Special Feature:
Somalia: Caught in the Storm

In Bakool region, an MSF outreach nurse is testing children with a MUAC at monthly nutritional screening. 800 children are checked for malnutrition. Photo © Espen Rasmussen

Since 1991, Somalia has been a state with no government. Fourteen years of conflict have left the country with enormous humanitarian needs and a high level of everyday violence. MSF was running health care projects in the capital, Mogadishu, as well as northern Somalia when war broke out, having begun working in the country in 1986.

The ongoing civil war has brought about a virtual collapse of public health structures and services. In most parts of the country, clinics and hospitals have been looted or seriously damaged. There are estimated to be only 4 doctors and 28 nurses and midwives for every 100,000 people in Somalia.

Unsurprisingly, Somalia has some of the worst health indicators in the world. More than one-in-ten children die at birth and of those that survive, a quarter will perish before their fifth birthday. The estimated overall life expectancy for a Somali is only 47 years.

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Violence is so widespread that few aid agencies choose to work there and permanent international staff members are extremely rare in most parts of the country. With 35 international and over 560 national staff on the ground, Doctors Without Borders/Médecins Sans Frontières (MSF) tries to fill some of the huge gaps in areas such as Mogadishu, Galkayo, Xuddur, Dinsoor, Jowhar, and Aden Yabaal. The projects mostly deal with primary health care across the worst affected areas in south and central Somalia, but also include services such as treatment for tuberculosis and visceral leishmaniasis, or kala azar, pediatric care, and even surgery.

Many Somalis live side by side with violence every day and even with the latest attempt at installing a government, their prospects of improvement appear remote. In a series of articles, MSF bears witness to the plight of the Somali people and the humanitarian catastrophe that the country now faces.