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MSF in Somalia, 2007
Field Staff: 1061
Reason for Intervention:
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2007 saw an escalation of violence in Somalia as fighting intensified between the Transitional Federal Government, groups linked to the Union of Islamic Courts and various other armed factions, particularly in the capital, Mogadishu. As a result thousands of people fled Mogadishu, increasing the medical needs in the country with a weakened health system.
Alleviating the suffering
Thousands of those who fled Mogadishu found themselves living without shelter, food, water or medical care. In April, MSF launched an emergency response in Afgooye, a town some 30 kilometers west of Mogadishu where many had sought refuge. MSF teams focused on meeting immediate needs, supplying medicines to the few existing health structures, such as the Hawa Abdi clinic, and distributing non-food items, such as plastic sheeting and jerry cans. With cholera cases reported in several locations, MSF staff also focused on providing clean drinking water through water trucking distributions.
Throughout the year, people continued to arrive from Mogadishu and needs increased every day. In Afgooye and Hawa Abdi, a large majority of the 1,700 weekly medical consultations carried out by MSF teams were linked to precarious living conditions: severe malnutrition, diarrhea and acute respiratory tract infections. MSF teams doubled the capacity in Afgooye and set up a pediatric ward in Hawa Abdi. The nutritional care center in Hawa Abdi also increased its capacity by the end of the year.
Despite the insecurity, MSF also opened new projects in Mogadishu itself. A cholera treatment center was opened in MSF’s primary healthcare clinic in Yaqshid in March. By May, the center had admitted over 1,000 patients, more than double the number treated in previous cholera outbreaks in the capital. Over the course of the year, three new outpatient clinics for children under 12 were opened in Balcad, Karaan and Lido. In December, the Lido clinic was reinforced with an inpatient ward.
MSF has increased its operational presence in Somalia.
A pediatric clinic opened in the Hawladag area of the capital in May had to be closed and relocated in November due to insecurity. The MSF team now carries out mobile clinics in displaced person’s camps around the city and continues to run an inpatient and outpatient clinic for children and an ante-natal care clinic in the K4 area of the city, reaching some 250 people a day. In late September, MSF started providing emergency surgical care in a hospital in the Dayniile area, receiving 705 patients in the emergency room and performing 140 surgical interventions in the first three months.
Victims of violence and displaced people were not the only ones needing medical assistance. The absence of public health services, coupled with chronic malnutrition, droughts, floods and regular outbreaks of cholera and other epidemics, have left the general population extremely vulnerable.
MSF expanded its activities, opening new projects in Hiraan region, Lower Juba region and Puntland. In Belet Weyne, Hiraan region, MSF opened a hospital program in February focusing on surgical care. Once the surgical capacity of the hospital was functioning well, MSF also started a pediatric ward providing maternity care. In Jamaame, Lower Juba region, MSF set up a 30-bed hospital with a large nutritional program and outreach activities in March. Since then, 950 patients have received nutritional treatment and MSF teams have carried out 1,400 consultations a month. Every day, four mobile medical teams screened between 300 and 1,000 children and pregnant women for malnutrition. The major health problems presented were malnutrition, pneumonia, and diarrhea.
In Kismayo, also in Lower Juba region, MSF began an emergency surgical project in September. In Bossaso, Puntland, a nutritional emergency intervention was launched in late August in camps where thousands of internally displaced people and refugees, both Somalis and Ethiopians, gather before trying to cross the Gulf of Aden to reach Yemen. Between August and December over 1,000 patients were treated for malnutrition.
Healthcare in a hazardous environment
With 14 projects in 11 regions, MSF was one of the biggest healthcare providers in Somalia in 2007. MSF’s medical teams performed more than 2,500 surgical operations, 520,000 outpatient consultations and admitted around 23,000 patients to hospital. Yet the challenges of working in such an insecure environment were evident. MSF was occasionally forced to remove its international staff because of violence, or threats of violence, against staff and patients, although MSF activities continued to be run by dedicated Somali staff. At the end of the year, two international staff members were kidnapped in Bossaso and held captive for a week before being released without being harmed.
MSF has worked in Somalia since 1991.