Global medical charity MSF told to pack up from Bajaur Agency

Government has refused to renew NOC for MSF in Bajaur, after stopping its operation in Kurram as well

PESHAWAR: After the closure of its operations in Kurram Agency, The Médecins Sans Frontières (MSF) has been asked to wrap up its operations in Bajaur Agency meaning the organisation will have no presence in the Federally Administered Tribal Areas (Fata).

MSF’s Country Representative in Pakistan Azaad Alessandro Alocco confirmed  to The Express Tribune that the health organisation has been told to stop its functions in the area.

“There was a single-line statement from the government asking us to wrap up our only surviving operations in Fata, which is in Bajaur Agency, as our request for renewal NOC was declined,” a spokesperson for the organisation said.

There are 120 staff members, all Pakistani nationals working in Bajaur Agency, he said while also adding that international staffers were not allowed to work in the tribal belt. However, the government allowed the foreigner team based in Timergara, Dir Lower district of Khyber-Pakhtunkhwa, to perform the operations.



“We are extremely disappointed by the authorities’ decision to refuse permission for MSF to continue providing urgently needed medical care in Bajaur Agency,” said Alocco.

“Healthcare services are very limited in the area and most of our patients cannot afford to pay even for basic medical care. As the only major hospital providing free, quality healthcare in the area, the closure of MSF’s activities will leave a major gap and have serious negative implications for the health of people living in region and the surrounding areas such as Mohmand Agency,” he added.

The statement further added that MSF has been informed by the Pakistani authorities that the no-objection certificate (NOC) required for carrying out medical activities in Bajaur will not be renewed, while giving no explanation.

Without a valid NOC, MSF is not permitted to continue providing medical services. MSF has informed its team and the local community in Bajaur Agency about the decision and will complete the closure process within two weeks.

In Bajaur, MSF has been supporting the Ministry of Health at the Tehsil Headquarters hospital at Nawagai since 2013.

“The number of people seeking healthcare at Nawagai hospital has continued to increase, illustrating the enormous need for medical care in the area,” Alocco said. “Since extending the emergency services at the hospital in February 2017 to be open 24 hours, 7 days a week, we have seen 100 per cent increase in the patient numbers,” he added.

According to the MSF, in first nine months of 2017, MSF teams provided care to 41,029 patients in the hospital, compared to 38,865 in 2016. More than 14,400 patients were seen in the stabilisation room between January and September 2017, compared to around 8200 in 2016. Besides, 1152 deliveries were assisted by skilled MSF medical staff between January and September 2017, compared to 1,291 in 2016.

In 2016 MSF teams at Nawagai hospital conducted more than 31,000 outpatient consultations and treated 167 children for malnutrition. The team also treated more than 800 patients infected with Leishmaniasis, an endemic disease in Bajaur.

MSF also manages support services in the hospital such as the laundry and infection control. MSF provides support including medical supplies and training to the Ministry of Health Khar Agency Headquarter Hospital for responding to mass casualty incidents.

For severely ill patients in need of more intensive medical care than what can be provided at Nawagai hospital, MSF ensured their referral to Khar Agency Headquarter Hospital or to the MSF-supported district hospital in Timergara, Khyber Pakhtunkhwa province.

MSF has been working with Pakistani communities who are affected from natural disasters, conflict or lack of access to healthcare, since 1986. Their teams are currently providing free emergency medical care in K-P, Sindh and Balochistan provinces.

The organisation’s Kurram Agency chapter was asked to shut down in September, 2017.