Somaliland: ‘Being close to the people was important to us’

In 2013, I was leading MSF’s programme in Somaliland –here the need for healthcare services was urgent and security risks in filling this void were deep. Among my responsibilities as Head of Mission (HoM) was to ensure that MSF’sprinciples of independence, neutrality and impartiality were never compromised. My team and I worked hard dayin and dayout to make this happen.

MSF was providing secondary healthcare services to a population of about 2,00,000 who otherwise had nearly zero access to healthcare. The medical facility we supported was a Ministry of Health (MoH) hospital.

A dilemma

MSF has always been close to the community it works in and therefore, asthe HoM, I had to make sure that we were not an outsider and that we understood the people we treated. Yet, due to the extremely precarious security conditions, we had to opt for armed protection.This was a huge compromise to MSF’s principle of neutralitybut one that was needed in view of such threatening circumstances.

I have workedfor MSFin the past in dangerous areas like Darfur.Yet this was the first time I saw the team  having to depend on armed guards for even being able to go to the hospitalonly 100 metres away. For MSF, this was very hard to accept as it couldsignificantly question MSF’s core principles. The situation was also difficult for the team to cope with, andthe dilemma of having armed guards within the hospital premises had a substantial impact on all of us. Only very rarely do we need to accept these compromises to our principles in the interest of being able to reach our patients. This is a dilemma that we can never easily accept.

Needless to say,each second counts when a life has to be saved. Since the guards had to always be with us, often the first thing that had to be considered was whether they were available.Medical professionals are very attached to what they’re doing – treating people who are seriously unwell. I knew that things could start to be overwhelming for them, and I tried that this thin line was not crossed.

MSF worked in collaboration with the MoH at the hospital.MSF provided training and shared expertise with MoH staff.Diabetes and blood pressure were chronic problems.  I also remember that a lot of women faced difficulties with their deliveries. An Operation Theatre was therefore restructured and necessary equipment was installed.These amenities were handed over to the ministry in due course.

The programme in Somaliland was wrapped up soon. This followed MSF’s decision to close its operations in Somalia in response to a series of serious attacks on its staffand facilitiessince 1991. 

My beginning with MSF

I know for a fact that what I experienced in Somaliland will stay with me longer.I went on my first international assignment with MSF in 2006 as an administrator for theprogramme in Ethiopia.  I have completed 11 assignments till now, in countries such as Sierra Leone, Indonesia and South Sudan. I want to share a bit about why I joined the organisationbefore ending.

I saw advertisements calling upon volunteers in the wake of the tsunami that hit southern India in 2004. The call was made by MSF, and I realised that this was a chance for me to give back to my community. I started my journey with MSF as an administrator responsible for a mental health project in Puducherry.

My first memories of MSF are therefore working with the fisherfolk whose lives had been destroyed by the tsunami; of realising that mental health services can change someone’s life. I also came to see theimportance of MSF’s medical work during mobile health clinicswhich covered the coastal lines of Puducherry.All ofthis inspired me to stay on.