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Charity suspends work in Afghanistan after five staff are killed
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     Utrecht

    The medical aid agency Médecins Sans Frontières (MSF) has suspended activities in Afghanistan after five staff working for its Dutch branch were killed in one of the worst attacks on humanitarian workers since the fall of the Taliban in 2001.

    A Norwegian doctor, Egil Tynaes, died along with Dutch logistics expert Willem Kwint, Belgian project coordinator Hélène de Beir, their Afghan translator, Fasil Ahmad, and their driver, Besmillah.

    Their vehicle was apparently hit by gunfire and grenades on a road near Khairkhana in the northwestern province of Badghis last week.

    Dr Egil Tynaes, aged 62, was a senior doctor at a clinic in Bergen. He had used periods of leave to work for aid organisations and had first worked for MSF in Afghanistan in 2002. He returned in March this year working on a tuberculosis project and training local staff.

    Hélène de Beir, aged 29, had studied international human rights before becoming MSF's humanitarian affairs officer working in the Ivory Coast and Iraq. She became project coordinator in Badghis last month.

    Willem Kwint, aged 39, had run his own information technology company before offering MSF his technical knowledge, arriving in Badghis last June.

    Dr Egil Tynaes was killed in Afghanistan last week

    They were part of a team active in the province since 1999, establishing a polyclinic in Khairkhana that in the first four months of this year had held 6000 consultations. Tuberculosis treatment for 45 patients had recently begun, and two weeks ago the team opened a mother and child clinic.

    MSF said its thoughts were with the families of those murdered but also with the population of Afghanistan, "whose access to health care and other humanitarian help is being increasingly put in jeopardy." It is now analysing the situation, but in the short term has suspended its activities with the exception of emergency care, which will continue with Afghan staff. All its international staff are returning to their headquarters while local support staff in Khairkhana are being brought to a safe location.

    The agency has 80 international and 1400 local staff and has been active in 12 Afghan provinces since 1979. It offers support in different forms from primary care to regional hospitals with specialised programmes for tuberculosis and psychosocial care.

    According to Associated Press, a spokesman for the Taliban admitted its responsibility for the attack saying there would be more attacks in the future as foreign aid workers were supporting the policy of the Unites States.

    Last month a report by Christian Aid warned of the dangers of blurring humanitarian and military roles in countries such as Afghanistan ( BMJ 2004;328: 1154).

    In February MSF's former international secretary, Dr Morten Rostrup, told the BMJ that MSF work was threatened by aid being coopted into the "war on terror."

    The United Nations said the deaths had confirmed its fears of a worsening security in the country. The secretary general, Kofi Annan, condemned the "cold blooded killing" of unarmed aid workers.(Tony Sheldon)