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MSF in Somalia, 2012
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Despite some improvements in security during 2012, the majority of people in Somalia are still living in crisis. Two decades of civil war have inflicted violence, displacement and loss of livelihood on the people of Somalia. Doctors Without Borders/Médecins Sans Frontières (MSF) continues to work in areas controlled by the government as well as areas held by opposition groups.
Most of the country’s healthcare infrastructure has been destroyed, leaving only one doctor in the country for every quarter of a million people. The nutritional crisis of 2011 in south and central Somalia further damaged coping mechanisms and caused massive internal displacement as people searched for food and security. At the beginning of the year, MSF decided to put on hold any opening of new nonemergency projects in Somalia until the safe release of its two colleagues, Blanca Thiebaut and Montserrat Serra, abducted from the Dadaab refugee camps in Kenya on 13 October 2011 and held against their will in Somalia.
Basic Health Care in the Capital
Access to food, water, sanitation, health services and shelter is irregular and
Malnutrition in the Afgooye Corridor
The Afgooye corridor, linking Mogadishu and the town of Afgooye, is an increasingly dense settlement of displaced people. MSF supports the 30-bed community hospital in Afgooye, the only health facility covering the needs of 180 villages. The hospital offers outpatient consultations, emergency services, maternity care and an outpatient feeding program. In 2012, staff carried out consultations with 25,640 people.
In November, MSF medical staff visited 34 camps, which host some 18,000 people. The team screened 1,530 children and treated more than 400 for malnutrition. They vaccinated against polio, diphtheria, tetanus, measles and pertussis (whooping cough), and all children under five years of age were given albendazole, to treat worms, as well as vitamin A. Staff returned in December for follow-up.
Comprehensive Care in Dinsor
In Bay region, MSF facilities in Dinsor offer inpatient care, a nutrition programme, maternity services, treatment for kala azar, a TB programme and outpatient services.
Mother and Child Programs in Middle Shabelle
During the second half of 2012, Jowhar and Balcad were on the front line of conflict and access became a challenge for the delivery of supplies and supervision visits. MSF staff support the maternity hospital in Jowhar, and offer mother and child healthcare, including nutrition and vaccinations, through four clinics in Kulmis, Bulo Sheik, Gololey and Mahadaay. Tuberculosis (TB) is also treated in Mahadaay and Gololey. MSF runs a mother and child programme at the clinic in Balcad.
Galkayo North and South
MSF has worked in the divided city of Galkayo, capital of Mudug province, for over a decade. Teams support pediatric and TB services in a clinic in Galkayo North, which is located in Puntland, a self-declared independent republic. A new maternity ward was opened in the clinic in December. In Galkayo South, administered by the state of Galmudug, a hospital team receives patients from both sides of the regional armed conflict. Comprehensive services include emergency, maternity and pediatric care, TB treatment and surgery.
MSF continues to run essential health programs throughout Lower Juba region. In Marere, a hospital offers outpatient services, reproductive health and emergency obstetrics, surgery and TB treatment. Mobile teams travelled to sites where displaced people had recently settled, offering basic healthcare and treatment for malnutrition. In Jilib, a health center housing a measles isolation unit and providing cholera treatment offers services around the clock. MSF also runs an inpatient nutrition program for children under five in the port town of Kismayo, the capital of the region. The team opened emergency treatment units in response to outbreaks of measles and cholera during the year.
In May, due to worsening security conditions, MSF made the difficult decision to close its basic healthcare programs in Dhusa Mareb and Hinder, Galguduud. The 108-bed hospital in Belet Weyne, Hiraan region, was closed at the end of the year. Activities in Guri-El hospital, Galguduud region, will be handed back to the community in January 2013.
Health Care in Somaliland
In the self-declared republic of Somaliland, staff are ensuring better access to healthcare and improving water and sanitation systems in Hargeisa, Mandheera and Burao (Burco) prisons. Support is also given to psychiatric patients in the Berbera mental health clinic. An MSF team works with the Ministry of Health at Burao general hospital in the Togdheer region of Somaliland, focusing on inpatient care. In 2012, emergency staff dealt with more than 10 incidents involving the arrival of numerous casualties. When flash floods affected the region, MSF made donations to health facilities in Buhoodle.
At the end of 2012 MSF had 1,990 staff in Somalia. MSF started working in the country in 1979.