Somalia
International Activity Report, 2009
In 2009, the people of Somali continued to be the victims of indiscriminate violence due to ongoing internal conflict. Many thousands needed emergency healthcare but the overall humanitarian response was inadequate. MSF worked in nine regions to provide urgent medical care.
Insecurity and violence
Abductions and killings of international and Somali aid workers, and ongoing insecurity remained the biggest obstacles to MSF’s efforts to respond to the vast medical needs throughout the country. In April two staff members were abducted in the Bakool region and held for ten days before being released. Following the abduction, MSF decided that it could no longer safely provide care to the people living in this region and closed its largest health centre in south and central Somalia, along with four other health posts.
In June an MSF employee died in an explosion in the Hiraan region that also killed 30 other people. In July, for the first time in 17 years, MSF had to suspend activities in its paediatric hospital and three other health clinics in northern Mogadishubecause of heavy fighting. The following month, armed men raided the MSF nutritional treatment centre in Jilib, taking crucial medical supplies and forcing staff to leave hundreds of severely malnourished children without access to crucial medical care. By the end of 2009 MSF had not been able to restart activities in Jilib. In December, two mortars hit Belet Weyne Hospital, injuring two MSF staff.
Overcoming the challenges
Despite these risks, MSF is still determined to provide free medical care to the Somali people. In 2009, more than 1,300 dedicated Somali staff, supported by more than 100 staff based in Nairobi, carried out some 650,000 consultations, 238,000 of which were for children under five years old. More than 49,000 women received antenatal care and 26,000 people were admitted to MSF supported hospitals and health clinics. Nearly 3,000 surgeries were performed, more than 900 of which were for injuries caused by violence. Teams treated more than 200 people suffering from the deadly neglected disease kala azar, 2,600 people for malaria and 1,300 for tuberculosis. More than 34,000 people suffering from malnutrition were provided with food and medical care and 224,000 children were vaccinated, including 92,000 for measles.
Responding to emergency needs
In two different regions, MSF was able to restart emergency surgical activities by recruiting doctors who had graduated from medical school in the capital Mogadishuin 2008. In the last five months of 2009, these doctors performed more than 100 major surgeries, nearly half of which were for injuries caused by violence.
In February, at a hospital just outside the capital, MSF staff treated people who had been injured in a dramatic upsurge in fighting. There were more than 120 admissions in just one day. More than 1,000 people, nearly half of whom were women and children under 14, were admitted for blast injuries. MSF’s hospital in the central town of Belet Weyne received more than 170 war-wounded patients needing surgery and, in Guri El, in the neighbouring region of Galgaduud, more than 230 patients were treated following renewed fighting.
In early 2009, renewed fighting in Guri El and Dhusa Mareb, central Somalia, prompted thousands of civilians to flee their homes. MSF supplied water and medical care to displaced people in the area. Throughout the year, teams also responded to outbreaks of cholera, treating 1,000 people. And when the number of reported measles cases increased, MSF launched large-scale vaccination campaigns in four regions of Somalia. Approximately 73,000 children between six months and 15 years old were vaccinated in Belet Weyne, Hiraan, Middle Shabelle, Lower Shabelle and Bay regions and around 1,500 people suffering from the disease were treated.
Drought, combined with chronic poverty, bad harvests, high food prices, and continuing violence meant that the number of children needing treatment for severe malnutrition reached an all-time high in MSF’s nutritional programme in Galcayo. Nearly 2,300 children were treated between October and December alone. Teams working in the Mogadishu suburbs treated more than 14,000 children for malnutrition during the year.
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