For years, Somalia has been a byword for anarchic violence, famine, and drought. It is depicted as an inhospitable, ungovernable country ripped apart by long-standing internal feuds and, more recently, as a harbor for terrorism and piracy. Yet not only is this portrayal superficial, but paradoxically it has served to obscure both the nature and severity of the current crisis. The unmitigated disaster that Somalis have experienced in the past two years is not just another episode of the country's troubled history; it is the result of a particularly brutal and escalating war spawned by the clash of national, regional, and international political agendas.
In December 2006, the Ethiopian army, citing national security concerns, pushed deep into Somalia to oust the Islamic Courts Union (ICU)--a multi-faceted political and military movement displaying the diverse characteristics of contemporary political Islam--that had established various degrees of relative stability in south-central Somalia, including the capital Mogadishu. On the coattails of Ethiopia's rout of ICU militias, the Somalia Transitional Federal Government (TFG), established under UN auspices in 2004 in Kenya, was installed in Mogadishu. Supported by the United States in the name of counter-terrorism, the Ethiopian-led regime change was welcomed on January 5, 2007 by the United Nations (UN), the European Union (EU), the African Union (AU), and the League of Arab States as "an historic opportunity for the Somali people to reach sustainable political solutions."
Yet almost immediately, an armed insurrection led by former ICU supporters started to intensify, followed by counter-insurgency operations carried out by TFG and Ethiopian forces. A fierce, rapidly escalating war was launched, leading to catastrophic consequences for an already exhausted population. Mogadishu was further destroyed, with thousands killed and injured by the fighting, while hundreds of thousands were forcibly displaced only to face dire conditions in makeshift camps.
As a humanitarian organization, Doctors Without Borders/Medecins Sans Frontieres (MSF) has no legitimacy to comment on the rationale for using military force in Somalia or elsewhere. Neither are we in a position to pass judgment on the relevance of decisions by the United Nations Security Council or other international players to support one belligerent or another. Our concern lies only with the manner in which conflicts are conducted and with their impact both on civilian populations and our ability to assist them. In that regard, not only has internationally-sponsored regime change led to the ratcheting up of unbridled warfare, including crimes that Amnesty International and Human Rights Watch have thoroughly documented, but it has also been supported by international governments and institutions in a way that has made it more difficult for humanitarian aid organizations, confronted with mounting security threats including targeted attacks, to help an increasingly beleaguered Somali population.
A Humanitarian Catastrophe
Since the overthrow of Siad Barre's regime in January 1991, Somalis have periodically experienced severe hardship as a result of war and political instability, none more dramatic than the famine of 1991-1992 that cost hundreds of thousands of lives. While regional islands of stability have emerged since, mainly in the northern part of the country, and while intensive, unregulated trade since the mid-1990s has generated significant economic activity, the socio-economic, educational, health, and nutritional status of a majority of Somalis has remained poor. Socio-economic surveys conducted by the United Nations Development Program (UNDP) and the World Bank estimate infant and maternal mortality to be among the worst in the world.
This already precarious situation deteriorated further from December 2006 onward. It is difficult to ascertain the precise magnitude and extent of the crisis, as surveillance systems able to provide accurate population figures, mortality, morbidity, and malnutrition rates are nearly non-existent due to security constraints. …