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No sanctuary in times of conflict:. A systematic analysis of security incidents affecting MSF’s medical mission from 2009-2013 in four highly insecure contexts. Maya Sibley AAU analyst for MCUF June 13, 2014. BACKGROUND.

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No sanctuary in times of conflict

No sanctuary in times of conflict:

  • A systematic analysis of security incidents affecting MSF’s medical mission from 2009-2013 in four highly insecure contexts

  • Maya Sibley

  • AAU analyst for MCUF

  • June 13, 2014

www.msf.be


  • MSF works in highlyunstablecontexts, and faces frequentacts of violence againstitsbeneficiaries and medical mission

  • Typology of violence against MSF ispoorlyunderstood – increasing violence isperceived, but not evidence-based

    • Launch of three-yearproject:


  • How many and what are the trends in security incidents in Afghanistan, DRC, South Sudan and Kenya?

  • What are the consequences of security incidents in these four contexts?

  • What are the opportunities and limitations of SINDY reports with regards to the data needs of the MCUF project?

  • SINDY reports & semi-structured interviews for Q3

  • Data collection




  • INCIDENT TYPOLOGY

  • Trend over time

  • Baseline not established, but no increase observed over study period

  • MCUF hotspots

Most perpetrators are unknownFrom those identified, the most common perpetrator is State Security Forces

(25% overall)

  • Most frequent types of aggression

  • Afghanistan Armed entry 42%

  • DRC Robbery 34%

  • South Sudan Threats 38%

  • Kenya Robbery/Death threats 38% (each)


Victim typology
VICTIM TYPOLOGY

National staff are the most common victims in absolute numbers but international staff are 5.1 times more at risk (p-value <0.0001, CI: 3.9-6.7)

  • Males are more frequentlyvictims in Afghanistan (59%) , DRC (73%) & S. Sudan (6%)

  • Women are more frequentyvictims in Kenya ( 67%, but sample size issmall)


Incident triggers consequences
INCIDENT TRIGGERS & CONSEQUENCES

  • The most common triggers and consequences of incidents were mapped (N, %)

  • Trigger:

  • Financial constraints60 (30%)

  • Active conflict & civil unrest 30 (15%)

  • General consequence:

  • Financial loss 64 (32%)

  • Compromisedquality of care 45 (23%)

  • Interruption of services 37 (19%)

  • Compromisedneutrality 32 (16%)

  • Types of consequence per victim:

  • Psychological 206 (62%)

  • Physical 65 (20%)



Sindy reporting
SINDY REPORTING

  •  Half had not reported to SINDY a recent MCUF incident (4/8) 

  • TOP 4 REASONS FOR NOT REPORTING

  • MAIN SINDY SHORTCOMINGS FOR MCUF

  • Descriptive narrative

  • What should and shouldn’t be reported unclear

  • SINDY fields are vague

  • “Managing the security situation was a priority over reporting”

  • “Incidents occur so frequently that if we did systematically report, we would be constantly reporting!”

  • “I feel demotivated due to lack of SINDY report feedback and no security analysis from HQ.”

  • “SINDY is used only for reporting incidents which directly or indirectly have an impact on MSF activities.”



Bias limitations
BIAS & LIMITATIONS

  • Data quality / Partial data

  • Inconsistent reporting

  • Lack of denominators

  • Victims

  • Time sensitive

  • Highly subjective

  • Limited capacity & know-how


  • First evidence-based mapping of violence directed against MSF and its beneficiaries.

  • Context-specific and general patterns of violence were identified, allowing development of more appropriate tools for the monitoring of “Medical Care Under Fire”.

  • Such monitoring is vital to sustain MSF operations in such contexts.



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