Today, the main reasons for admission to Istarlin Hospital are car accidents, gun shots and trauma due to other types of violence.

"One day in late January, three children were playing with a grenade in a town 160 kilometres north of Guri El," says Gadenne.

"The grenade exploded causing the deaths of two and injuring the third. The young boy was brought to Istarlin Hospital three days after the incident. The boy's condition is stabilized and the main challenge is for him to restore the complete function of his right arm."

"Galgaduud is stark in lack of health care," says MSF's field coordinator Colette Gadenne. "Previously there has been no ability to respond locally to outbreaks of measles, meningitis or to nutritional emergencies."

Health indicators are abysmal in Somalia and access to medical care remains a key concern: According to the United Nations, 78 percent of the population has no access to health care whatsoever.

MSF is already providing medical care in six regions in central and southern Somalia. The organisation offers free basic healthcare as well as treatment for diseases such as kala azar, tuberculosis and malaria, all of which are rife in the country.

Hospitals

After several assessments in the Galgaduud region, MSF is opening a new project consisting of two components. MSF will support the already existing 50-bed Istarlin Hospital in Guri El town, approximately 450 kilometres north west of the capital Mogadishu.

The organisation will also open an out-patient department (OPD) in Dhusa Mareeb, the regional capital of Galgaduud, located 65 kilometres from Guri El. The town's hospital has not functioned since the last government collapsed in 1991.

Acute needs

There is a great need for free medical care in Galgaduud.

"From February, patients can finally receive acute medical care and life-saving surgery in Istarlin Hospital without having to pay for it," says Gadenne.

Today, the main reasons for admission to Istarlin Hospital are car accidents, gun shots and trauma due to other types of violence.

"One day in late January, three children were playing with a grenade in a town 160 kilometres north of Guri El," says Gadenne.

"The grenade exploded causing the deaths of two and injuring the third. The young boy was brought to Istarlin Hospital three days after the incident. The boy's condition is stabilized and the main challenge is for him to restore the complete function of his right arm."

Accidents

Guri El town is located on the only road between Mogadishu and Galkaayo. Car and truck accidents are frequent. All the patients from accidents in a radius up to 250 kilometres are brought to Istarlin Hospital.

"When the medical team walked out of the operation theatre after the boy's surgery, they immediately had to consult another two patients injured during a car accident," says Gadenne.

Volatile security

After 15 years of civil war, Somalia remains lawless and security can be considered as highly volatile. Since the new transitional federal government was appointed in October 2004, the general population is still waiting for a drastic change in their everyday life.

"But MSF's 20 year presence in Somalia and the opening of our new project are proof that it is possible to provide relief here, even with the lack of a functioning central government," says Gadenne.