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无国界医生工作受限制　被迫暂停救命的医疗项目
MSF forced to suspend lifesaving medical activities after restrictions imposed on its work.



由于苏丹（Sudan）当局实施愈来愈多的限制，医疗人道组织无国界医生被迫暂停在苏丹北达尔富尔省（North Darfur）杰贝斯（Jebel Si）的大部分医疗项目。无国界医生是该地区唯一提供医疗服务的组织。

无国界医生苏丹救援行动经理克里斯蒂娜（Alberto CRISTINA）说︰“随着我们缩减在杰贝斯的医疗项目，该地区将有超过十万人完全无法获得医疗护理。”

在过去一年，不断增加的阻碍令无国界医生的工作受到威胁。自二零一一年九月以来，药物和医疗物资的运送无法获得批准，而无国界医生亦愈来愈难为员工申请工作和出入许可。同时，进出杰贝斯（Jebel Si）交通亦被削减。

由于缺乏医疗物资和足够的人手，无国界医生无法继续提供门诊或者住院的诊症，疫苗注射项目亦要结束。难产妇女也将无法接受救命的剖腹生产手术。为孕妇提供的蚊帐和生产工具套装、以及营养治疗物资的库存亦已经耗尽。

由于无国界医生的人员已经无法稳定危殆病人的病情，他们别无选择，只能将病人转介到八小时车程以外，位于埃尔法舍尔（El Fasher）的医院。这对于出现紧急产科并发症的妇女而言特别危险，她们很难在旅程中存活下来。

无国界医生目前只能提供有限的营养健康护理，产前检查和健康教育。

克里斯蒂娜说︰“如果我们无法尽快将药物和物资送到医院和医疗站，很可能会出现疾病爆发，而产妇死亡和产前产后的死亡个案很可能会增加，甚至达到紧急水平。”

在该地区，产妇死亡率已经达到危急水平，而可预防和治疗的疾病（如脑膜炎和麻疹）的爆发和营养不良也很常见。在过去两年，无国界医生在卡古卢（Kaguro）治疗了一千八百零五名五岁以下的营养不良儿童。

无国界医生自二零零五年开始，在杰贝斯地区一个医疗站提供医疗援助，以于二零零八年，在卡古卢开设一个乡村医院，并在该地区开设五个医疗站。这些是该地区仅有的医疗设施，为当地大约十万常住人口，以及大约一万游牧人口提供医疗服务，他们都完全依赖无国界医生的医疗护理和紧急援助。

该地区没有本地医疗服务，或其它提供医疗援助的国际组织。最近的卫生部医疗设施距离数个小时车程，但由于当地局势不稳，以及崎岖的地形和糟糕的路况，让病人获得医疗护理极其困难。

克里斯蒂娜说︰“无国界医生希望情况可以得到解决。一旦相关限制解除，组织准备就绪恢复项目。当医疗物资、后勤设备和国际人员能够再次抵达这个地区，无国界医生的医疗队伍已经准备好为杰贝斯的居民提供救命的医疗护理。”

无国界医生呼吁苏丹政府提供必要的支援，以恢复无国界医生在该地区的工作，为居民提供重要的医疗援助。

无国界医生今天就当地的情况发表报告《请伸出援手》。报告已经交予苏丹政府，并同时要求紧急解除对无国界医生工作的限制。

无国界医生自一九八五年开始在达尔富尔工作，自二零零四年开始一直在该地区提供医疗护理。目前，无国界医生在北达尔富尔的多个地区工作，包括尚吉多巴亚（Shangil Tobaya），泰維勒萊（Tawila），达尔扎加瓦（Dar Zaghawa），以及南达尔富尔的施里亚（Shaeria）地区，提供多种医疗护理，包括基层和二层医疗护理，以及应对紧急事故。


As a result of increasing restrictions imposed by Sudanese authorities, the medical humanitarian organisation Médecins Sans Frontières (MSF) has been forced to suspend most of its medical activities in the Jebel Si, in Sudan’s North Darfur State. MSF is the sole health provider in the region.

“With the reduction of our activities in Jebel Si, more than 100,000 people in the region are left entirely without healthcare,” says Alberto CRISTINA, MSF’s operational manager for Sudan.

Over the past year, increasing obstacles have put MSF’s work under threat. No shipments of drugs or medical supplies have been authorised since September 2011, while MSF has encountered growing difficulties obtaining work and travel permits for its staff. Meanwhile, transport options to and from Jebel Si have been slashed.

Without medical supplies or sufficient staff, MSF can no longer provide either outpatient or inpatient consultations, and its vaccination programme has had to close. For women with complicated deliveries, lifesaving caesarean sections are no longer possible. Stocks of mosquito nets and delivery kits for pregnant women have run out, as have nutritional supplies.

With MSF staff no longer able to stabilise critically ill patients, they have no choice but to refer patients to the hospital in El Fasher, eight hours’ drive away. This is particularly hazardous for women with emergency obstetric complications, who have a poor chance of surviving the journey.

MSF is currently only able to provide limited nutritional healthcare, antenatal consultations and health education.

“If we are not allowed to deliver medicines and supplies to our hospital and health posts soon, disease outbreaks are likely to occur, and maternal and perinatal deaths are likely to increase and may even reach emergency levels,” says Cristina.

In the region, levels of maternal mortality are critical, and outbreaks of preventable and treatable diseases such as meningitis and measles are common as well as malnutrition. Over the past two years, MSF treated 1,805 children under the age of five for malnutrition in Kaguro.

MSF began providing medical assistance in the Jebel Si region in 2005, through a single health post, and by 2008 was running a rural hospital in Kaguro and five health posts throughout the region. These are the only health facilities in this area, and serve a permanent population of approximately 100,000 people, as well as about 10,000 seasonal nomads, all of whom are entirely dependent on MSF for healthcare and emergency assistance.

There are no local health services in the region, and no other international organisations providing medical assistance. The nearest Ministry of Health facilities are several hours’ drive away, but insecurity in the area, as well as mountainous terrain and poor roads, makes access extremely difficult.

“MSF is hopeful that the situation can be resolved,” says Alberto CRISTINA. “The organisation is ready to resume activities once the restrictions to its work are lifted. When medical supplies, logistical equipment and international staff are once again able to reach the region, MSF medical teams are ready to provide lifesaving medical care to the people in Jebel Si.”

MSF calls on the Government of Sudan to grant the necessary support so that it can resume its work and provide vital medical aid to the people of the region.

MSF’s report on the situation, Somebody Help, will be released today. The report has already been shared with the Government of Sudan along with urgent requests for restrictions on MSF’s work to be lifted.

MSF started working in Darfur in 1985, and has been providing medical care in the region continuously since 2004. Currently, MSF works in various locations in North Darfur, including Shangil Tobaya, Tawila, Dar Zaghawa, as well as in Shaeria locality in South Darfur, providing a range of services including primary and secondary healthcare, as well as responding to emergencies.