Doctors Without Borders closes all operations in Somalia after 22 years

NAIROBI — Medical aid agency Doctors Without Borders (MSF) closed all its operations in war-torn Somalia on Wednesday, warning of growing insecurity, after 22 years of working in the Horn of Africa troublespot.

"The closure of our activities is a direct result of extreme attacks on our staff, in an environment where armed groups and civilian leaders increasingly support, tolerate, or condone the killing, assaulting, and abducting of humanitarian aid workers," MSF president Unni Karunakara told reporters.

The pullout by MSF, an aid agency that has earned a reputation for working in the toughest of conditions, is a major blow to the reputation of the internationally-backed government in Mogadishu.

"We are ending our programmes in Somalia because there is an increasing imbalance between the risks and compromises that our staff must make, and our ability to provide impartial care to the Somali people," Karunakara said in the Kenyan capital.

MSF has treated more than 300,000 people so far this year alone in Somalia, a statement added.

Karunakara, who said MSF's activities had been put under "unparallelled levels of risk", cited the killing of two staff in Mogadishu in December 2011 -- and subsequent release of the gunman -- as well as the kidnapping of two MSF workers from the Kenyan refugee camp Dadaab in October 2011.

The two kidnapped staff, Spanish women working as logisticians, were released last month after 21 months in captivity in Somalia.

But MSF said that wider attacks had forced it to make the "painful" decision to shut operations.

"Respect for humanitarian principles, always fragile in conflict zones, no longer exists in Somalia today," Karunakara added.

"There have been dozens of attacks against people, against vehicles, hospitals... we've just reached our limit," he said, adding that 16 MSF staff have been killed in Somalia since 1991.

The closure of MSF medical operations in at least 11 sites -- including in the capital Mogadishu, where MSF runs the only intensive care unit for children -- will impact hundreds of thousands of the most needy Somalis, he said.

Many of those areas are not under the control of central government, including Burao in the self-declared independent region of Somaliland, Galkayo in the northeastern Puntland region and the flashpoint southern port of Kismayo.

Operations were also shut in areas under the control of the extremist Shebab, who had allowed MSF to work despite expelling almost all other international aid agencies.

As MSF announced the pullout, Shebab gunmen stormed their compound in Dinsor in the southern Bay region.

"Shebab fighters broke in, ordered all the staff to leave and have taken everything, including their laptops," said a local MSF worker, who asked not to be named.

"Gunmen entered the hospital and set up base there, ordering patients to leave," said Ali Mohamed, a resident in Dinsor.

Last year, MSF's more than 1,500 staff provided over 624,000 medical consultations and admitted more than 41,000 patients to hospitals.

Armed groups targeted MSF's already insufficient funding, Karunakara said, and the "tolerance of these abuses" by civilian leaders had "taken away what little access to medical care is available to the Somali people".

Somalia's embattled government, selected in November in a UN-backed process, was hailed at the time by the international community as offering the best chance for peace in Somalia since the collapse of central government in 1991.

A 17,700-strong African Union force fighting alongside the national army has forced Shebab fighters from a string of towns in the past two years.

But Somalia's often rag-tag security forces, incorporating multiple militia forces into its ranks, has also been repeatedly accused by rights groups of a string of abuses.

Shebab fighters remain a potent force, with suicide commandos staging a brazen attack on a key UN compound in the centre of Mogadishu in June that killed 11.