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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

slide2
BACKGROUND
  • 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:
slide3
THREE RESEARCH QUESTIONS
  • 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
slide6
Locations
  • Reflect security strategy taken
  • 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
slide13
CONCLUSIONS
  • 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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