32-year-old Fadumo Mohamed is from Lower Shabelle, a region in southern Somalia, not far from the capital Mogadishu. Named after the river that farming communities have relied on for centuries, the area is a microcosm for the multi-layered crisis that has been battering Somalia and its people since the 1990s. The situation in Lower Shabelle is particularly difficult, with recent droughts as well as, paradoxically, subsequent flooding, devastating farming and pastoral communities that—long before the ruthless addition of extreme weather—lived hand-to-mouth.
The Ripple Effects of a Generation-long Crisis
The humanitarian crisis in Somalia is one of the longest-running and most complex in the world. Armed conflict, marred by human rights abuses, weather-related shocks and severe epidemics—each event capable of devastation on its own—all play a part in this decades-long tragedy.
The ramifications are staggering. According to the UN, an estimated 5.2 million people will require humanitarian assistance in 2020, a 19% increase since 2019. 2.6 million people are internally displaced; of these, 800,000 live in informal settlements in and around Somalia’s capital, Mogadishu, with little or no sanitation and limited access to the most basic services, such as healthcare.
Fadumo, who is married and lives here with her family, is one of them. Dreaming of a better life, and driven to work so she could send money back to her parents, Fadumo arrived in Mogadishu 16 years ago. Her story isn’t uncommon; the land that used to sufficiently provide for the family when Fadumo grew up in the Lower Shabelle region no longer does. This drove her to the capital to make a living when she was only a teenager.
Weak health systems are another consequence of the crisis. Preventable diseases that should have been consigned to history, such as measles, are still widespread in Somalia. Entirely preventable with an affordable and effective vaccine, measles still kills and threatens the lives of thousands of children in the country. In 2017, the country suffered an outbreak, affecting 31,000 people, 83% of whom were children. For this and other reasons, Somalia has among the highest child mortality rates in the world: one out of every seven Somali children won’t live to see their fifth birthday.
The Good News
International Medical Corps runs a clinic called Hegan Health Center in Mogadishu. With a special focus on mothers like Fadumo and their young children, the clinic also supports mothers-to-be throughout their pregnancy and delivery, and offers family-planning services. In addition, to make sure more children survive their first years, the clinic screens for and treats malnutrition, and provides children with vaccinations against diseases such as measles.
Talking about her experience at the clinic, Fadumo says, “Some months ago, I heard my neighbors saying there was a facility that was being supported by an organization. From then on, I started routinely visiting it. I used to go there for check-ups, as well as treatment before and after delivering my children. At the facility, we are given health talks and encouraged to vaccinate our children. We also learn about preventable diseases—such as tuberculosis, whooping cough, diphtheria, polio and measles—that we didn’t know before. My two young children completed their vaccines at the facility. I have just brought my boy here to get his measles vaccine.”
To reach and immunize more children than ever before, in 1978 the World Health Organization launched the Expanded Program on Immunization (EPI) in Somalia. A recent effort under the program, supported by International Medical Corps, vaccinated some 4.5 million Somali children against measles. We can already see the effects: From May, 2018 to November, 2019 the number of suspected cases dropped by 35.5 percent.
The odds are still stacked against mothers and babies in Somalia, a country struggling with unacceptable levels of maternal and child mortality. Wider access to affordable and reliable vaccines have saved the lives of millions of children around the world, but a child in sub-Saharan Africa is still more than 15 times more likely to die before the age of five than one living in a high-income country.
But conditions are slowly improving. With the help of fierce vaccination advocates like Fadumo—who now tells other mothers in her community about the importance of immunizing your children—we are determined to keep moving the trend in the right direction, one mother and child at a time.
International Medical Corps supports children and mothers at Hegan Health Center thanks to the UK Aid Somali Health and Nutrition Programme (SHINE).