By Missy Ryan
BAGHDAD, Nov 21 (Reuters) - Some Western aid groups driven from Iraq in recent years are cautiously coming back, weighing the danger to their staff against the lives they may save among increasingly desperate Iraqis.
"The risk is still high but ... right now you need life-saving operations in Iraq," said Kasra Mofarah, who heads the NGO Coordination Committee in Iraq, an umbrella aid group.
Non-governmental groups like Medecins Sans Frontieres and the International Rescue Committee both set up offices in safer parts of northern Iraq this year after earlier withdrawing from the country.
"The security situation remains dire," said Melissa Winkler, an IRC spokeswoman. Still, she said, "we felt compelled to return and respond to the growing humanitarian crisis".
In a country wracked by sectarian strife, aid workers tread carefully. At least 94 have been killed since the U.S.-led invasion in 2003.
Bombings and kidnappings still plague Iraq, although violence has dropped sharply in the past several months partly due to the deployment of an extra 30,000 U.S. troops.
Despite the improved security, Iraq’s humanitarian crisis has reached a boiling point, aid workers say.
Some 2.3 million Iraqis are displaced within Iraq, the United Nations says, struggling to find homes, jobs and health care. Some 4 million people need food assistance; only one out of three children under five has access to safe drinking water.
While 43 percent of Iraqis now live in "absolute poverty", aid groups noted in a recent report, humanitarian assistance from major donors fell 47 percent from 2003 to 2005.
AID GROUPS IN CROSS-HAIRS
More than two-thirds of the aid groups present in Iraq in 2003 have left, many hastily as violence threatened local and foreign staff, the NGO Coordination Committee said.
A bomb destroyed the U.N. office in Baghdad in August 2003, killing 22 people, including mission chief Sergio Vieira de Mello. Two months later, the International Committee of the Red Cross office was bombed in the capital.
Workers became targets. In 2004, Margaret Hassan, a British -Iraqi employee of U.S.-based CARE, was kidnapped and killed.
Some groups reacted by pulling foreign staff, relocating headquarters to the Kurdish north or to Jordan. Some decided not to pursue future projects or halted work within Iraq altogether.
"The work we were able to do could not justify the level of danger to our staff -- one kidnapped and held for 10 days, another killed in a bombing," Winkler said. IRC left in 2005.
Since then, many groups have done what they can from afar.
U.S.-based Catholic Relief Services, which shut its Iraq office in 2004, is one of a number of groups assisting some of the 2 million Iraqi refugees living in neighbouring countries.
It also helps groups in Iraq that among other things give vaccines and food to needy children and mothers.
MSF gives supplies to Baghdad hospitals and brings Iraqi doctors out for emergency medical training abroad.
"It is not an approach we’re satisfied with because (Iraq) is one of the main humanitarian crises," said Malika Saim, MSF’s emergency operations director.
MSF is slowly trying to change that. In July, the Paris- based group began operations in the Kurdish city of Sulaimaniya to treat burn and trauma victims.
"It is impossible to have ... the guarantee of complete safety, however the evolution of the conflict situation is objectively showing signs that there may be possibilities to negotiate a space to work," Saim said.
THE NICE BLONDE SWEDISH GIRL
Other organisations, such as U.S.-based Mercy Corps, have hunkered down in Iraq, trimming activities in areas of greatest risk and shifting on-the-ground responsibilities to Iraqi staff.
The group is now headquartered in Sulaimaniya, but it has managed to maintain a spate of projects across Iraq with a staff of around 150, including a dozen foreigners.
The U.S. Agency for International Development funds a host of Western groups that have adapted to Iraq’s dangers, said one U.S official in Baghdad, requesting anonymity.
He said that now only "pockets of places" remain where violence makes it impossible for Western organisations to work.
But most aid groups remain leery, and say they will stick to the low-profile strategies that have allowed them to carry on.
"Our principle was that we never wanted to show up on their doorsteps with Blackwater escorts, guns pointing," said Paul Butler, Mercy Corps’ country director, referring to the U.S. security firm accused by many Iraqis of heavy-handed tactics.
And when Western staff land in the riskiest areas, Mofarah quipped, "of course it is not the nice blonde Swedish girl".
Yet for others, like CARE and Save the Children, which have both left Iraq, the risk remains too great.
"There is no question that there is need in Iraq. However, there is not sufficient political and military stability," said Alina Labrada, a CARE spokeswoman. (Editing by Dean Yates)