Hundreds of thousands of people fled in all directions throughout the region, desperately in search of safety. The displaced, many of whom have been forced to flee multiple times, have little or no access to health care, food, water or basic shelter. They find shelter in camps or with host families, or hide in the forest where they are under threat of attack from all armed groups. Few aid agencies have established humanitarian programs with a continued presence outside the provincial capital, Goma.
One of the greatest challenges facing independent humanitarian action today is that of reaching civilians caught in war and armed conflicts. Nowhere is this more frustratingly illustrated than in Iraq, where MSF has struggled to gain a meaningful foothold since the US-led invasion of 2003. Various military and political actors have sought to use and abuse humanitarian action for political purposes and in doing so have made humanitarian organizations a target for violent attacks. This has undermined the ability of MSF, and other neutral humanitarian organizations to address critical needs of the civilian population.
MSF was forced to leave the violence-affected regions of Iraq in 2004 when attacks on humanitarian aid workers placed its teams at too great a risk. The recent moderation of violence levels in Iraq has presented MSF with new opportunities to re-engage inside Iraq with direct medical care. In 2008, MSF has cautiously started several new projects inside Iraq.
The figures are shocking. The World Health Organization (WHO) estimates there are 178 million children suffering from undernutrition across the globe. All told, malnutrition contributes to 3.5 to 5 million deaths in children under five each year. According to UNICEF, the situation is actually getting worse in 16 high-burden countries. In the world’s “malnutrition hotspots,” the Horn of Africa, the Sahel and South Asia, many families simply cannot afford to provide nutritious food—particularly animal source foods such as milk, meat, and eggs—that young children need to grow and thrive. Instead, they struggle to survive—far from the media spotlight of high-profile humanitarian emergencies—on a diet of little more than cereal porridges of maize or rice, amounting to the equivalent of bread and water.