© UNICEF Somalia/2008/Iman Morooka

Severely malnourished, Asha, 20 months old, sits on her mother’s lap at a mobile clinic in Bossaso. She was eventually transferred to a UNICEF-supported stabilization centre at Bossaso Hospital.


Asha is only 20 months old but in her short life she has already survived conflict, displacement and severe malnutrition.

In January 2008, her family fled the escalating fighting in the Somali capital, Mogadishu, and sought refuge and security in Bossaso, North-East Somalia. Asha’s mother, Khadija, decided to leave Mogadishu when conditions there became unbearable. “I had a good job in Mogadishu selling fruits and vegetables,” she recounted tearfully, “but fierce fighting disturbed our life more and more every day until it became impossible. Sometimes, I couldn’t get home after finishing work because battles had blocked the roads. There was also one time when I got home and couldn’t find my family, who had had to evacuate because they feared death. So I discussed it with my mother, and she gave me permission to leave Mogadishu with my two children.”

But life in Bossaso proved just as hard. The family lives in a camp for internally displaced persons (IDPs), where even minimum basic services, like water and sanitation, are inadequate. As a divorced single mother, Khadija is the sole provider for her two young children. She works as an ice cream vendor, but barely earns enough to cover even the most basic needs. Despite her best efforts, she has been unable to provide enough food for her family. “In Mogadishu, I was able to feed my children three times a day because I had a stable job, but now I can hardly feed them once a day. I can’t afford it.” Baby Asha, who was in good health when they left Mogadishu, became malnourished. “She was losing weight every day and vomiting anything I fed her,” says Khadija.

It is an all too common experience for displaced Somalis. Separated from their communities and support networks, they often become victims of marginalization, exploitation and unemployment. The nutritional status in most Bossaso IDP camps is poor. Home to more than 28,000 people, the Bossaso camps report global malnutrition rates, which are classified as ‘very critical’ at 24 per cent – well above the 15 per cent emergency threshold.

In August, Khadija was able to have Asha examined by trained medical personnel thanks to the UNICEF-supported outreach feeding programme. Community health workers, who monitor children’s conditions in IDP camps, referred Asha to the mobile clinic of the outpatient therapeutic programme, where severely malnourished children are treated with therapeutic food, and their condition is regularly monitored. As a result of her symptoms – vomiting, coughing and diarrhoea – the outpatient therapeutic programme referred Asha to the inpatient stabilization centre at Bossaso Hospital, another UNICEF-supported intervention that treats severely malnourished children with medical complications. There, children receive free, round-the-clock medical care provided by professional staff, and parents get free accommodation and meals. Once Asha’s metabolism is regularized, she will be returned to the outpatient therapeutic programme until she regains her normal weight.

Malnutrition is one of the biggest challenges facing Somali children. One in six children under age five is acutely malnourished, and one in forty is severely malnourished. Thirty-six per cent are estimated to be underweight. Across the country, UNICEF and its partners reach more than 5,000 severely malnourished children every month through 133 outpatient therapeutic programmes and 20 stabilization centres.

Though security conditions continue to deteriorate in many parts of Somalia, UNICEF and its partners keep providing lifesaving interventions so that vulnerable children, like baby Asha, are given a chance to know there’s more to life than hunger and despair.