Somalia is coping with the imminent threat of famine. An estimated 6.2 million people are in need of humanitarian assistance, and malnutrition rates are rising. Some 388,000 children aged under five are acutely malnourished.
With limited resources for basic services, the government has to prioritize its health care in urban areas, relying on the Red Crescent and other charitable organizations to respond to the health needs in rural areas. According to the World Health Organization, 5.5 million people currently lack access to basic health care services.
Innovation + community action
The Red Crescent has been an important partner in responding to the health care needs across Somaliland, providing a lead role in the response to health emergencies, providing innovative solutions to community-based health programming, and deploying mobile health clinics to respond to the unique needs of rural populations.
They support and operate 33 fixed health facilities and 33 mobile clinics. Since the beginning of 2017, the Red Crescent has provided medical treatment to about 350,000 people, with the support of the International Federation of Red Cross and Red Crescent Societies (IFRC) and its partners.
The dry, desert drive to the remote village of Lamadhahder in Togdheer region of Somaliland is long, taking about one hour from the only paved road south of the city of Burao. Three nurses and a midwife fit into the Red Crescent Land Cruiser, packed with health supplies and everything they need to set up a mobile health clinic.
The mobile clinic stops at a line of women wrapped in colourful hijabs standing in anticipation of their arrival. By 9:00am, the heat is already fierce, making waves across the desert landscape. A makeshift structure covered by a local dry, bristled bush provides partial shade to the clinic. Red Crescent health care staff jump into action, unloading boxes of nutritional supplements, weight scales, pharmaceutical supplies, tables and chairs.
The Red Crescent health care staff know that many of the patients they will see today are acutely malnourished and extremely vulnerable. Like many villages in this area, drought has driven food insecurity to crisis levels. Most – if not all – of the livestock that villagers depend on for their livelihoods have died. Malnutrition rates, particularly among children, are high.
“Due to the rising malnutrition cases, the mobile health clinic clinics have had to adapt,” says Kwame Darko, IFRC health delegate in Somalia. “We have had to change the composition of the teams in order to respond to the unique needs in rural areas.” This has meant going from one midwife, one nurse, one auxiliary nurse and two community volunteers to four skilled health care workers.
Three health care staff greet community members in the village and explain what services they will be able to provide at the clinic today. These include treatment of common illnesses, immunization of children and women of childbearing age, screening of children to determine cases of malnutrition, safe motherhood services (antenatal, deliveries and postnatal), and promotion of community health.
One of the first patients seen by the nurse is three-year-old Amal Abdi Muhammed. Her history, weight and height are documented along with an arm measurement that helps to gauge her malnutrition level. Unfortunately, the reading shows she is severely malnourished. If she doesn’t urgently get the nutrients she needs now at this crucial age, she will be more susceptible to diseases, infections, stunted growth and even cognitive delays.
The nurse gives Amal a highly nutritious, ready-to-eat peanut paste called Plumpy’Nut. This is used to treat severe acute malnutrition for children six months of age and above. Depending on the child’s condition, they are expected to stay on the supplement for up to six months.
Amal’s mother, Fadumo Abdi Muhammed, is given a four-week supply of Plumpy’Nut. This will last until the mobile clinic comes back to the village, providing some relief to the family who is now relying on just one meal a day.
“The drought has affected us very much. We lost 25 camels and 150 goats and sheep,” says Fadumo. “We now have nothing. We depend on our relatives for food and other necessities.”
In a country where maternal mortality rates are some of the highest in the world, a midwife is a vital part of the mobile team, ensuring pregnant women, new mothers and babies are receiving the care they need. Red Crescent midwife Samira Mohamed Ali checks a woman’s blood pressure in the clinic. Many women she sees today – pregnant and new mothers – are suffering from anaemia. Samira prescribes them with essential multiple micronutrients and iron tablets to help subsidize what they are unable to receive in their limited diet.
“We prioritize our children – to feed them first,” a mother explained while in line to receive care.
In times of drought, this is far too common the case. Mothers sacrifice their own health for the betterment of their children and family.
Depending on the needs, the mobile clinic staff will rotate to a new village each day, often working long hours in the desert heat in harsh conditions and sleeping in the communities they serve.
Thanks to the generous support of the global community through the International Red Cross and Red Crescent Movement, we are reaching some of the most isolated, vulnerable and hard-to-reach communities with life-saving health care. However, gaps in support still need to be filled. The IFRC Emergency Appeal is supporting the Red Crescent in Somalia to ensure their short and longer-term efforts continue to meet the urgent needs of people now and build their resilience to future droughts.