The medical humanitarian organization Doctors Without Borders, also known as Médecins Sans Frontières (MSF), has been forced by the Pakistani government to withdraw from the north-western tribal district Kurram.
Without providing an explanation, Pakistani authorities refused to issue MSF with a ‘No Objection Certificate’. Foreign organizations and journalists working in Pakistan require these certificates in order to operate in certain areas. In the absence of a certificate, MSF cannot continue their medical practice in this area.
The regional health authorities declined to comment on the reason for the refusal of the certificate. An anonymous employee of MSF said the Doctors Without Borders organization had never been denied the certificate before in their 14-year presence in the Kurram district.
MSF aims to respond to urgent medical needs in Pakistan, with a focus on people in isolated rural communities and areas affected by conflict. Their services include diagnosis and treatment facilities and materials for coping with natural disasters and mass casualties. MSF does not accept funding from any government, military or politically-affiliated group for its services in Pakistan. It relies solely on voluntary financial donations from individuals around the globe.
The 14-year stay of MSF in the Kurram district has been plagued by violence and has been the site of several deadly militant attacks. In June 2017, two explosions in the city of Parachinar killed at least 70 civilians and wounded many more in an attack at a crowded market. MSF plays an essential role here as the region has some of Pakistan’s poorest health services and lowest literacy rates.
Catherine Moody, the representative for MSF in Pakistan, reported that the organization was “saddened by the decision from the authorities” to halt its medical services in the region. Until recently, it had been providing these services in cooperation with the Sadda and Alizai hospitals, with 70 staff members carrying out 36,498 outpatient consultations in Sadda and 6,416 in Alizai in 2016.
The decision will negatively affect the many patients that reside in the region. Though the Pakistani government did not provide a reason for denying the group the certificate and forcing their withdrawal, they must be held responsible for providing an equally effective alternative to MSF. It is also important to address the cause of the conflict in the region, to prevent the destruction and casualties as seen during the attack in June.
The presence of the MSF is crucial to the health and wellbeing of many. In such a low-income area as Kurram, the Sadda and Alizai hospitals alone may not necessarily be an affordable option for many residents.
Dr. Talha Rahman, who operates the Elaj Trust, a group that aims to provide improved health care in Pakistan, said “There is a big gap in health care facilities in the area, the government is not doing its work, which is why international and foreign aid agencies come in to fill the void.”
The state minister for interior affairs, Muhammad Tallal Chaudry, said that MSF has not been banned or forced to withdraw from their work in other places in Pakistan. For the near future, MSF has said it will continue to provide medical services in the Pakistani provinces of Khyber Pakhtunkhwa, Sindh, and Balochistan.
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