The medical group Doctors Without Borders is reporting a drastic decline in medical care for people in the Somali capital Mogadishu that has corresponded with widespread conflict across the country. Nick Wadhams has more from our East Africa bureau in Nairobi.
Doctors Without Borders says that only 250 hospital beds are now available in Mogadishu, down from 800 at the start of the year. About 75 percent of the staff in those hospitals have also fled.
The group says that people are terrified about leaving their homes and are not getting even basic treatment. It says that the warring parties in Somalia, which include Islamic insurgents, Ethiopia troops and forces of the transitional government, are not allowing doctors to work, a fact it calls shocking and absolutely unacceptable.
The situation has only gotten worse in recent months. Doctors Without Borders says it is seeing a new wave of people escaping the violence. Some 30,000 people are estimated to have fled in July alone to the west. An MSF worker who has worked there, Gustavo Jorge Fernandes, says malnutrition among the displaced is high.
"During the month of July, from 1,500 children under five in the area we found that almost 38 percent present signs of acute malnutrition and among those almost 12 percent present signs of severe acute malnutrition, which for a better understanding means that 12 percent of this population is at immediate risk of dying," said Fernandes.
Somalia has been without an effective government since 1991. Conditions there became drastically worse in December, when Ethiopian forces invaded to oust the Islamic Courts Union, a group that Ethiopia and the United States say maintains strong links to al-Qaida.
Doctors Without Borders has treated some 60,000 people in that time but says even that is not nearly as much as it wants to do. "We're only able to reach a fraction of the enormous population in this city which requires assistance and that is, yeah it's making us feel extremely frustrated and angered that it is not possible to bring the medical assistance that we wish to provide in the manner that is required by those people," said Colin McIlreavy, the Somalia mission chief for MSF. "There's a willingness by MSF to do more yet we are constrained by the ongoing and we feel increasing level of insecurity."
The group says it is trying to talk to all parties in the conflict and has been able to work effectively in similarly chaotic situations. While its own employees have not been specifically targeted, it argues that insecurity is too high to provide medical care to people who need surgery or other more complicated treatment.
