Despite more than two decades of bringing medical care to one of the most dangerous countries in the world, the humanitarian group Doctors Without Borders is withdrawing from Somalia due to "unparalleled levels of risk." In an announcement today, the group says that "extreme abuses" perpetrated against the staff and it supporters, combined with a total lack of support from civilian leaders have forced them to close all their medical and health programs, cutting off the only source of vital health services for the country's most endangered citizens. 

Known in most of the world by its French name, Médecins Sans Frontières, the organization has had a continuous presence in Somalia since 1991, a period that has included a civil war, the disastrous American intervention, drought, famine, the rise of offshore piracy, and brutal sectarian violence. The last few years in particular have been marred by the rise of Al-Shabaab, an al-Qaeda affiliated terrorist group that has taken over large swaths of the country while doing battle with Kenyan peacekeepers and the Somali military. 

MSF specifically cites the violence of these groups as the reason for the pullout. Somalia is the only country where the doctors use armed guards for protection, as they are usually able to negotiation safety guarantees, even from combatants in the worst war zones. However, 14 staff members have been killed in dozens of attacks on their facilities since 1991 and two employees of the group were recently released after being kidnapped and held hostage for nearly two years. (Correction: It's actually 16 deaths, when counting the two most recent murders of MSF staffers in 2011.)

The president of MSF, Unni Karunakara, said this is "undoubtedly the most difficult announcement I have had to make," but "respect for humanitarian work and principles no longer exists in Somalia."

Doctors Without Borders, which won the Nobel Peace Prize in 1999, says it has more than 1,500 staff in Somalia, providing free health care, immunisations, water and food relief, and disease management. They gave no indication of what conditions would be necessary for them to return to the country.