The country’s already-strained health system could be pushed to the brink if the coronavirus hits vulnerable communities.
As the COVID-19 pandemic overwhelms countries with strong health care systems, Somalia – already reeling from the cumulative effects of multiple recent shocks – is preparing for the worst. The country has experienced conflict, drought, floods, a locust invasion, all in the last nine months.
For many of the tens of thousands of displaced families living in settlement camps in and around Mogadishu, social distancing is simply not an option – the communities depend on shared resources and spaces.
One displaced woman, Zahra Ali Mohamed, explains how social distancing is particularly challenging in camps because of overcrowding and the communal nature of daily life: “How do you expect people to practice social distancing in a camp where every makeshift house is close to each other, where we share communal toilets and common gathering areas? It’s impossible.”
Zahra, who first heard about the COVID-19 virus on the radio, says that if it spreads within her community, “it’s going to be a very difficult time for many because there are poor hygiene practices in the camps due to overcrowding and lack of sufficient amenities and resources.”
According to the United Nations, more than 2.6 million people are internally displaced in Somalia.
“Somalia’s health system is ill-equipped to manage an increasing burden. COVID-19 puts additional pressure on the current system – it could mean complete shutdown or diminished service provision at all levels of healthcare,” says Ahmed Khalif, Country Director for Action Against Hunger in Somalia.
With eight confirmed cases as of April 8, Action Against Hunger’s team in Somalia has been supporting various stakeholders, including the Ministry of Health, health facility staff, and at-risk communities as part of our prevention plan. “We are closely coordinating with Ministry of Health Taskforce on COVID-19 to support the implementation of the National Preparedness and Response Plan,” says Khalif.
The number of cases in Somalia and throughout Africa is predicted to rapidly rise in the coming weeks: New models from The London School of Hygiene and Tropical Medicine predict with 95% certainty that all African countries will reach 10,000 COVID-19 cases by early June, at the latest.
For more than a year, Action Against Hunger has led a coalition of partners – known as the Somali Health and Nutrition (SHINE) Program – to support Somalia’s health authorities to deliver primary and secondary healthcare services and strengthen the health system in Mogadishu and surrounding areas. The project works within Maternal and Child Health Centers and Nutrition Stabilization Centers by providing immunizations, medical services, and nutrition treatment for severely malnourished children and by training, coordinating, and providing incentives to healthcare staff.
Now, the healthcare staff and centers supported by SHINE are bracing for the coronavirus.
“The threat is high in Somalia as bordering countries, Ethiopia and Kenya, are confirming an increasing number of cases. Our health system is not well designed to respond sufficiently to the pandemic if it gets to the community level,” says Hussein Isse, technical lead for the SHINE program.
In health facilities, Action Against Hunger has enforced new measures to separate the crowds of mothers seeking services and waiting with their children.
“As difficult as it is to distance mothers who come in by the hundreds to the health centers on a daily basis, we now have mothers sit apart in twos on the benches in the waiting area instead of the normal four-person seating arrangement,” says Hawo Ibrahim, the District Health Officer at Waaberi Health Center in Mogadishu.
Action Against Hunger is raising awareness and sharing information on how to properly implement preventive measures, such as handwashing, in the communities we serve across the country, working with the Ministry of Health and other partners. Our teams are spreading the word through text messages, radio public service announcements, education materials from banners to pamphlets, and other methods.
We are providing face masks, gloves, soap, and handwashing stations for key areas within health centers – a tough challenge as the entire world competes for limited supplies. The prices for personal protective equipment (PPE) have quadrupled in recent weeks.
“We continue to support rapid training of healthcare workers, reinforcement of health systems, and advocacy for equitable distribution of medical supplies, such as personal protection equipment. With support from the European Union’s Humanitarian Aid agency (ECHO), we are on the frontlines fulfilling and implementing the priorities identified in Somalia’s national COVID-19 Response Plan,” says Khalif.
As Action Against Hunger’s teams prepare for a pandemic, we’re also committed to keeping our lifesaving nutrition, food security, and water and sanitation programs going. Because hunger doesn’t stop for a pandemic – and neither can we.
