Catherine Moody, the country representative for Doctors Without Borders in Pakistan, said in the statement that the organization was “saddened by the decision” to force it to halt its work in the region, noting that it had provided medical services there for 14 years.

Foreign citizens and organizations working in Pakistan require a no objection certificate to operate in certain areas. Pakistani nongovernmental organizations and journalists also face restrictions when working in the tribal areas.

Doctors Without Borders provided “diagnosis and treatment facilities to the community” and immunizations for children and it responded to “emergencies, disease outbreaks and mass casualties,” the organization said.

The region’s health authorities did not respond to requests for comment, but Dr. Mohammad Ishaq, who works there, said Doctors Without Borders was asked to leave because it did not have valid documents.

Dr. Ishaq said he thought the organization “was doing a great job for the patients” in the tribal areas, adding that he did not know why its license to work there was revoked.

An employee of Doctors Without Borders, who asked not to be identified, said the organization had never been denied the operating certificate in the past. He said he feared that the decision would affect many patients in the region, where, he added, the organization had 70 staff members working at its two sites.

The official who notified Doctors Without Borders that its operations would need to be shut down said that he was simply following orders from officials in Peshawar, the administrative and economic hub of the tribal areas, and did not have any information about the reasons for the decision.

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