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Field diary: More efforts needed to help Somali families survive and thrive

© UNICEF Somalia/2010/Kunii
Women carry their babies in a camp in Bossaso, a town in Somalia's north-eastern Puntland region.

UNICEF Chief of the Child Survival Programme in Somalia Dr. Osamu Kunii recently visited the country’s semi-autonomous region of Puntland and filed the following first-hand report.

By Dr. Osamu Kunii

BOSSASO and GAROWE, Somalia, 1 September 2010 – As soon as I arrived in Bossaso, the main port town located in northeast Somalia, the scorching heat, strong wind and barren plains brought back the memory of my past experience in Somalia.

I returned to the country with excitement after having worked there in 1985 and 1993 with a non-governmental organization. This time I am here as Chief of the Child Survival Programme at the UNICEF Somalia Support Centre.

Threats to camps

I had hoped that a new nation would be established and the daily life of Somalis improved when I left in 1993. It is heartbreaking that today the security situation is still deteriorating. According to the Food Security and Nutrition Analysis Unit in Somalia, some 2 million people – nearly half of them children – still need humanitarian assistance in the country.

During my stay in Bossaso, I visited camps for families that had been displaced since fleeing fighting in the southern and central parts of the country. I spoke with one woman, a mother of two and head of her household, who said that it took her four days to reach the camp by truck after escaping fighting in Mogadishu, the capital. Her children suffered severe malnutrition and diarrhoea.

© UNICEF Somalia/2010/Kunii
A displaced child stands in a settlement camp in Bossaso, northeastern Somalia.

Fortunately, the family’s condition is improving after having been treated at a therapeutic feeding clinic and receiving health services with UNICEF support. Left without any intervention, it is likely that they would have died from complications of their illnesses.

In some camps for displaced people in Bossaso, more than 26 per cent of children under five are acutely malnourished; among them about 5 per cent suffer from severe acute malnutrition. These are critical figures that reflect the need for urgent measures.

Crucial interventions

Besides lack of food intake, malnutrition is caused or worsened by additional factors including poor hygiene, infectious diseases and poor breastfeeding practices – all of which threaten camps for displaced people.

In Bossaso’s camps, many malnourished children suffer from diarrhoea and pneumonia. Many mothers do not exclusively breastfeed, which exposes infants to contaminated food and unsafe drinking water. 

In spite of limited human resources, I found that the UNICEF Stabilization Centre based in Bossaso Hospital and the Outpatient Therapeutic Programme facilities (OTPs) in the camps are functioning well. UNICEF plays a crucial role as the Nutrition Cluster lead agency, supporting a majority of the nutrition activities in Somalia. In northeast Somalia’s Puntland province, for example, UNICEF is providing support to one stabilization centre and 29 sites of OTPs.

© UNICEF Somalia/2010/Kunii
A settlement for displaced people in Bossaso, in Somalia's northeastern Puntland region.

Nonetheless, these interventions are not enough to respond to the high level of malnutrition among displaced people and vulnerable populations in hard-to-reach areas. We need more resources.

Commitment to health

During my trip, I visited with the Puntland Minister of Health in Garowe – the region’s capital – who expressed his gratitude for the continued support of UNICEF. We discussed and reviewed the current support programmes and I was impressed by the Minister’s enthusiasm and commitment to health and nutrition.

We further discussed how to increase coverage of high-impact interventions, how to reach the most vulnerable and how to leverage resources and enhance the capacity of health personnel.

I also visited Maternal and Child Health (MCH) clinics in the area. UNICEF currently supports 48 MCH clinics and 93 health posts in Puntland alone by providing essential drugs as well as training and incentives for health personnel.

But there remains room for more assistance. Basic equipment such as delivery beds are lacking. Given that many children and mothers still die in their homes before reaching MCH facilities, there is critical need for strengthening the sheer capacity of these facilities.

The trip gave me a stronger understanding of the overall health and nutrition situation in Somalia. I look forward to continuing to work with UNICEF and to improve the lives of Somali children and women.



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