Humanitarian Health Challenges in Somalia: Saving lives and reducing vulnerabilities1 |

Humanitarian Health Challenges in Somalia: Saving lives and reducing

vulnerabilities

Emergency Preparedness and Humanitarian ActionWHO Regional Office for the Eastern Mediterranean

Humanitarian Health Challenges in Somalia: Saving lives and reducing

vulnerabilities

Emergency Preparedness and Humanitarian ActionWHO Regional Office for the Eastern Mediterranean

Humanitarian Health Challenges in Somalia: Saving lives and reducing vulnerabilities2 |

ContextContext

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

Humanitarian Health Challenges in Somalia: Saving lives and reducing vulnerabilities3 |

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

Health IssuesHealth Issues

Humanitarian Health Challenges in Somalia: Saving lives and reducing vulnerabilities4 |

Acute episodes: Drought Nov ’05 – April ‘06

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.

Humanitarian Health Challenges in Somalia: Saving lives and reducing vulnerabilities5 |

Somalia cross border food security situation analysis

Jan-Jun 2006

Humanitarian Health Challenges in Somalia: Saving lives and reducing vulnerabilities6 |

Floods in South Central Somalia July ‘06 – Jan ’07

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

Humanitarian Health Challenges in Somalia: Saving lives and reducing vulnerabilities7 |

MapMap

Somalia :

Flood Hazard Distribution Map

Humanitarian Health Challenges in Somalia: Saving lives and reducing vulnerabilities8 |

Rift Valley Fever – Dec ’06 – Jan ‘07Rift 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

Humanitarian Health Challenges in Somalia: Saving lives and reducing vulnerabilities9 |

Somalia:

Human RVF cases in Lower Juba

Suspected cases reported from Afmadow & Kismayo Districts (close to Kenyan border)

Humanitarian Health Challenges in Somalia: Saving lives and reducing vulnerabilities10 |

Acute Watery DiarrheaFeb ’07 – to date

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

Humanitarian Health Challenges in Somalia: Saving lives and reducing vulnerabilities11 |

WHO ResponseWHO 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

Humanitarian Health Challenges in Somalia: Saving lives and reducing vulnerabilities12 |

ChallengesChallenges

Cross-border issuesNon-existent and/or changing counterpartsPastoralism misunderstoodInadequate local leadershipLimited preparedness plans and capacitiesExtremely limited human resources Insecurity and access Funding constraintsDonor fatigue

Humanitarian Health Challenges in Somalia: Saving lives and reducing vulnerabilities13 |

ICT ChallengesICT Challenges

Non-existent regulatory structuresUnreliable national/zonal networksHigh logistical and operational costsVirtual trouble shootingLooting/confiscating of equipment and vehicles

by factions (Polio equipment in January’07)

Humanitarian Health Challenges in Somalia: Saving lives and reducing vulnerabilities14 |

Lessons LearnedLessons 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