The COVID-19 pandemic is an unprecedented global crisis. Médecins Sans Frontières/Doctors Without Borders (MSF) is doing all it can to respond in Somalia and Somaliland, as we strive to keep essential life-saving activities running in a context of global shortages of supplies and restrictions on the movement of staff.
Even before the COVID-19 crisis erupted, Somalia was grappling with significant humanitarian challenges. Millions of people have been forced from their homes by conflict, climate-related disasters, such as droughts, locust swarms and heavy flooding. In recent weeks, heavy rains have again caused flash floods across several parts of the country, with the UN estimating that over 200,000 people are affected due to loss of houses, farmlands and other livelihoods.
In response to these current floods, we are rushing in essential medical supplies to one of the affected areas, the Bardera district of Jubaland state, to urgently help in containing the risk of water-borne diseases such as cholera. Our teams will also provide the district hospital with hygiene kits, mosquito nets and kitchen kits to be distributed among 2,500 displaced families. Many in the area had barely time to recover from the previous floods in late 2019.
“We face now an extremely challenging situation. As confirmed COVID-19 cases quickly rise across the country, we can’t forget the ongoing needs of the Somali community. We will struggle to allocate attention and resources to deal with this new disease, which we are still learning about, while also responding to all the existing medical needs in the country. Families will be hit by climate disasters, women will continue to give birth, children will continue to fall sick from malnutrition and patients with chronic diseases will continue to need medication. All of this is taking place at a time when the humanitarian response capacity is stretched globally,” says Gautam Chatterjee, MSF country representative for Somalia and Somaliland.
In recent weeks, MSF has been coordinating with the Somali health authorities, the World Health Organization and other health actors to prepare for the arrival of COVID-19 in Somalia and Somaliland.
In towns like Las Anod, Galkayo and Baidoa, where we were already providing medical care, our teams have put in place new hygiene controls and preventive measures to protect frontline staff. This includes training on infection prevention and control (IPC) and on how to identify COVID-19 symptoms and triage suspected cases. We are also engaging with communities to ensure they are aware of ways to minimise the risk of infection and providing technical and logistic advice to the authorities to set up isolation wards. In Jubaland, we will donate infrared thermometers to frontline health staff and hygiene kits to strengthen the screening capacity and preparedness of the local authorities.
In Hargeisa, the capital of Somaliland, MSF is supporting the Ministry of Health on their COVID-19 response. MSF´s support has included strengthening IPC measures, training emergency room staff and ambulance drivers, and providing interim support for medical staff.
The global shortage of personal protective equipment (PPE) and other essential medical supplies has affected Somalia and Somaliland and MSF’s work in the region. MSF is working on solutions to overcome shortages in order to equip and protect both our staff and the Ministry of Health staff working in the facilities we support and to ensure the continued delivery of essential medical care.
“Frontline healthcare professionals and other workers must be protected and receive adequate training on preparedness and prevention of the disease,” says Chatterjee. “Without them, there is no response to the pandemic, or to general health needs, so we must keep them safe and free from infection to treat patients.”
A major concern for MSF are high risk people, such as patients with underlying health conditions, older people and vulnerable groups living in precarious circumstances such as in camps and crowded urban areas. There are several million internally displaced people, refugees and migrants living in Somalia and Somaliland, who lack access to basic services, including healthcare, clean water and proper sanitation.
A major outbreak of COVID-19 in such a low-resource context will put a lot of pressure on an already fragile, overstretched health system. It is therefore crucial to spread awareness among the community and to increase testing and contact tracing capacity.
“It is crucial to ensure that low-resource contexts like Somalia, where the direct and longer-term consequences will be profound, are not forgotten. This must be a moment for global solidarity and we need to work hand-in-hand to overcome this immense challenge,” says Chatterjee.
MSF provides medical and humanitarian assistance to people affected by conflict, epidemics, disasters or exclusion from healthcare in 72 countries. Our actions are guided by medical ethics and the principles of impartiality, independence and neutrality. We have worked in Somalia and Somaliland since 1991. In 2013, MSF was forced to leave the country after a series of violent attacks against our staff. Our teams resumed treating patients in May 2017, in recognition of the enormous unmet health needs of the population. Currently, MSF carries out medical activities in hospitals in towns and cities, with a focus on maternal, paediatric and emergency care, nutritional support, and diagnosis and treatment of tuberculosis (TB) and multi-drug-resistant TB. MSF also runs mobile clinics for internally displaced people. At present, MSF provides essential medical activities in Hargeisa and Las Anod (Somaliland), North Galkayo (Puntland state), South Galkayo (Galmudug state) and Baidoa (South-West state). Our regular in-and-out short responses in Jubaland state have been temporarily suspended and other non-essential activities elsewhere have been put on hold.