Memorandum submitted by Médecins
Sans Frontières (MSF)
Drawn from the MSF Report: Persecution,
Intimidation and Failure of Assistance in Darfur[115]
There is a war in the West of Sudan, with two
rebel movements—the Sudanese Liberation Army (SLA) and Justice
and Equality Movement (JEM) having launched an insurgency against
the rule of Khartoum. After dramatic attacks in early 2003, the
Government of Sudan countered with a decisive military response
as well as arming and organising tribal militias to launch a campaign
of violence and forced displacement against the civil population
(presumed to support the rebel insurrection). Mass violence against
civilians in Darfur began with a wave of attacks against villages
in February 2003 and escalated in summer 2003.
For over a year, the people of Darfur have endured
a vicious campaign of violence and terror which has led to huge
numbers of deaths and forced more than a million people to flee
from their destroyed villages in search of safety. Over a year
after their escape from their villages and after countless promises
from the Government of Sudan and world leaders, safety has still
not been found. The victims of violence were forced out of their
homes; their homes were destroyed; they were pursued during their
flight; harassed and violated during flight and they have continued
to be persecuted and intimidated as they seek shelter in crowded
and miserable displaced settlements. The pervasiveness of the
violence against civilians in Darfur, as well as its duration
over time represents a crime of enormous magnitude. The failure
to stop the violence against civilians in Darfur was matched with
an equally staggering failure to provide the necessary assistance
for these devastated communities in the first year of the conflict.
Patients in MSF clinics in Darfur and in neighbouring
Chad have repeatedly recounted to us how armed militia attacked
their villages, killing and raping the inhabitants. These people
saw not only their homes destroyed, but also the militia purposefully
destroyed their crops and water sources, ensuring that their way
of life was torched along with their houses. Almost 1.8 million[116]
people were forced to flee their homes, including 200,000 who
crossed the border to seek refuge in neighbouring Chad. Very few
of them envisage how and when they can return and take up their
lives.
Humanitarianism is based on the notion that
people have the right to find safety and succour amidst the violence
of war. In Darfur the villagers fleeing violence and persecution
have found little of either, as the violence and intimidation
continued in their places of refuge. Rape and killings have been
commonplace in the towns and camps where over a million displaced
people now huddle.
The scale and impact of violence has been documented
in a series of nutritional and retrospective mortality studies,
which MSF conducted through the spring and summer of 2004. [117]The
results of these surveys reflect the pervasiveness of the violence
and appalling consequences of the atrocities committed against
people in Darfur, but also the failure of the response to aid
the victims of this violence.
In all surveys conducted by MSF, the leading
cause of death for those over the age of five years was violence
rather than disease or malnutrition. In one study in Wade Saleh
district in West Darfur, 60% of the deaths in people above five
years of age were due to violence. Surveys completed by MSF in
September 2004 showed that the leading cause of death (32.5%)
suffered by displaced people living in Kalma camp over the previous
seven months was violence and this figure was a staggering 78%
of those aged 18-49 years. Among the displaced population in Muhajaria
and Shariya, who had not been exposed to violence in the first
part of the year, mortality was relatively low. But mortality
recently surged due to new fighting and recent displacement—almost
entirely in those over five years of age (95.5% of all deaths
in those aged 18-49 years was due to violence in the previous
30 days prior to survey).
While men seemed to be the primary target, women
and children were also killed in large numbers. Studies in the
large displaced camp of Murnei in West Darfur showed that 75%
of the deaths of adult women resulted from violence. In the villages
around Murnei, which had been torched in the campaign of terror,
an average of 5% of the total population was killed. Those who
survived told MSF staff of people being locked in houses as they
were set afire. MSF staff saw clear signs of torture evident amongst
some of the survivors.
The camps of refuge have been turned into congregations
of fear, in which people claim they live under the guard of some
of the same armed men who burned their villages and killed their
families. The displaced are too scared to go home and yet frightened
to remain where they are. In several camps, people were too scared
to transport wounded children to a hospital, fearing to be attacked
on the road. Although the Government of Sudan has claimed that
the violence has been brought under control, the displaced still
face violence and intimidation.
The massive violence against civil populations
resulted in elevated mortality, destruction of livelihoods and
flight. The terrified populations that crammed into towns and
villages across Darfur, seeking relative safety then suffered
a second calamity. These terrified populations faced suffering
and death due to a massive public health crisis induced by deprivation
during their ordeals and lack of shelter, water, food, an adequate
sanitary environment and access to essential health care. The
aid programme was one year late and remains inadequate.
Even in the easily accessible Kalma camp, located
30 minutes from the major urban centre of Nyala, 3.2% of children
still suffered from severe malnutrition in September 2004. For
many months, the 75,000 people in Murnei camp were forced to survive
on less then 1,000 kilo calories per day—less than half
of what is minimally required to sustain a human being. Less than
a third of the families in the large camps in Kass owned any soap—essential
to avoiding diarrhoeal and skin diseases.
The lack of assistance has forced people into
desperate measures and dangerous survival mechanisms. In the displaced
settlements, people are forced to search for firewood to exchange
for food even though it means running the risk of rape for women,
of execution for the men. Some told MSF that they were so desperate
and so scared they would send the children out in the hours before
dawn to search for wood—in the hope they would be less subject
to attacks.
In the full MSF report, MSF seeks to convey
what has happened to the health of people in Darfur based on data
emerging from our clinics and surveys. We do this in order to
create some understanding of the magnitude and depth of the suffering
and the failure to address these problems. We try to combine this
with a human perspective gathered from the conversations and laments
of the thousands who came to our clinics for assistance but who
themselves were unable to remain silent about the atrocities committed
against them and their families.
While this picture of suffering, which has left
hundreds of thousands of broken lives amidst the burned-out houses
and villages of Darfur is a reflection of what has happened, we
have to remind ourselves that this violence and suffering has
still not ended. The people of Darfur continue to live in fear
of violence and intimidation, even while an assistance effort
goes on around them.
METHODOLOGY
The report is based on a series of cross-sectional
nutrition and mortality surveys[118]
carried out in conjunction with Epicentre[119]
in six locations of Darfur—as well as face-to-face encounters
with displaced people and patients, reported by the teams working
in West, South and North Darfur since the beginning of the year
2004.
MSF PRESENCE
MSF currently has over 200 international aid
workers and over 2,000 national staff working throughout the three
States (West, North and South Darfur) and an additional 30 international
staff and 160 national staff caring for Darfurian refugees in
Chad. MSF medical teams in 26 locations in Darfur conduct medical
consultations, treat victims of violence, care for severely and
moderately malnourished children, improve water and sanitation
conditions, and provide blanket feeding and other essential items
for more than 700,000 displaced people in Darfur. Since the beginning
of its operations, MSF has born witness to the extent and the
nature of the violence against people in Darfur and its impact
on the health and nutritional status of the population.
November 2004
115 http://www.msf.org/source/countries/africa/sudan/2004/1101/darfur2004-11-01.doc Back
116
United Nations, Darfur Humanitarian Profile No 7, October
1, 2004, p 2, UNHCR Press Release of 27 October 2004. Back
117
Epicentre surveys in Kalma, Kass and Muhajaria, September 2004;
Epicentre survey in Habilah, August 2004; Epicentre survey in
Kebkabyia, August 2004; Epicentre survey in Murnei and Zalingei,
June 2004; MSF-Holland food and nutritional survey in Wadi Saleh
and Mukjar provinces, April 2004. Back
118
Epicentre surveys in Kalma, Kass and Muhajaria, September 2004;
Epicentre survey in Habilah, August 2004; Epicentre survey in
Kebkabyia, August 2004; Epicentre survey in Murnei and Zalingei,
June 2004; MSF-Holland food and nutritional survey in Wadi Saleh
and Mukjar provinces, April 2004. Back
119
Epicentre is a non-profit organisation created in 1987 by Me«decins
sans Frontie"res, which groups health professionals specialised
in public health and epidemiology. In 1996, Epicentre became a
World Health Organisation Collaborating Center for Research in
Epidemiology and Response to Emerging Diseases. www.epicentre.msf.org Back
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