Doctors Without Borders pulls out of Somalia due to 'extreme attacks'

An international aid organization that was a lifeline for hundreds of thousands of Somalis for 22 years announced Wednesday that it was pulling out of the country, saying the threat of deadly violence had become intolerable.

The withdrawal of Doctors Without Borders (DWB) is a blow to the government's effort to convince Somalis and foreign donors that security is improving and a stubborn Islamist insurgency is on the wane.

Within hours of the announcement, al-Qaeda-linked al-Shabab militants raided a DWB hospital in southern Somalia, forcing patients out before ransacking it.

"In choosing to kill, attack and abduct humanitarian aid workers, these armed groups, and the civilian authorities who tolerate their actions, have sealed the fate of countless lives in Somalia," said Unni Karunakara, international president of DWB.

Sixteen of DWB's staff members have been killed in Somalia since it began working there in 1991, when civil war erupted, but the organization stayed on, negotiating with militant groups and hiring armed guards -- something it does not do in any other country.

"But we have reached our limit," Karunakara said. "The closure of our activities is a direct result of extreme attacks on our staff."

The pullout comes one month after two Spanish DWB workers were freed by their Somali kidnappers following almost two years in captivity.

In early 2012, the group closed two major medical centers in the capital, Mogadishu, after two international staff were shot dead by a former colleague.

Dozens of foreign DWB staff pulled out of Somalia in recent weeks, the charity said. 

The departure will deprive many Somalis of medical help. DWB spokesperson Tim Shenk told Al Jazeera that in several locations the organization was effectively the only source of quality medical care. In 2012 alone, its teams there provided more than 624,000 medical consultations, admitted 41,000 patients to hospitals, cared for 30,000 malnourished children, vaccinated 58,600 people and delivered 7,300 babies.

"In Jowhar, MSF (the French abbreviation of Doctors Without Borders) provided free C-sections for women who otherwise have nowhere else to go for their emergency surgeries," Shenk said. In Galkayo, MSF provided the only facility for treating tuberculosis."

As a consequence of the departure, some 1,500 local doctors, nurses and assistants will be jobless.

There was no immediate comment from the Somali government, which is struggling to pull the nation out of two decades of conflict and is unable to provide basic public services, including health and education.

DWB told Al Jazeera that all parties need to be willing to negotiate acceptable conditions for humanitarian aid and medical assistance, but "we do not expect to resume operations in Somalia any time soon," Shenk said.

Lisa De Bode contributed to this report. With Al Jazeera and wire services