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WASHINGTON, May 12 (OneWorld.net) - The only humanitarian organization providing ambulance services in Swat has been forced to suspend emergency services in the region and reduce efforts in other parts of northwestern Pakistan due to ongoing fighting between the Taliban and state forces.

• Girls in the northern Swat valley of Pakistan were restricted from attending school after the Taliban took control of the region following a peace deal with the Pakistani government. © bogavanterojo (flickr)Medecins Sans Frontieres (MSF), which was also the only group supporting the hospital in Mingora, the largest city in Swat, has tapered its activities in northwestern Pakistan due to general insecurity and several incidents directed at the organization itself. "Even before this new offensive, civilians in northwestern Pakistan were already struggling to survive a terrible situation," said MSF's Pakistan and Afghanistan coordinator Brice de le Vingne. "Today, curfews, roadblocks, and intensely fierce warfare make it virtually impossible for them to reach hospitals and clinics." Unknown numbers of civilians are trapped in their homes, unable to go out to buy food, get clean water, or visit a doctor if they need to, said MSF, adding that it is largely impossible for its own medical teams to reach people in need. (See the full statement below.)

• The number of people fleeing and seeking to flee their homes in northwestern Pakistan has spiked since a massive operation by the Pakistan military was launched on May 5 "to flush out Islamic fighters in Buner, Swat, and some areas in the nearby Dir district," reports the humanitarian news agency Inter Press Service. "The provincial government estimates between 150,000 to 200,000 people have already arrived in safer areas of North West Frontier Province (NWFP) over the last few days, with another 300,000 already on the march or about to leave," stated the United Nations late last week. These internally displaced persons (IDPs) are joining an additional 550,000 IDPs from Pakistan's tribal areas and NWFP. The influx "will place huge pressure on the resources already shared by around 93,000 people sheltering in 11 [UN High Commissioner for Refugees] UNHCR-supported camps and over 450,000 staying in rental accommodation or [with] host families," added the United Nations. In response, the humanitarian agency has established three new camps for people made homeless by the conflict and is providing relief supplies and necessities -- including tents, jerry cans, safe water, and hygiene kits -- to hundreds of thousands of those affected.

• "Pakistani armed forces and Taliban militants should take all necessary precautions to avoid civilian casualties in fighting in Pakistan's volatile Swat valley and adjoining areas of the North West Frontier Province," appealed the international monitor Human Rights Watch (HRW) yesterday amid reports that the Taliban is preventing civilians from leaving the combat areas and using them as human shields. The watchdog "also received reports from people forced to flee the fighting, that the Taliban are continuing their vigilantism and violent attacks, including killings and public beheadings, particularly in Mingora."

• "Since 2007, the Taliban have imposed their authority in Swat and adjoining areas through summary executions -- including beheadings -- of state officials and political opponents, public whippings, and large-scale intimidation of the population," writes HRW. "Girls' schools have been shut down, women have not been allowed to leave their homes unless escorted by male family members, polio immunization programs were halted, and nongovernmental organizations were expelled." In early April, Pakistani President Asif Ali Zardari signed a peace accord increasing the Taliban's control over numerous districts within the NWFP and allowing them to establish their version of Islamic law in Swat in exchange for laying down their arms. Last week, however, Prime Minister Yusuf Raza Gilani "declared an end to the peace deal with the Taliban, citing multiple violations of the deal by the Taliban and vowing to 'eliminate them,'" explalains HRW.  

MSF forced to reduce its emergency activities in north-western Pakistan

From: Medecins Sans Frontieres

Civilians trapped in crossfire with little chance to get food, water or medical care

May 07, 2009

Islamabad/Brussels - Medecins Sans Frontieres (MSF) has had to halt its emergency medical care in the Swat region of Pakistan and reduce activities in other areas affected by the current warfare. The international humanitarian organisation was the only one supporting the hospital in Mingora and providing ambulance services in Swat. The reduction of MSF's activities is a result of the generalised insecurity in addition to a number direct incidents against MSF itself.

"Even before this new offensive, civilians in north-western Pakistan were already struggling to survive a terrible situation," says Brice de le Vingne, Brussels-based coordinator for MSF's work in Pakistan and Afghanistan. "Today, curfews, roadblocks and intensely fierce warfare make it virtually impossible for them to reach hospitals and clinics. They are literally locked into this situation of extreme violence. On top of that, it is largely impossible for our medical teams to assist them."

Unknown numbers of people cannot escape the warfare. Trapped in their homes, they cannot go out to buy food, get clean water, visit a doctor if they need to.

MSF calls on all parties to respect the rights of injured civilians to medical treatment and to provide space for MSF to assist them without being subjected to further violence, threats and intimidation. As a priority, MSF needs to be able to evacuate wounded people and replenish Saidu Sharif hospital with urgently needed medical supplies.

"This is a completely untenable situation," says De le Vingne. "It has gone from dire to absolutely desperate. And there is every chance that things will get even worse. Right now, exactly when the risks facing people are radically increasing, we are simply not able to set up much of the necessary lifesaving activities."

Hundreds of thousands are seeking refuge in less insecure parts of Pakistan. They often stay with host families, putting extra strain on local resources including health care, or in improvised camps.

In Lower Dir, MSF continues to provide clean water and basic health care to displaced people in two camps. And in Peshawar, MSF prepares for a possible arrival of more displaced, including injured civilians who cannot find treatment closer to home. MSF has a team on standby in Dargai to assist all those who need surgery.

From December 2007 to December 2008, during curfew hours MSF ambulances transferred around 1,300 war-wounded patients and other emergencies from various parts of Swat towards Saidu Sharif and hospitals in Peshawar and Islamabad. In September, MSF treated almost 4,000 cholera patients during an outbreak of the disease. Such lifesaving assistance is no longer possible.

Other activities of MSF in Pakistan- in Baluchistan, Kurram agency, and in the Peshawar area - continue uninterrupted. MSF works in three basic health units in the Peshawar neighbourhoods that are hosting families displaced by the war, has supported a camp in Charsadda and distributed essential non-food items to over 30,000 displaced people in Peshawar, Charsadda and Mardan since August.

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