Somalia: Enduring needs in a war-ravaged country

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Despite a new transition government trying to bring order, the country remains fractured. Somalia ranks near the bottom of the United Nations' human development index. The health care system, along with all state services, has collapsed. Most doctors have fled the country and, apart from staff working with NGOs, no doctors or nurses have been trained in Somalia since the outbreak of war. The only available public or free health care is via the few NGOs still working in the country. MSF suspends programs in Mogadishu The security situation has deteriorated over the last year in the capital, Mogadishu, as tension between the government and faction leaders rose. In March 2001, MSF suspended its medical programs and cholera activities in the city indefinitely, after its compound was violently attacked and ransacked during a meeting with a UN assessment mission. MSF medical activities elsewhere in Somalia continued. In the south, in the Bakool region, MSF vaccinated 27,000 children for measles and continues to provide in- and outpatient health care for around 150,000 people. In Kismaayo, after nine years of training medical staff and running the 200-bed hospital, MSF handed management of its projects over to the local authorities. In Giohwar and Aden Yabal, in Middle Shabele, 11 health centers and six mother and child health care programs provided 160,000 consultations over the last year. Three mobile teams ensure that many of the primarily nomadic people in more remote areas receive care and follow-up. Further north, in the town of Galkaayo on the Ethiopian border, MSF runs a 60-bed hospital, which also has 2,000 outpatient consultations per month. Some people walk for hours and sometimes days to reach the hospital, many crossing the border from Ethiopia for treatment. Treating kala azar MSF gives technical support to the kala azar diagnosis and treatment programs of all NGOs in Somalia. Last year, 800 patients throughout the country were diagnosed and treated for this deadly parasitic disease. Although kala azar treatment is difficult and expensive, over the years MSF has developed expertise in training medical staff to treat the disease, and is campaigning for more affordable and simplified treatments through its Access to Essential Medicines Campaign. MSF has been working in Somalia since 1986. CAPTION: A patient with kala azar (visceral leishmaniasis) lies in the corridor of a hospital in Humera in northern Ethiopia. The disease, spread by the bite of an infected sandfly, threatens about 350 million people worldwide, mostly in developing countries. It is still treated as it was in the 1940s. International staff: 12 National staff: 126