Security gives MSF unique problems in the troubled republics
Jonathan Steele in Nazran Saturday December 20, 2003 The Guardian
Satsita Khadirova watches from a corner of the cramped room as her 15- year-old daughter washes clothes in a baby bath, then huddles over a two-ring gas stove to make lunch for her younger siblings. Like many Chechen refugees, their father died a few months ago of tuberculosis caused by damp and miserable living conditions.
The family's home is a tiny space on the upper floor of a former warehouse and tractor repair workshop, long since abandoned to the post-Soviet scrap-heap of closed factories and collapsed agriculture.
The cold brick walls are draped in blankets to provide some insulation. Wooden floors cover the uneven concrete, and gas pipes and electric wires have been installed, courtesy of Médecins sans Frontières. Twenty-two other families live in the same bleak building.
The money for these "non-food items" comes largely from Echo, the European Union's humanitarian arm; MSF distributes them and organises who gets what.
Perhaps nowhere else in the world does MSF go so far beyond its original medical brief as in its work in Ingushetia with refugees from the two recent wars in the neighbouring republic of Chechnya.
About 90% of the 70,000 Chechen refugees no longer live in tents. To escape the winter cold they moved into kompaktniki, a vague term which covers a variety of disused garages, pig farms, chicken factories, bakeries and workshops.
Besides arranging the installation of floors and ceilings, MSF has supervised repairs and even built new housing.
MSF's work in the northern Caucasus is unique for other reasons. It faces a huge security problem and very difficult relations with the authorities.
Although there is no fighting in Ingushetia or Dagestan, the two republics which border Chechnya, the danger of kidnapping is ever present.
In August last year Arjan Erkel, its head of mission in northern Caucasus, was abducted in Dagestan and he has not been seen since.
MSF suspended all its operations in Dagestan, and forbids its international staff to enter Chechnya. Although it resumed work in Ingushetia a few months later, its foreign staff no longer sleep in the republic.
To add to the security problems, the Russian government prohibits radio communications. This is not a place for the familiar sight of white Toyota Landcruisers with large antennae and the red MSF logo on the side.
"In virtually every other country the government either supports or is neutral to MSF," says Duccio Staderini, head of MSF mission in Russia. "Here officials often create deliberate difficulties."
He served in western Afghanistan before going to Moscow and says even the Taliban were easier to work with.
"The latest restriction is that we have to get passes to go into the tented camps in Ingushetia.
"In another case, we were given permission to build 140 houses for refugees and then told to destroy them."
The authorities' policy is not to make life too comfortable for Chechens. To prove that the war is almost over and Chechnya is "normalising", they have been putting pressure on the refugees to go home.
The crudest method is to close the tented camps. One shut in December last year after the authorities gave a deadline for cutting off its gas and power supply. Another closed in October, and early this month refugees in the Alina camp were told to pack and find somewhere else to live because the tents were to be pulled down.
It was the last stage in a slow squeeze which has reduced Alina's numbers from 3,944 in early January to 818 by the beginning of December.
About 30,000 refugees have returned to Chechnya this year, lured partly by supplies of flour and other food from the World Food Programme and partly by promises of compensation for damaged homes made by the pro-Moscow Chechen administration, although so far fewer than 100 families have got it. Once there, they still benefit from MSF programmes.
Although no international staff go there, MSF uses a network of Chechen staff to take medicines and equipment to 25 Chechen hospitals, clinics and pharmacies in six regions of the war-torn republic.
It has paid special attention to Grozny's central hospital, helping to restore its operating theatre. The hospital managed to perform 395 operations last month,
As staff show visitors round the renovated building, which still has no sewerage or piped water (the city's drainage was destroyed in 1999 by artillery and bombs), Russian troops walk down the corridors and even come into the wards.
"Normalisation" clearly has some way to go.