges were the fact that towns and villages had been besieged, hundreds of thousands of people had died and 12 million had been driven from their homes during the more than seven-year war, he noted.
Turning to the 23 countries that attended task force meetings in Geneva, Mr. Egeland insisted that “too few acted courageously” to hold back the warring parties’ worst excesses against civilians.
“All hell was let loose on them and no one was willing and able to shield and protect them,” he said, adding nonetheless that “what happened here in Geneva helped cause some of the few really achievements, also in the protection of civilians”.
The task force’s successes included securing aid deliveries to the majority of people in besieged areas in 2016, Mr. Egeland said, compared with only two per cent a year earlier, and organizing the first high-altitude air-drops of aid to besieged people in Deir Ez-Zor in eastern Syria.
In a joint statement released on Thursday from Astana – where regular meetings have been held since January 2017 – Iran, Russia and Turkey reiterated their support for the UN-backed launch of a Constitutional Committee for Syria in Geneva “that would enjoy support of the Syrian parties…at the soonest possible time”.
Staffan de Mistura, UN Special Envoy for Syria, who has been leading efforts to form a Constitutional Committee, noted on Thursday that the Astana meeting had achieved “no tangible progress” in resolving a 10-month stalemate on its composition, as had been outlined in Sochi in January this year.
Aid groups fear for civilians in Idlib as ceasefire deal deadline looms - Report from CARE, Mercy Corps, International Rescue Committee, Save the Children
Four international aid agencies working in Syria’s north-west region of Idlib have warned of dire consequences for millions of civilians if the Russia-Turkey deal, due to be implemented by October 15, doesn’t result in a sustained reduction of violence in this overcrowded province.
Local organizations that partner with CARE International, the International Rescue Committee (IRC), Mercy Corps and Save the Children, as well as civilians receiving aid have expressed fears that violence could spiral out of control in the next few days if either the deal collapses or fighting escalates in areas not covered by it. Almost 3 million people live in Idlib, and it is estimated that even a limited military offensive would displace hundreds of thousands of people.
“Idlib residents, and aid workers hold their breath as the deadline for a political deal looms. While the terms of the agreement are known, we don’t know what the plan is if parties on the ground fail to implement it. Will it be all out war? Over and over again, similar deals have simply ended in a bloodbath. Civilians caught in this stand-off must be spared at all costs,” said Wouter Schaap, Syria country director for CARE International.
“The people of Idlib need a deal that offers long-term protection to civilians and allows aid to reach all those in need. Aid efforts are already stretched to the maximum in Idlib, where the population has doubled in recent years as people relocated there from areas retaken by the government of Syria. Aid organizations are at full capacity responding to the current needs of both displaced people and local communities. Though we are prepared to respond to any emergency, if this deal falls short and military operations start, many hundreds of thousands will struggle to get the help they will so badly need,” said Lorraine Bramwell, IRC Syria Country Director.
In September, Russia and Turkey agreed to create a demilitarized area in Idlib, which armed groups must leave by a provisional deadline of October 15. Provided it is implemented in line with International Humanitarian Law and does not result in an increase in violence in areas outside the demilitarized zone, the agreement could offer a potential lifeline to the people of Idlib. Civilians have already lived through years of war, during which many families have been forced to flee their homes multiple times.
Now, reports that different parties to the conflict are refusing to engage with the terms of the deal and commit to it long-term threaten to undermine the hope of a reduction in violence in Idlib.
“We already see the impact of this nerve-wracking situation on children, who tell us they are terrified at the prospect of more violence. The school year has barely started, but the facilities we support are making contingency plans to suspend classes and training young children on how to evacuate in the event of an attack. Many children in Idlib have been forced to flee their homes up to a dozen times, forcing them to miss years of school and causing stress and upset. Renewed conflict would compound the suffering of more than a million children in Idlib,” said Sonia Khush, Syria Response Director at Save the Children.
“Some people we help have stocked up on food, expecting to be stuck at home for days on end if fighting resumes. Others have packed their bags and are ready to move at the first airstrike. In both cases, our aid workers might not be able to reach those people if the security situation doesn’t allow them to move. And everyone fears losing their life if bombs start raining from the sky. What we need is a deal that not only holds but is also extended to other parts of Idlib and guarantees full humanitarian access to people in need,” said Arnaud Quemin, Syria Country Director for Mercy Corps.
Syria: Why we fear bloodshed in Idlib
An escalation of violence in Idlib province could quickly become a humanitarian catastrophe, warns the Norwegian Refugee Council.
Idlib hosts the highest concentration of displaced people in Syria. Violence in and around Idlib over the last year has forced people to flee time and again. Half of Idlib’s population of three million has been displaced from other parts of Syria. Civilian lives would be at stake if hostilities intensify.
Idlib is the last remaining so-called “de-escalation” zone in Syria. The makeup of Idlib is similar to places like Eastern Ghouta, southern Syria and Raqqa. It has a diverse mix of armed groups – some designated terrorists – and a high number of civilians in the same areas. Efforts must be taken to avoid targeting civilians, their homes, hospitals and schools.
Tens of thousands of civilians depend entirely on aid. Their greatest lifeline is assistance from humanitarian organisations. Many families lack access to clean water and sanitation facilities. Children who have been out of school for years have forgotten how to read. A battle over Idlib’s future risks cutting off lifesaving aid to countless people in need.
A staggering 700,000 people could be displaced overnight. Already people are on the move again out of fear of what might come next, and are struggling to find shelter. As NRC witnessed in Eastern Ghouta or Aleppo, routes to safety came too little too late for thousands of civilians trapped in the violence.
The only way to truly ensure the safety of civilians in Idlib is to prevent an outbreak in violence altogether. We must see the world’s top powers commit to peaceful negotiations and agreements which protect civilians and grant them safety.
As we look ahead, the humanitarian community must nevertheless prepare for the worst-case scenario. We must draw on what we have learned from previous emergencies in Syria and do our best to help people as they flee.
Sep. 2018 (UN News)
United Nations Secretary-General António Guterres has expressed deep concern over the growing risk of a humanitarian catastrophe should a full-scale military operation take place in Syria’s war-battered Idlib province.
Mr. Guterres urgently appealed to the Government of Syria and all parties to exercise restraint and to prioritize the protection of civilians in the event of any escalation of the conflict.
The Secretary-General further called on all parties “to take all necessary measures to safeguard civilian lives, allow freedom of movement, and protect civilian infrastructure, including medical and educational facilities, in accordance with international humanitarian law and human rights law.”
The statement came one day after John Ging, Director of Operations with the UN Office for Coordination of Humanitarian Affairs (OCHA), told the UN Security Council that intense aerial bombardment and shelling in Idlib and three other governorates in north-west Syria have left death, damage and destruction in their wake, and placed an even greater strain on aid workers and communities hosting displaced people.
http://bbc.in/2Bgqucu http://www.unicef.org/emergencies/syria/ http://www.unocha.org/syria http://www.humanitarianresponse.info/en/operations/whole-of-syria http://reliefweb.int/country/syr http://news.un.org/en/tags/syria
* Children and armed conflict in the Syrian Arab Republic. Of Syria’s 6.2 Million displaced people, 2.6 million are children, roughly 42 percent: http://undocs.org/s/2018/969
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Violence in central Mali has reached unprecedented levels, with alarming consequences for civilians
by Médecins Sans Frontières (MSF), agencies
Patrick Irenge has been MSF’s medical coordinator in Bamako, Mali, since September 2017.
While this West African country has been facing a political and security crisis since 2012, violence has intensified in the central region and is seriously affecting the civilian population.
Patrick describes how this insecurity has created an unprecedented emergency and reviews MSF''s response, assisting the most vulnerable alongside our regular projects.
The crisis in northern Mali has been ongoing since 2012. It is not getting any better, having intensified in the centre of the country. What is the situation like now?
In Mali, a climate of violence has been established in the daily lives of people in the centre and north of the country.
In the centre, security incidents and intercommunity conflicts have been on the rise for over a year; the massacres in the village of Ogossagou (March 2019) and more recently the village of Sobane (June 2019), together killing 160 and 35 people, including 24 children (data from June 17) are the tragic proof of this.
The heavy toll of these attacks has generated international media coverage and prompted widespread indignation but, unfortunately, while the astonishing violence of these deadly events is unusual, they are just the latest two examples among a multitude of others. Currently, the region of Mopti suffers security incidents on an almost daily basis.
The most alarming thing is that these incidents are increasingly affecting the civilian population, creating a climate of insecurity, fear and mistrust with even more disastrous consequences.
What is the impact of this violence on the humanitarian situation? What are the greatest needs of the people living in the worst hit areas?
First, we must remember that in central and northern Mali, a large majority of the rural population lives very modestly, surviving on agriculture and livestock. They already face hardship associated with the rainy season and lean months.
Now, added to these seasonal difficulties is the population''s lack of mobility, with some communities now completely unable to move. This immobility is caused by people''s fear of taking a road that may have been mined, and the presence of armed actors in the region or by the fear of crossing the hamlet of another ethnic group.
As a result, entire villages are literally hemmed in; their inhabitants can no longer carry out their usual economic activities and no longer have access to primary healthcare. Our teams in Douentza, and in daily contact with the community, also bear witnesses to this immense struggle to access care.
Another problem is the increasing number of displaced people who have fled violence. These families have often left everything behind (belongings, livestock, etc.) and live in makeshift shelters or host communities, left to cope on their own with no hope of returning to their homes.
Generally speaking, the needs of the affected and displaced populations are numerous: food, healthcare, basic items, shelter, protection and access to water. And, unfortunately, humanitarian aid is insufficient because providing regular aid is very difficult or almost impossible in the most remote areas.
On the health front, what are the most glaring signs of the deteriorating humanitarian situation?
There are several alarming signs. An obvious indicator is the late arrival of large numbers of patients at health structures. Far too many are waiting to be seriously ill before deciding to seek medical assistance.
We are also seeing an increase in cases of malnutrition that are directly linked to the decline in economic activities which allow families to meet their basic needs.
Many pregnant women can no longer attend health centres for antenatal care and are often forced to give birth at home, increasing the risk of complications and deaths at the community level.
Children also suffer serious consequences as they no longer have access to routine vaccinations or other preventive treatments such as seasonal malaria prophylaxis. As such, they are dangerously exposed to several life-threatening diseases. In some remote villages our teams have treated children who had never even been vaccinated, which would suggest that some people have not had access to medical care for years.
There is also a sharp increase in psychological disorders among people who have suffered and fled violence or who fear impromptu attacks.
How is MSF responding to this situation?
In parallel with the medical structures we support, MSF has intensified its emergency response activities since May 2018.
We monitor how people''s needs are evolving across the country everyday thanks to the presence of our teams in the field (an alert management system); we also launch exploratory and evaluation missions on the spot to quickly identify large population movements and other serious situations.
Our teams do this through mobile clinics which generally provide curative, preventive and psychological care and, where required, distribute essential relief items. These targeted interventions enable us to come to the aid of the most vulnerable and to temporarily protect their health despite insecurity.
This is a strategy that we also use in our regular projects. We call them "one-shot" clinics: as soon as a safety window, such as a temporary lull in violence a specific area opens up, we deploy a team that can provide the maximum level of care on the spot, including crucial preventive treatments and vaccinations. Sometimes there are more than 180 consultations in one day.
You mention the "one-shot" mobile clinics. Has MSF adopted other strategies to address the problem of access to populations?
Our identity – as a neutral, impartial and independent organisation – and our acceptance have allowed us and continue to allow us to reach particularly difficult areas. But since insecurity is an unstable and highly unpredictable variable, MSF has indeed been pushed to adapt operations to the conflict situation in central and northern Mali.
One strategy has been to involve the community more in the management of certain diseases through the training of community health workers and the provision of medicines. For simple pathologies, such as malaria or diarrhoea, patients are now cared for within their communities rather than in a health centre.
These community health workers are also trained to monitor pregnancies and to detect signs of malnutrition and other serious illnesses in order to refer cases on time.
This method of decentralisation has also been applied in nomadic communities who, because of their lifestyle, have limited access to health facilities. So when this population moves to track the livestock feed requirements, community health workers from the community follow suit and continue to provide health care.
Another important aspect, on which we focus our efforts, is vaccination because in a situation of conflict it really helps to strongly reduce mortality in children.
What are MSF''s biggest concerns for the coming months?
At the moment, we are worried that the insecurity will continue to intensify, inevitably depriving more and more people of access to healthcare and essential items.
Besides, as mentioned previously, Mali faces a number of challenges on a cyclical basis. For example, the rainy season that has just begun will bring its fair share of problems, such as peak malaria season, flooding, deteriorating road conditions and thus the accessibility of communities.
There is also a risk of lack of food because insecurity has significantly restricted farming activities. The difficulties that the Malian population will face in the coming months are more serious than in previous years.
* For several months, Médecins Sans Frontières (MSF) has been intensifying its medical activities in Mali. Despite the difficulties related to the security context, MSF has launched emergency interventions mainly in the central region to meet the important needs of the population. Unfortunately, this increase is also the sad indicator of an alarming humanitarian situation that is deteriorating day by day.
Cycle of violence against civilians must stop, says UN expert
Alioune Tine, the Independent Expert on the situation of human rights in Mali, says continuing deadly attacks on civilians in certain areas of the country could be described as crimes against humanity and urged stronger protection of people and property.
Tine made the remarks following the weekend attack on the Dogon village of Sobanou-Kou in central Mali’s Mopti region. He said he had received reports of many people killed and injured, as well as dozens abducted, with high numbers of women and children among the victims. Investigations by the authorities are continuing and further details, including exact casualty figures, will be available soon, Tine said.
The expert said the Sobanou-Kou attack on 9 June which continued overnight is part of an intensification of the deadly cycle of violence in central Mali, and these attacks are regularly carried out against civilian populations.
"Impunity for these crimes gives the perpetrators a sense of immunity – and these human rights abuses, documented almost every week for more than a year, could be characterised as crimes against humanity."
He said he welcomed the government’s quick response to the attacks on civilians in the Mopti region, including incidents on 1 January and 23 March in Fulani villages, as well as others in the area.
"However, I urge the Malian authorities to take more preventive measures to protect civilians, including the establishment of a stronger security presence in the centre of the country, the disarmament and the immediate dissolution of all armed militias, and conduct of effective judicial investigations to bring perpetrators to justice," Tine said.
"I would like to stress the absolute necessity, with the support of all concerned partners, to further strengthen the security of people and property in these areas exposed to this spiral of violence."
He said a comprehensive and coordinated approach is needed to prevent further violence and to tackle the problem in a sustainable way. "I appeal to civil society, traditional and religious leaders, and also to the international community and the regional authorities, to discharge their respective responsibilities." http://bit.ly/2J2ENSF
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