Plagued by civil wars for more than 18 years, Somalia is still torn apart by unabated violence. Many foreign aid workers, who boldly decided to come to help the nation's starving people, have now decided to leave one of the most dangerous places in the world after more threats and killings of their colleagues. An escalation of attacks on aid workers and human rights staffers in southern and central Somalia is putting at least 3 million people at even greater risk of malnutrition and disease. Many organizations have suspended programs and withdrawn staff in a country that is in the middle of what may be the worst humanitarian crisis in its history. Unidentified armed groups commonly kill, kidnap and threaten aid workers with death. There are now fears food distribution will come to an end in Somalia, which has suffered during a two-year rebellion by Islamists that has left more than 16,000 civilians dead and uprooted up to a million. Most foreign aid workers are staying away from the country, delegating their work to local employees, who in turn have become the victims of repeated violence and killings. The local aid workers now appear to have had enough of working under these conditions. Duniya Sheikh Daud, an aid worker for Iida, a group that campaigns for women's rights and against female genital mutilation, was gunned down by unknown assailants in October near the town of Gurilel. In January, unidentified men shot and killed the World Food Program's local aid worker Mohamud Omar Moallim, 49, while he distributed food to displaced people at Daynile, 10 km. northwest of Mogadishu. "After I received death threats and was informed that I'm a target for a group, I decided to stay in my home for security reasons," a Somali female aid worker, who worked in the field for many years, told The Media Line during an interview at her house. She was her family's breadwinner until she quit her job four months ago. Another aid worker, who calls himself Abdi and asks that his full name not be published, said some staff hope to resume work, as some aid agencies have started to negotiate the security of their workers with the Islamists who control large swathes of territory. "This is better than the unreliable security we had earlier, so we can now have a way to do some work," he said. Islamist rebel factions control most of southern and central Somalia, while feuding militias hold sway elsewhere; hundreds of African Union peacekeepers are based in the capital, Mogadishu. Thousands of Somalis are dependent on the food provided by the aid agencies, but that has been reduced by the waves of attacks against the workers. Analysts say that if this violence continues, it may lead to more famine and disease. "The aid workers have no protected areas to work in," said Somali analyst Ahmed Du'ale. "They can't help because they will be killed or abducted." A-Shabab, an armed Islamist organization, offered various conditions for aid agencies to operate in areas under its control. "We are ordering the humanitarian aid agencies to register to work in Bay and Bakol regions to guarantee their security," A-Shabab official Sheikh Abdullahi Abu Ayman said recently. However, the group's spokesman, Sheikh Mukhtar Robow, suggested aid agencies could work freely in the region. "They are helping the deprived and thirsty people in the region; I don't think it's right to force them to register," Robow said at a news conference in Baidoa, the former seat of the Somali parliament. "We appreciate how they have assisted the people in the past and hope they will continue doing the same." The aid agencies and workers find it difficult to know what to do. Not only does A-Shabab offer mixed messages, but the government offers its own directives. "We are informing all aid agencies to register with the government and the government will be responsible for their security," Abdiqadir Mohamed Walayo, spokesman for the Somali premier, told reporters in Mogadishu. It will not be easy to adhere to orders from the government and opposition while operating throughout the country. "Since we want protection, we have to accept all the orders," a Somali aid worker in Mogadishu who asked to remain anonymous said by phone. "Large parts of the country are no-go areas and it is now impossible to have a clear picture of the humanitarian situation on the ground." The Somali government needs its forces trained to establish security so that civilians and aid workers can perform their daily duties without restraint, said Mohamed Muse, a Somali analyst based in neighboring Kenya; most foreign aid agencies are now located in its capital, Nairobi. Several Somali regions have been hit by severe droughts but are receiving no aid. "We need food and water, but all we get is some insufficient stuff from our brothers in the region," said Fatima Ali, a mother of five who lives on the northern outskirts of Kismayo, which faces the effects of a severe drought. More than 3 million people in Somalia are in acute need of food or medical aid. Violence against aid workers has reduced since Sheikh Sharif Sheikh Ahmed was elected the country's president earlier this year, as he vowed reconciliation with his opponents when he was elected. However, he has not taken any concrete steps to prevent the attacks. Ahmednor, a local aid worker, said the Somali government's pledge to improve the security of aid workers is the only chance to provide some reliable protection to the humanitarian agencies, but the government only controls small parts of the country. He urges all the armed groups in Somalia to respect the aid agencies and their staff since they are independent organizations. The year 2008 was one of the worst for the aid agencies in Somalia in terms of killings and abductions; most of the country's streets were closed by Ethiopian troops, and food aid trucks were forced to undergo rigorous security checks. The aid workers The Media Line spoke with have become more optimistic in recent weeks, following the formation of the new government. However, they realize the government's geographic sphere of influence is extremely limited. People remain hungry.