7 April 2009

Somalia: Providing Healthcare Against All Odds in Mogadishu

Nairobi — World Health Day on 7 April is just another difficult day for medical personnel in Mogadishu, capital of war-torn Somalia, where threats and intimidation are part of their routine.

"We have had armed men in hospitals demanding that their [friend] be treated; they even go to the extreme of removing patients from the table right in the middle of surgery," Abdirizaq Ahmed Dalmar, head of the Somalia Medical Association, said, detailing the difficulties personnnel faced while discharging their duties in the city.

"We even had 'technicals' [battlewagons] coming into hospital compounds once. We operate under the most difficult of conditions. My hope is this will be a better year," he said.

Over the past few years, access to medical care for civilians and displaced persons in and around the city has decreased due to escalating violence, medical workers told IRIN.

Security fears

"With shelling and fighting almost on a daily basis, both medical staff and people in need of medical care are unable to access the medical facilities," Dalmar said.

Often, terrified medical workers are forced to flee the city for their safety, Dalmar said, adding that the past two years had been the worst for the city's health system, with hospitals closed or barely functioning.

He said at least 37 hospitals and clinics closed between 2007 and 2008 due to the fighting, with some taken over by the military.

"There were times that I could not reach the hospital due to the intensity of the fighting," he said. "People needed me but I could not help because they made the area around the hospital a war zone."

Staying power

Mohamed Mahamud Bidey, the dean of the Benadir University Medical College and a doctor in Mogadishu, told IRIN: "Some of our colleagues have been killed, maimed and kidnapped but we are still trying to provide healthcare to those who need it."

He said a group of doctors had set up the first medical college in the city since the civil war began to replace doctors who had left or died. "It is a clear commitment to our people and we are prepared to continue no matter what."

People had to understand that health workers were neutral and provide treatment to everyone, "no matter what group he is from", he said.

"My only wish as we mark this year's World Health Day is for all Somalis to protect and respect health centres and health workers," he added.

Demand for services

Lul Mahmamud Mohamed, the head of the paediatric department at Benadir Hospital, said she had returned home in 2005 from Britain "because I knew my services were needed here more than there".

Mohamed now cares for thousands of children both from the city and surrounding camps for the displaced, who come for the free services. On average, at least 1,000 children seek treatment at the hospital every month, she said.

"Most of those who come cannot afford to buy even the most basic drugs," Mohamed said.

She said doctors in Mogadishu suffered with the population in terms of the insecurity.

"There are times when I cannot access my patients because of the security situation," she said. "My biggest problem, however, is when a patient is in need and I cannot help them, because I don't have the equipment I need or the drugs I need. This is the biggest frustration for me."

However, despite the insecurity and frustration, Mohamed is staying. "I have no intention of leaving. I will share whatever I have with the people of this country," she said.

[ This report does not necessarily reflect the views of the United Nations ]

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