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Humanitarian Health Challenges in Somalia: Saving lives and reducing vulnerabilities Emergency Preparedness and Humanitarian Action WHO Regional Office for the Eastern Mediterranean. Context. More than 15 years of conflict and insecurity

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  1. Humanitarian Health Challenges in Somalia: Saving lives and reducing vulnerabilitiesEmergency Preparedness and Humanitarian ActionWHO Regional Office for the Eastern Mediterranean

  2. Context • More than 15 years of conflict and insecurity • South Central Zone worst off  over 2 million people (> 450,000 IDPs) in chronic need of relief and assistance • Dilapidated health systems  • Unskilled work force • Old or destroyed infrastructure • Nonexistent governing structures and regulatory capacities • Limited access • Unchecked private sector

  3. Health Issues • Chronic food insecurity - malnutrition rates over 25% in some areas • Prevalent infectious and communicable diseases - diarrhea, malaria, measles, ARI, Meningitis • Non-existent or very weak surveillance system • Low immunization coverage - re-surgence of polio cases • Difficult access to primary health care - nomadic population • Limited access and availability of safe water and sanitation services

  4. Acute episodes: Drought Nov ’05 – April ‘06 • Worst drought in the Horn of Africa in a decade – more than 11 million people affected • Drought affected pastoral and agricultural communities, an estimated 1 million people in South Central Somalia • A regional problem: a cross-border issue (population and live stock movement) • Inequity of response on different sides of the border (pull-factors) • Increased competition for resources between crises in the region but also internationally.

  5. Somalia cross border food security situation analysis Jan-Jun 2006

  6. Floods in South Central Somalia July ‘06 – Jan ’07 • Over 500,000 people affected • Contamination of water sources • Acute Watery Diarrhea, Malaria, Acute Respiratory Infections • Vector-borne: Malaria and Rift Valley Fever

  7. Map Somalia: Flood Hazard Distribution Map

  8. Rift Valley Fever – Dec ’06 – Jan ‘07 • Hundreds of deaths in livestock • 103 suspected human cases; over 50 reported deaths • On-going conflict between TFG and UIC complicating surveillance and outbreak response

  9. Somalia: • Human RVF cases in Lower Juba • Suspected cases reported from Afmadow & Kismayo Districts (close to Kenyan border)

  10. Acute Watery DiarrheaFeb ’07 – to date • Mainly South Central affected • Over 12,000 cases with over 400 deaths • Outbreak ongoing • Affected population moving out of Mogadishu to the periphery to evade conflict • Health care and monitoring capacities already very limited and overstretched Picture: Cholera Treatment Centre in Safarloyle, Somalia

  11. WHO Response • Emergency supplies • Strengthening and facilitation of coordination • Disease surveillance and outbreak response • Provision of outreach essential health services • Immunization coverage • Water and Sanitation • Technical support to zonal/district authorities • Health education • Training of health staff

  12. Challenges • Cross-border issues • Non-existent and/or changing counterparts • Pastoralism misunderstood • Inadequate local leadership • Limited preparedness plans and capacities • Extremely limited human resources • Insecurity and access • Funding constraints • Donor fatigue

  13. ICT Challenges • Non-existent regulatory structures • Unreliable national/zonal networks • High logistical and operational costs • Virtual trouble shooting • Looting/confiscating of equipment and vehicles by factions (Polio equipment in January’07)

  14. Lessons Learned • Effective early warning does not always translate into timely or adequate response in slow-onset (drought) disaster/s • Investment in national capacity • As emergency continues, enhance understanding of, invest and strengthen pastoralist livelihood systems

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