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Context

More than 15 years of conflict have left Somalia with dilapidated health systems, chronic food insecurity, and limited healthcare access. Natural disasters like droughts and floods exacerbate the situation, impacting over 2 million people. Inadequate surveillance systems further complicate disease control efforts, with recurring outbreaks of infectious diseases. The WHO response focuses on emergency supplies, disease surveillance, and strengthening healthcare services amidst numerous challenges such as cross-border issues, limited resources, and funding constraints.

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Context

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Presentation Transcript

  1. Humanitarian Health Challenges in Somalia: Saving lives and reducing vulnerabilitiesEmergency Preparedness and Humanitarian ActionWHO Regional Office for the Eastern Mediterranean

  2. Context • More than 15 years of conflict and insecurity • South Central Zone worst off  over 2 million people (> 450,000 IDPs) in chronic need of relief and assistance • Dilapidated health systems  • Unskilled work force • Old or destroyed infrastructure • Nonexistent governing structures and regulatory capacities • Limited access • Unchecked private sector

  3. Health Issues • Chronic food insecurity - malnutrition rates over 25% in some areas • Prevalent infectious and communicable diseases - diarrhea, malaria, measles, ARI, Meningitis • Non-existent or very weak surveillance system • Low immunization coverage - re-surgence of polio cases • Difficult access to primary health care - nomadic population • Limited access and availability of safe water and sanitation services

  4. Acute episodes: Drought Nov ’05 – April ‘06 • Worst drought in the Horn of Africa in a decade – more than 11 million people affected • Drought affected pastoral and agricultural communities, an estimated 1 million people in South Central Somalia • A regional problem: a cross-border issue (population and live stock movement) • Inequity of response on different sides of the border (pull-factors) • Increased competition for resources between crises in the region but also internationally.

  5. Somalia cross border food security situation analysis Jan-Jun 2006

  6. Floods in South Central Somalia July ‘06 – Jan ’07 • Over 500,000 people affected • Contamination of water sources • Acute Watery Diarrhea, Malaria, Acute Respiratory Infections • Vector-borne: Malaria and Rift Valley Fever

  7. Map Somalia: Flood Hazard Distribution Map

  8. Rift Valley Fever – Dec ’06 – Jan ‘07 • Hundreds of deaths in livestock • 103 suspected human cases; over 50 reported deaths • On-going conflict between TFG and UIC complicating surveillance and outbreak response

  9. Somalia: • Human RVF cases in Lower Juba • Suspected cases reported from Afmadow & Kismayo Districts (close to Kenyan border)

  10. Acute Watery DiarrheaFeb ’07 – to date • Mainly South Central affected • Over 12,000 cases with over 400 deaths • Outbreak ongoing • Affected population moving out of Mogadishu to the periphery to evade conflict • Health care and monitoring capacities already very limited and overstretched Picture: Cholera Treatment Centre in Safarloyle, Somalia

  11. WHO Response • Emergency supplies • Strengthening and facilitation of coordination • Disease surveillance and outbreak response • Provision of outreach essential health services • Immunization coverage • Water and Sanitation • Technical support to zonal/district authorities • Health education • Training of health staff

  12. Challenges • Cross-border issues • Non-existent and/or changing counterparts • Pastoralism misunderstood • Inadequate local leadership • Limited preparedness plans and capacities • Extremely limited human resources • Insecurity and access • Funding constraints • Donor fatigue

  13. ICT Challenges • Non-existent regulatory structures • Unreliable national/zonal networks • High logistical and operational costs • Virtual trouble shooting • Looting/confiscating of equipment and vehicles by factions (Polio equipment in January’07)

  14. Lessons Learned • Effective early warning does not always translate into timely or adequate response in slow-onset (drought) disaster/s • Investment in national capacity • As emergency continues, enhance understanding of, invest and strengthen pastoralist livelihood systems

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