Despite the end of the war for independence from Russia, the Republic of Chechnya and the health of the Chechen population continue to be affected by instability. Beneath the relatively calm surface, a different conflict persists, with frequent reports of security incidents, vehicle explosions and shootings. Violence has also spread to the neighboring regions of Ingushetia, Dagestan, Kabardino-Balkaria and North Ossetia. Due to this insecurity, Médecins Sans Frontières (MSF) has implemented a ‘remote control’ project model in the Northern Caucasus. For the projects located in Chechnya, the work is supervised by the management team, who work from the coordination office some 1000 kilometers away in Moscow. Members of this team are occasionally able to make very short visits to the region.
In a situation where health needs are so extensive, MSF has responded in Chechnya with broad medical programmes, including primary care clinics, surgery, TB treatment and mental health support. In MSF supported clinics, Chechen doctors treat a population suffering from stress-related illnesses. MSF mobile clinics reach out to internally displaced persons (IDPs), who have returned to Chechnya but continue to live in temporary shelters. With special emphasis on mother-and-child care, MSF also provides pediatric care and gynecology services and supports existing mother-and-child facilities in Grozny. MSF’s presence in Grozny’s Hospital # 9 supports the neurosurgery and trauma departments, where MSF doctors treat over 150 violence-related trauma cases a year, and an intensive care unit, as well as a reconstructive surgery project to treat long-standing war injuries.
TB treatment was one of the major unmet needs in Chechnya following the end of the war. Started in 2004, the MSF-supported TB treatment programme recently expanded and now covers the population of the republic and ensures access to the TB patients in the remote mountainous regions in the South.
One by one, humanitarian organizations are closing down their emergency programs in Chechnya. However, the security situation in the region remains volatile and MSF assessments demonstrate a persistent need for health services for the population. As Willem de Jonge, Head of Mission for MSF explains, "We can see that there is real progress in Chechnya, but also a potential that things might change for the worse at any moment."