Dr. Asma Aweis Abdallah is the medical activity manager with Doctors Without Borders/Médecins Sans Frontières (MSF) in Baidoa, Somalia. Here is what she and her team are seeing on the ground.
The situation in Somalia is catastrophic. We are facing one of the worst droughts in 40 years. The country experienced famine in 2011, and drought in 2017, in addition to conflict and health emergencies like cholera, measles, and malnutrition. This is all alongside high maternal and child mortality rates. We haven't had enough time between one disaster and another.
MSF has an emergency program in Baidoa where we support the regional hospital for pediatrics with an emergency room and both outpatient and inpatient services. We also provide sexual and reproductive health care, maternity care, and mental health services.
Our outreach program focuses on health and nutrition services. We admit 500 children each week into our feeding program. We build latrines and bring clean water by truck. After an outbreak, we started supporting a cholera treatment center. With all these programs we are supporting around 20 percent of the population, but the needs are far more than that.
Many people are leaving their homes and arriving in Baidoa looking for health and humanitarian assistance. The city hosts the highest number of displaced people in Somalia, second only to Mogadishu. In this year alone we have received more than 200,000 new arrivals, with some taking long journeys to get here. They do so without proper transportation and face security issues along the way. Before they reach Baidoa, they've already gone through so much. We see mothers who tell us they have lost babies on the way, but they continue their journey to bring other children for treatment.
We have witnessed a lot of critical conditions and people going through so much grief and pain. One of the patients was a 23-year-old mother who came in with her child—the mother had measles and the girl had malnutrition. Because we don't have adult inpatient care in the hospital, we had this mother who had measles in the pediatric isolation room. They walked over 110 miles trying to find care.
By the time they arrived, they already had several other complications. The child died two days after admission and the mother died one day later. To witness families leaving the hospital with fewer members is one of the saddest things, but it´s the story of many families because of the impact of malnutrition and other diseases.
Most of the children we receive are already under weight. Some lose subcutaneous fat and are just skin on bone. When this condition is chronic, it affects the development of the brain of the child and also the community at large because children are tomorrow's generation—grave losses that occur all because of inadequate nutrition.
Malnutrition also reduces the immune system’s response to other infectious diseases, so children who have malnutrition are prone to other health issues. In Baidoa we are seeing this cycle of people coming in with infectious diseases, then coming back for malnutrition or the other way around. There are also a lot of outbreaks attributed to the water shortage, climate change, and the lack of vaccination coverage for children under 15. It´s increasing the mortality rate among children.
It´s a difficult feeling for every human to witness others going through difficult situations. But being Somali and this being the situation of the Somali community, it makes me feel very sad. But it is something we can alleviate if we all work together to establish the required services for the community.
In Somalia and Somaliland, MSF teams work in hospitals in Baidoa in South West State, Galkayo North in Puntland state, Galkayo South in Galmudug state, and in Somaliland in Las Anod and Hargeisa. The focus of our medical activities include maternal, pediatric, and emergency care, nutritional support, and diagnosis and treatment of tuberculosis. MSF also runs mobile clinics to deliver care to people living in displacement camps and the surrounding communities.