Somalia has been a stateless country since 1991. For 16 years, the country has huge unmet needs and a high level of daily violence. The civil war has virtually destroyed all the structures and public health services.
"There were young men with guns stopping the bus" Woman, aged 17, seven months pregnant, May 13, 2007, MSF South Galcayo Hospital, South Galcayo
"I left Mogadishu because of the fighting. I remember a lot of bullets hitting our houses. My brother died when the house was hit. We were living in a big building; the bullets damaged it heavily and killed my brother. A big bomb was then thrown at the house, which collapsed. Another family who was living in the same building was killed &#— five children and four adults.
"After that we all left. A group of 11 people left with me while my mother, my husband and the other children went to the bush. I had to go to Galcayo because I'm pregnant. I couldn't go with them to the bush and now I don't even know if they are still alive. I came here alone. I'm 17 years old and this is my first baby.
"I came to Galcayo by bus and we had a lot of problems on the way. There were young men with guns stopping the bus. A group of them took four girls out of the bus and raped them. A guy who was sitting behind me saved me. He said he was my husband and that I was pregnant. I do not know who these men were. They then brought the women back to the bus and, after robbing us all, they ordered the driver to go. Those women told me that it was not the first time it happened to them. They were going to Bossasso and when I stopped in Galcayo, they continued. They did not go to the hospital.
"I have no family in Galcayo so when I came here I started to work in the house of some people and when the woman saw that I was sick, she sent me to the hospital. I stopped in Galcayo because I didn't have enough money to go further. Most people fleeing Mogadishu go to Bossasso, Burco and other places in the North. But you need more money to get that far."
In many parts of the country, clinics and hospitals have been looted or seriously damaged. Violence is so widespread and the clan-based structure so very complex that very few aid agencies are working in Somalia.
"Militia shot our car without telling us to stop" Man, late 30s, school teacher, May 13, 2007, MSF-MDO South Galcayo Hospital, South Galcayo
"I came to Galcayo 11 days ago because of the bad situation Mogadishu. There was a lot of shelling, many explosions. I lived in Mogadishu for a long time and this time it was the worst fighting I had ever seen. Many dead bodies on the roads. Many women and children hurt in the fighting, just while walking in the street. People could not leave their houses.
"I came to Galcayo with my family. On the road to Galcayo we faced a lot of roadblocks. They stopped us and asked us for money otherwise they would take our goods and the car. Since the fighting started, the gangs on the road increased. The journey here took three days, with militias and gangs frequently attacking our car.
"At one point militia shot our car without telling us to stop. We were ready to give our goods but they just shot instead. One passenger was killed and one was injured. It was at night. There was no hospital around there and two hours later the man who was badly injured died. Then we reached a small town and we left both the dead and the injured in the local hospital although they told us they had no medicines.
"I came to Galcayo because my sister lives here and I was looking for a job. I had a good job in Mogadishu. I was a teacher, but when the fighting started the school was closed and all the children and teachers left. Here it is more peaceful.
"I am here in Galcayo hospital now because one of my children is sick. In Mogadishu some hospitals closed because of the fighting, some were destroyed by shells and those which remained opened became very full.
"In Mogadishu, I saw a lot of destruction; shells destroyed many buildings, with women and children inside. A lot of people have left the city and went to the nearby towns of Balcad, Afgooye, Jowhar, Huddur, Miiraan or Belet Weeyne. My uncle died in Mogadishu after a shell hit his house. My mother and brother still live near Mogadishu and will stay there until peace returns."
Stateless and without a public health system, the country desperately needs external aid.
"Young people remember where their families died and do not want to go back there" Woman, 27 years old, May 19, 2007, MSF South Galcayo Hospital, South Galcayo
"I came from Mogadishu one month ago. I saw a lot of children and young boys killed and injured - the numbers were uncountable. People with guns just shoot. I saw a man buying water and a militia guy shot at his water. I saw his skin was burnt but we could not help him.
"Our house was hit and destroyed by an explosion; some died and some fled to other places. We came to Galcayo. Now we don't have a house and we have lost all our goods. We lost everything. I only have my daughter with me. I don't know what happened to the rest of my family. I left without knowing where they went.
"I was told that my aunt and brother are dead. Some of my family were injured and are now in a hospital in Mogadishu. I don't know where my husband is. He didn't leave Mogadishu because he's sick. He has malaria.
"I first went to Ba'adwin. A lot of people left Mogadishu and went to the bush and stayed in the countryside of Ba'adwin for example. They say they don't want to go back to Mogadishu even if peace returns, including those whose houses were not destroyed. Young people remember where their families died and do not want to go back there.
"My sister is now staying outside Ba'adwin. She has nine children; six of them were at school but they had to evacuate and now they are not learning. She says she doesn't want to go back to Mogadishu.
"I was six months pregnant when I left Mogadishu but I lost my baby. I think I started to have problems while we were leaving, in the car. I lost the baby when I was at home in Ba'adwin. Then I had a lot of pain and bleeding. I managed to get to Galcayo hospital after 12 hours on the bus from Ba'adwin. I left my daughter in Ba'adwin; she is one and a half years old."
MSF is filling some gaps in the most affected areas in the south and the centre of the country, implementing primary healthcare projects, treating tuberculosis and kala azar, providing therapeutic nutrition for malnourished children, offering paediatric care and carrying out surgical interventions.
"There was a bad smell of dead people" Woman, 30 years old with two children, one a year and seven months and a second three years old, May 19, 2007, South Galcayo Hospital, South Galcayo
"It all started with one explosion that hit my neighbours' house and killed them. Since then, there were continuous explosions in our neighbourhood, many people died and the houses were destroyed. There was a bad smell of dead people. There was no one to collect the dead bodies and we could not even put them on the side of the street because of the fighting...dead women and dead children.
"We had to leave. We had no money, nothing to eat. I went with my two children by foot to Afgooye, 30 km west of Mogadishu. It was many hours of walking but we were not alone; a lot of people were walking on the same road with us, people who did not know each other.
"I then found people who were going to Galcayo by car and left Afgooye with my children. On the way to the north, my money finished but the people who were travelling with me in the car collected money for me; this way I could make it to Galcayo. My husband had called me when I was still in Mogadishu and said he was in Galcayo. He said he was planning to leave the country by car, but when I arrived, he was not there any longer.
"In Galcayo I did not know anyone I could stay with so, when I arrived, I went to an IDP camp. Then I asked people in South Galcayo. I said I needed a place to sleep and now I sleep outside their house with my children. I am sick now and my children are also sick. I came to this hospital to get treatment. Before leaving I had always lived in Mogadishu."