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Field diary: In Somalia's Boroma district, Child Health Days campaign is making strides

© UNICEF Somalia/2010/Morooka
A child receives immunization against measles in Hayaayabo village, in north-western Somalia's Boroma district, during a round of the Child Health Days campaign.

Communication Officer Iman Morooka from the UNICEF Somalia Support Centre sends the following firsthand report from a visit to north-western Somalia’s Boroma district, near the border with Ethiopia.

By Iman Morooka

BOROMA DISTRICT, Somalia, 17 June 2010 – I arrive in Hayaayabo village early in the morning. This is one of the sites where the Child Health Days Campaign, supported by UNICEF and the World Health Organization, is being implemented.

Just the day before, I've come from the city of Hargeisa, the capital city of Somaliland, accompanied by armed escorts – a security measure that is mandatory for all staff movements in this area affected by conflict.

Hayaayabo village is situated in a hilly area, about 3 km away from Boroma district’s main town. A village elder here says a lack of safe water and health services is the biggest problem that villagers face. To fetch water, they must walk all the way to town, bringing it back on donkeys – or carried by women with heavy jerry cans on their backs. And when a child gets sick, the nearest health facility is a hospital 5 km away.

© UNICEF Somalia/2010/Morooka
A woman holds packets of oral rehydration salts for the treatment of diarrhoea and 'aquatabs,' or water-purification tablets, in Somalia's Boroma town, near the border with Ethiopia.

Boosting immunization

Today, one of the Child Health Days outreach teams is providing essential services for children and women in the village. It is only 8:30 a.m., but there is already a long queue waiting to be assisted.

Somalia's immunization rates are amongst the lowest in the world. But through Child Health Days, vaccination coverage has improved significantly. In many areas, the campaign has helped increase measles immunization and other vaccine coverage from less than 30 per cent to nearly 90 per cent, a remarkable achievement – especially in an area that is difficult to reach with humanitarian assistance.
At the campaign site, I see the social mobilization car with its megaphone repeating messages and playing songs composed for the campaign. I also see the health team busy attending to the many mothers and children who have gathered. The team registers children and provides nutritional screening, vitamin A supplements, de-worming tablets and oral polio vaccine drops. They immunize children against diphtheria, whooping cough and tetanus, and mothers of child-bearing age against tetanus.

© UNICEF Somalia/2010/Morooka
A woman and her children walk towards the Child Health Days immunization campaign site in a village in the outskirts of Boroma town, Somalia.

Reaching every community

Next, we drive another half hour to a village where a Child Health Days team has built a tent because they didn’t have shade under which to operate. UNICEF Health Officer Marian Yusuf Fahiye points to the traditional Somali huts scattered around the village. She explains how difficult it is to reach everyone in this mountainous environment, where communities are widely spread out.

Through meticulous planning and preparation with the local authorities and communities, however, the Child Health Days campaign has divided up teams in order to reach every community. In the Adwal region alone – where Boroma district is located – 117 teams have travelled around the region to implement the programme.
The work of the health team is not always easy. They tell me about one young mother who came to the site with her child but refused to have him vaccinated because the injection was painful. Although the team tried to persuade her, she wouldn’t change her mind.

While the team does occasionally encounter such cases of refusal, intensified and strengthened social mobilization efforts have helped to educate people about the benefits of immunization. During my visit, the health team is able to convince a woman who initially refused her tetanus vaccine. They change her mind by explaining the risks of remaining unprotected.

Unexpected challenges

Before heading back to Hargeisa, I also visit some families on the northern edge of Boroma town who benefited from a UNICEF-supported water-and-sanitation project. In response to a serious water shortage in the area, UNICEF helped connect the town’s supply system to an additional water source. As a result, the town’s water supply increased by 30 per cent, allowing for new household connections to be installed.

UNICEF is supporting 12 water-supply systems across Somalia, managed by public-private partnerships and serving over 430,000 people.

Fatuma, a mother of five, says she is happy now that she is paying less for water – and has a safe and constant supply in her own home. She tells me that she used to have to buy water every few days, which cost the family significantly more. There were times when even the water seller didn’t have anything to sell.  

On our way back to Hargeisa, a challenge awaits us. The normally dry river bed is flooded by heavy rains. There are no bridges to cross over to the other side, so we are forced to divert from the main road and drive for hours through the hills and streams. After many failed rainy seasons, heavy flooding is now hitting various locations across the country.

Somalia is not only plagued by chronic emergency caused by its prolonged conflict, but also faces hardships caused by natural disasters such as drought and flooding. About half of the country’s population of 3.2 million is in need of humanitarian assistance. Almost half of those are children.



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