NAIROBI, Kenya (AP) — The aid group Doctors Without Borders said Wednesday it is pulling out Somalia after 22 years of work there because of attacks on its staff.

Doctors Without Borders, also known by its French initials as MSF, said the decision is the result of "extreme attacks on its staff in an environment where armed groups and civilian leaders increasingly support, tolerate, or condone the killing, assaulting, and abducting of humanitarian aid workers."

The pull-out comes about a month after the release of two Spanish women who were MSF employees and who were abducted in a Kenyan refugee camp and held in Somalia for nearly two years. The group said the pull-out will cut off hundreds of thousands of Somali civilians from humanitarian aid.

"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. "We are ending our programs in Somalia because 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 pull-out is a huge blow to Somalis in need but also the reputation of the country, which has been seen as making strides in security and governance. Somalia fell into anarchy in 1991 and for much of the last decade Mogadishu was ruled by warlords and al-Qaida-aligned militants. Those militants from al-Shabab were forced out of the capital in 2011, and a new government was voted into place.

Al-Shabab still controls much of the country's south. The group allows very few outside aid groups to operate in its territory.

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(Photo: AP Photo/Khalil Senosi)