01/01/2014 13:13 GMT | Updated 03/03/2014 05:59 GMT

Goodbye to an Ominous Year

Triskaidekaphobia is the sort of word learned on Fridays, generally late night, as the pub crowd thins of professionals, leaving behind a handful of oddballs good at Sudoku, trivia and crosswords. It denotes a morbid fear of the number 13. I, for one, have never been triskaidekaphobic.

I work for Médecins sans Frontières (aka Doctors Without Borders). Professional humanitarians are many things; rarely superstitious. And yet 2013 has proven a year to leave behind, and I find myself harbouring nothing morbid, yet nonetheless fairly shaken by the 13th year of the new millennium.

There are many culprits, which gives pause to think hard about whether there has been a simple coincidence of misery and violence or whether the current state of affairs is a Dickensian ghost of crisis future.

Start with Syria. From a humanitarian perspective - from any perspective - the situation inside Syria is horrific. War is never pretty; the protracted and deliberate destruction of a civilian population and its bases for life all the worse. The humanitarian response, stretched yet coping with over 3million refugees in bordering nations, has been steadfastly marginalized within the country, effectively prevented from delivering aid that is impartial, effective, or anywhere nearly proportional to the needs. A brutal logic seems to have supplanted the Geneva Conventions, one where "my enemy's doctor is my enemy" (see this previous MSF post), a perversity that also holds true for the enemy's baker, the enemy's healthcare system, and the enemy's children. The number of Syrians inside Syria who have no access to assistance or safety exemplifies the triumph of local sovereignty over universal ideals.

Now pass to Central African Republic, where the March coup by a ragtag jumble of militias precipitated a slide into chaotic violence and now inter-communal purges, with Muslim and Christian "defense" militias perpetrating atrocities on one another. Hundreds of thousands have been forced to flee their homes. Long an ignored crisis, the number of humanitarian actors present has been small, and insecurity restricts even further the availability of healthcare, shelter or clean water. CAR's people endure deprivation and fear without sufficient access to assistance and safety. It gets worse. Only months ago, a colleague passed a checkpoint where he witnessed a summary killing. In a world of bad, it is still exceedingly rare that such an act is perpetrated so openly and nonchalantly in front of a foreign aid worker. That is the incarnation of impunity. Now complete with the beheading of children.

The list continues. South Sudan, only weeks ago so full of the promise of a new nation, has folded rapidly into a combination of armed political power struggle and ethnicity-fuelled pogroms. Once again, people huddle among themselves in the bush or crush into the camps of UN Peacekeepers, with assistance and safety falling short of the immensity of needs.

In Myanmar, militant Buddhism and mute political leadership have given rise to the targeting of ethnic Muslims in Rakhine state, burning their homes to the ground, driving whole communities into flight and excluding people from their access to basic public services. Though born and raised in Myanmar, the Rohingya people cannot safely enter a hospital.

I have not mentioned the immense disaster caused by Typhoon Haiyan, where the cities and houses of hundreds of thousands of Filipinos were flattened in a matter of hours, triggering an armada of relief. Or the eastern Democratic Republic of Congo, where shifting spasms of warlord predation maintain a state of fear, a state of constant displacement, and a state of want for a hundreds of thousands. In August, as I drove north from the bustling aid hub of Goma, evidence of government or international aid providing education, healthcare or shelter grew ever more scarce. That same month MSF closed a major health centre in Pinga town, due to threats from local populations who feared our work and resources were being exploited by rivals.

And I have not mentioned Somalia, from where MSF was forced into a complete withdrawal after over two decades of work. Our decision eliminated the access of Somalis to health services that had yielded over 600,000 medical consultations, 58,000 vaccinations and 7000 safe deliveries in 2012. We had exceeded our limits. Our relatively unprecedented withdrawal was prompted by the continued attacks against aid workers in an environment where the armed groups and civilian authorities progressively supported, tolerated or condoned a violent lack of respect for the medical humanitarian mission.

It is this disturbing withdrawal from Somalia that casts its shadow over 2013, because we are capable - no, practiced - at working in situations of conflict, violence and insecurity. That's MSF's core business. Whether in Somalia, Darfur, DRC or CAR, communities in crisis have found their way to assistance, and our humanitarian aid to them. Never perfect and never enough, but often adequate to sustain life and alleviate substantial suffering amidst similar conditions to those in Somalia today.

As a director in MSF, the spectre of Somalia 2013 leaves me feeling apprehensive about Syria, CAR or Sudan in 2014. Or Myanmar and DRC. Or many others. Humanitarian action has always been a limited project, designed as a bandage on present wounds rather than as a cure to the underlying politico-economic pathologies. 2013 strikes me as a year where those limitations and their human consequences have confronted us more forcefully than in the recent past. 2013 calls into question the 20 years of gains made since the barbarity of war in Liberia or the genocide in Rwanda.

Though certainly depressing, the observation that 2013 was a bad year is fairly unimportant. More worrisome is the prospect that 2013 signals a dangerous trend, even while experts tell us there has never been so much peace in the world. I see a mounting number of places that have reached a critical mass of disrespect for international law and universal ideals, or their outright rejection; and where rudimentary compliance is no longer deemed useful. That goes for the most notorious abusers, and perhaps especially for the most vocal defenders, those in the West who wield these idealistic instruments as a sword of double-standard in order to maintain their own power.

Whether the threat of a barrel-bomb being dropped from a helicopter by your own government or the machete at the hand of your erstwhile neighbour, a shocking mass of people crowd into abandoned schools, churchyards, basements and makeshift camps, seeking the elemental refuge of one other in the persistent face of murder. That is an unsettling legacy for the year. So it is with considerable relief that I leave 13 behind, and hope it also marks an unambiguous call for change. We must renew the commitment to reach people in crisis, and we must ignite the political action necessary to protect people from it.