( CNN ) -- Doctors Without Borders is pulling out of Somalia after more than two decades because of frequent attacks on its staff , the aid group said Wednesday . The group , internationally known by its French name , Medecins Sans Frontieres , has worked in the nation since 1991 . It said civilian leaders tolerate or `` condone the killing , assaulting and abducting `` of aid workers . `` The same actors with whom MSF must negotiate minimum guarantees to respect its medical humanitarian mission have in some cases played a role in the abuses against MSF staff , either through direct involvement or tacit approval , particularly but not exclusively in south-central Somalia , '' it said . In 2011 , two MSF members were killed in Mogadishu , and their convicted killer was released early , the group said . Aid worker dies after attack in South Sudan . In addition , 14 other staff members have been killed and dozens of MSF 's ambulances and medical facilities have been attacked , the group said . `` 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 Dr. Unni Karunakara , MSF 's international president . `` ... The situation in the country has created an untenable imbalance between the risks and compromises our staff must make , and our ability to provide assistance to the Somali people . '' The aid agency had a staff of about 1,500 in the nation to provide various services , including health care , malnutrition treatment , surgery and relief supplies . Somalia has been plagued by a long-running struggle between government forces and Al-Shabaab , a militant Islamist group with connections to al Qaeda . It has waged a war to implement a stricter form of Islamic law in the country . Two years ago , Somali and African forces pushed the militants out of the capital , Mogadishu , raising hopes of a return to relative security after about 20 years of violence . But the militants have maintained control of large chunks of southern and central Somalia , where they stage attacks . Until last year , Somalia had not had an effective government since dictator Mohamed Siad Barre was overthrown in 1991 . Rape and injustice : The woman breaking Somalia 's wall of silence .
The aid agency had a staff of about 1,500 in the country , where it has operated since 1991 . Civilian government ` ` of the killing , torture and abducting ` ` of aid workers , it said . Somalia has been plagued by a struggle between government forces and Al - Shabaab .