Importing food against all odds

NAIROBI, 31 March 2010 (IRIN) - Prolonged conflict in Somalia and rising world food prices have severely undermined food security, forcing most Somalis to rely on imports.

However, the challenges of importing food into the war-torn country are almost insurmountable at times, say business people.

One of the biggest hurdles is dealing with exporters without having a proper bank account.

Liban Yusuf, who is based in the coastal city of Bosasso, the commercial capital of the self-declared autonomous region of Puntland, told IRIN that to overcome the banking challenge, "you either use money transfer companies to send the money or you open an account in a place like Dubai [United Arab Emirates] and put the money there - and neither is easy.

"We bring stuff from Brazil, India, Thailand, Pakistan, Dubai and Oman," he said. "I import sugar, rice, flour and cooking oil."

Since the 11 September 2001 attacks in the US, he said, money transfer companies are reluctant to deal with large amounts, "even when they know that it is going to buy food. They are terrified and they make our lives more difficult."

Cash in a bag

A businessman in the capital, Mogadishu, who requested anonymity, said another option was simply to carry cash.

"Just imagine someone carrying a million dollars in a bag; it is impossible, but people do what they have to, to get the food into the country," he said.

A Somali agronomist told IRIN that more than 50 percent of the food consumed in the country was commercially imported.

The Food Security and Nutrition Analysis Unit - Somalia said in its 2009/2010 Post-Deyr report that 542,000MT of cereal was imported in 2009, of which 119,000MT was food aid while 423,000MT was commercial.

According to Yusuf, the importing difficulties increase the cost of goods. "We have to pay every step of the way and that adds to our expenses, making our goods even more expensive."

He said importers also have to deal with shipping goods twice. "If I buy sugar from Brazil and the ship is bigger than 7,000T, I have to unload it in Dubai or Oman and put it on another ship that can dock in the port of Bosasso [which accommodates ships no larger than 7,000T].

"This of course will add to the cost of the goods," he added.

Extra "taxes"

But, said Yusuf, the problems did not end with the goods' arrival in Somalia.

A 50kg bag of rice imported from India cost US$24 to import to Bosasso but then, he said: "I have to pay $1 per bag tax, so that makes it $25."

To transport the same bag to the central town of Beletweyne, some 1,100km south, will cost another $4, Yusuf said.

"This not only includes the transport cost but also the money paid at different checkpoints manned by different militias," he said.

Ali Mohamed Siyad, chairman of Mogadishu's Bakara market traders, told IRIN that 20 years of non-existent government had taken their toll on trade.

"For the past 20 years, things have been getting progressively worse for us," he said, adding that the continuing upsurge of violence in Mogadishu was making importing goods "next to impossible".

Siyad said: "A ship docks today and then fighting erupts in the city. That ship has to wait however many days it takes for the fighting to stop before it can offload its cargo."

He said any additional cost is passed on to the consumer. "It is unfortunate but it is a fact of life that the poor consumer usually pays in the end."

Caveat emptor

The lack of government structures to regulate imports has other negative effects on the consumer, according to Salad Dini, another Mogadishu businessman.

"Less than five months ago, unscrupulous businessmen brought in a consignment of rice that was rejected by Dubai, because it was not fit for human consumption."

The consignment ended up in the Mogadishu markets, he said. "We have no way of knowing if people got ill or even died because of it; who is there keeping records of such things?"

By and large, he said, Somali businessmen are honest, "but you get the odd ones who will bring in stuff that will harm their people, and we have no way of stopping them".

ah/mw[END]

Situation of IDPs "at its worst" as aid runs out

NAIROBI, 29 March 2010 (IRIN) - As more aid groups pull out of camps for internally displaced people (IDPs) and more people flee Mogadishu to escape the violence, the plight of IDPs is at its most extreme, says a doctor-turned-relief-worker in Mogadishu.

"[Relief] aid is at its lowest and the need is even greater than at any time," Hawa Abdi, who turned her 26ha property into an IDP camp, told IRIN on 29 March.

She said hundreds of thousands of displaced families living in IDP camps on the outskirts of the city were facing an uncertain future as food begins to run out because they were no longer getting the necessary support from aid groups.

Fighting between government troops and insurgents in and around Mogadishu has been going on for years now but aid workers have described the displacement in 2010 as the highest in many years.

Abdi lives with at least 70,000 IDPs in her compound where, she said, "food is scarce as people who used to find work in Mogadishu can no longer do so due to the increased insecurity".

She said many aid agencies had withdrawn without empowering local Somali aid workers to do the job. "They [aid agencies] cannot do the work for obvious reasons but at the same time they don't trust us [Somalis] to do the job."

Abdi blamed the warring parties, insurgents and the government troops. "They should protect those who come here to help their brothers and sisters but they are not doing so and are the ones forcing many good people to leave."

She said the IDPs' health was also deteriorating. Abdi, a gynaecologist, added that almost 40 percent of women coming to her clinic had experienced a spontaneous abortion.

Many children were also malnourished, she said.

Aynabo Ilmi, 43 and a mother of seven, has been an IDP since 2007 when she fled her home in Mogadishu after her husband was killed.

"The last time we received any food aid was in October 2009; up to now we were depending on help from other Somalis and whatever work we could find," said Ilmi.

She said many IDPs depended on the food distribution and casual work "but now both are gone".

Ilmi said it was almost impossible to go to Mogadishu because fares for public service vehicles had risen so much that "any money you make from work will end up paying for the fare; what is the point if I cannot come back with something for my children?"

Highest displacement

Despite the worsening conditions in IDP camps, more people were arriving daily, said Abdi.

"We have recorded over 1,000 families in the past week," she said.

According to the UN Refugee Agency, UNHCR, the rate of displacement in 2010 has been among the highest in the past few years. So far this year, 169,000 have been displaced across the country, the agency said.

"People's coping mechanisms are progressively weakening, at a moment when humanitarian agencies have very limited access to the needy," Roberta Russo, a spokeswoman for UNHCR Somalia, said.

Asha Sha'ur, a member of Somalia's civil society, told IRIN children were the worst-affected. "We are getting reports of severely malnourished children; many parents have reached their limit and don't have anywhere to turn."

She said the lucky ones were those with relatives in the diaspora. "They may get some money to tide them over but the majority of the displaced have no one," she said.

Abdi said the diaspora Somalis had been helping her clinic but the needs were often more than the help received. "These are their people and they should do everything humanly possible to help them get out of this predicament."

Abdi said Somalis in the diaspora should not limit their involvement to only sending money "but get politically involved and help find a lasting solution".

ah/mw[END]

High-risk truckers still unaware of HIV

HARGEISA, 26 March 2010 (PLUSNEWS) - The truck drivers who criss-cross Somalia are considered at high risk of HIV, but incomplete prevention messages mean they are ill-equipped to protect themselves against the virus.

"The highest risk of disease spreading can come from the drivers who are going from town to town, deep in Somalia to Puntland [autonomous region in the northeast of Somalia] all the way to south-central Somalia and coming back to Somaliland," Hassan Omar Hagga, director of training at the Somaliland AIDS Commission (SOLNAC) secretariat, told IRIN/PlusNews.

He noted that border towns were of particular concern.

"In Tog-wajale [Somalia-Ethiopia border town] there are sex workers, but we do not recommend the use of condoms because we are a Muslim state," he said. "For this reason we can't urge people to use condoms; on the contrary, we tell people to give up adultery."

As a result of this policy, truck drivers and sex workers often hold misconceptions about condoms and as such, rarely use them.

"We do not use condoms at all, but sometimes we use plastic bags," said Karshe Gele*, a truck driver in the Somaliland capital, Hargeisa. "We consider that condoms are the carriers [of HIV].

"We know that it [HIV] is transmitted through sexual intercourse, but we think that [prevalence] is not much in Somaliland," he added.

HIV prevalence in Somaliland has risen from about 0.9 percent in 1999 to 1.3 percent in 2007, according to Said Ahmed Abdi Mouse, communication and awareness officer for SOLNAC.

"We have made tangible [progress] against HIV-related stigma compared with 1999, when it was a shock to talk about HIV/AIDS publicly, but still stigma and limited education about the disease exist in the country, particularly in remote areas," SOLNAC's Hagga added.

* Not his real name

maj/kr/mw[END]

Funding shortage could force UN health agency to curtail activities in Somalia

The international community's lack of financial support for healthcare activities in Somalia could undo the progress made so far in the Horn of Africa nation, the United Nations World Health Organization (WHO) announced today.

"WHO had requested, in the 2010 Consolidated Appeals Process for Somalia, $46 million, of which only 8 per cent have been funded so far," agency spokesperson Paul Garwood told reporters in Geneva, noting that the main donor was the UN Central Emergency Fund itself.

In recent years, millions of children have been vaccinated and hundreds of medical staff have been trained in surgery and surveillance of disease outbreaks.

The WHO is currently on the verge of reducing such activities in parts of the country, even as the number of reported disease cases, such as cholera, is on rise and the risks of outbreaks very high, Mr. Garwood said.

In addition, fighting between Government and its supporters and rebel forces killed 48 people and wounded more than 400 others in the first half of this month, he added.

Meanwhile, the top United Nations envoy to Somalia today said that he is pleased with the momentum generated by recent events in regard to the peace process in the war-torn nation, including a security sector reform meeting and the signing of an agreement between the Somali Government and a rebel group.

"We are a quarter of the way into the second year of the TFG's [Transitional Federal Government] term and managing the status quo is not an option. A number of firm and significant steps have been made that show the willingness and ability of the Government to use this transitional period wisely and for the benefit of the Somali people," Ahmedou Ould-Abdallah, the Secretary-General's Special Representative, said in a statement.

The comments come just days after he met with Somali Prime Minister Omar Abdirashid Ali Sharmarke and the head of the African Union Mission to Somalia (AMISOM), Boubacar Diarra, at a meeting in Nairobi, Kenya, of the Joint Security Committee (JSC).

During the meeting this past Tuesday, participants discussed the progress made and future actions needed to further the TFG's national security and stabilization plan, including training initiatives supported by the European Union and other members of the international community.

The UN does not have a peacekeeping mission in Somalia, but is mandated by the Security Council to work politically and logistically with the international community to support AMISOM and the TFG.

TFG President Sheikh Sharif Sheikh Ahmed was elected in January 2009, the first formal Government in Somalia since the overthrow of Siad Barre in 1991 pushed the country into turmoil.

A number of former rebel groups have at times supported TFG, the most recent being Ahlu Sunnah Wal Jama'a, which signed a peace agreement with the Government earlier this month.

Mr. Ould-Abdallah said the agreement was an additional indication of the Government's commitment to associate all willing parties towards restoring peace and reconciliation.

In a related development, the Independent Federal Constitutional Commission (IFCC) wrapped up a workshop on Tuesday in Djibouti to lay out new parameters for the Constitutional process. The IFCC is expected to have a final draft Constitution prepared by 1 July.

This weekend, the Special Representative, along with UN Secretary-General Ban Ki-moon, will attend the Arab League Summit in Sirte, Libya. While the meeting will focus on the Middle East, specifically the peace process between Israelis and Palestinians, Mr. Ould-Abdallah is expected to raise the situation in Somalia with Arab leaders.

The talks will come ahead of a conference hosted by Turkey addressing Somalia's reconstruction and development, which is expected to take place on 22 May in Istanbul.

Source: UN News Center

Safety of uprooted Somalis key concern for UN refugee agency

12 March 2010 – The United Nations refugee agency today expressed its deep concern for the safety of more than 8,000 people trapped in the Somali capital, Mogadishu, by clashes which have uprooted more than 100,000 people since the start of the year. Some 8,300 people who do not have the means to get out of the capital remain displaced in Mogadishu, according to the UN High Commissioner for Refugees (UNHCR).
“As the fighting rages on, aid agencies cannot access and assist these extremely vulnerable IDPs [internally displaced persons],” agency spokesperson Andrej Mahecic told reporters in Geneva.
Characterizing the clashes in both the capital and other parts of the Horn of Africa nation as “relentless and indiscriminate,” UNHCR said the situation for civilians continues to deteriorate.
The latest round of violence between Government forces and Al-Shabaab militia is concentrated in Mogadishu’s northern suburbs.
Since last month, 33,000 people have escaped violence in the capital, with nearly half fleeing to the Afgooye corridor, a stretch of road 30 kilometres from Mogadishu, joining nearly 366,000 other IDPs who are sheltering there.
Neighbouring Kenya has also witnessed an influx of refugees, with 10,000 new Somali refugees having been registered in the first nine weeks of 2010 alone.
Mr. Mahecic said that with violence persisting in Somalia, UNHCR fears that the Dabaab refugee complex in northern Kenya, already home to 270,000 refugees, could see a spike in arrivals.
Somalia, the agency said, continues to be among the countries generating the highest number of displaced people and refugees, with over 1.4 million IDPs and more than 560,000 refugees.
The UN Office for the Coordination of Humanitarian Affairs (OCHA) reported today that insurgents disrupted food aid deliveries bound for five sites in Mogadishu as part of a feeding scheme supported by the World Food Programme (WFP).
Two trucks were seized on 6 March, but were released the next day, thanks to the intervention of elders. Three out of the five sites received their rations, and once the security situation improves, it is hoped that the remaining two sites – feeding 10,000 people – will be able to carry out their work.
This week, WFP and its partners reached over 130,000 people in central Somalia and in the semi-autonomous Puntland region with food supplies, OCHA reported.
In January, the agency had to suspend operations across southern Somalia in response to intimidation of its staff and the imposition of a number of unreasonable demands by armed groups that contravened WFP’s rules and regulations for delivering food for the hungry.
The assistance of UN agencies such as WFP is critical in the strife-torn Horn of Africa nation, where ongoing drought and civil unrest has left millions in need of humanitarian aid.
 Source: UN News Center

UN food agency welcomes review of its food distribution programme in Somalia

17 March 2010 – The United Nations World Food Programme (WFP) says it is ready to provide full assistance to any possible independent investigation into its food distribution operation in Somalia after a UN report that claims that some local contractors used by the agency have diverted aid for military use. “Our integrity is paramount,” said WFP Executive Director Josette Sheeran in a statement, stressing that the agency would review and investigate every issue raised by the report of the group of experts serving on the Security Council’s Monitoring Group on Somalia.
The Monitoring Group recommends that the Council urges Secretary-General Ban Ki-moon to initiate an independent investigation into the food distribution programme.
“A handful of Somali contractors for aid agencies have formed a cartel and become important powerbrokers – some of whom channel their profits, or the aid itself, directly to armed opposition groups,” the report alleges.
The report singles out the Adaani family, one of the three largest contractors for the WFP in Somalia, as “a financier of armed groups,” and which has ties with Hassan Dahir Aweys, the leader of the militia coalition Hizbul Islam.
WFP said it would not engage in any new work with the three transport contractors named in the report as allegedly involved in arms-trading.
The Monitoring Group also recommends that WFP revise its internal procedures to diversify how it issues contracts and work closely with other UN agencies and offices to share information about the Somali business community.
Turning to Mogadishu, the report says the war economy has corrupted and enfeebled State institutions under the leadership of the Transitional Federal Government (TFG) and President Sheikh Sharif Sheikh Ahmed. The apparent corruption has spread to the Somali security services which sell their military supplies in open markets.
“The limited ability of the Transitional Federal Government to pay its officials and security forces is handicapped by entrenched corruption at all levels: commanders and troops alike sell their arms and ammunition – sometimes even to their enemies,” the report said.
The TFG’s survival is attributed not to its military but to support from the UN-backed African Union peace support operation known by its acronym AMISOM and clan militias that have turned against the rebel Al Shabaab militias.
In a related development, the TFG signed an agreement with a former rival group known as Ahlu Sunnah Wal Jama’a at the headquarters of the African Union (AU). Militias in Somalia are known to change allegiances frequently.
On the topic of piracy, which the Monitoring Group called “the most obvious symptom of the war economy,” it notes that attacks on shipping off Somalia increased in 2009, despite the presence of international naval forces offshore.
The report also cautions against the increasing involvement of Somalia’s immediate neighbours, Djibouti, Ethiopia and Kenya, which “are militarily involved in the conflict or plan to become involved in the coming months.”

The Monitoring Group singles out Eritrea to cease any subsidies to members of the armed opposition groups currently based in Asmara and cancel Eritrean passports issued to members of the group.
Source: UN News Center

Galgadud villages abandoned as water shortage bites

NAIROBI, 17 March 2010 (IRIN) - An acute water shortage after a prolonged drought in central Galgadud region of Somalia has forced thousands of people to abandon their villages, say officials.

"A prolonged drought, coupled with a drying-up of wells and barkads [water pans], is forcing many people to leave their homes," said Abdirahman Mohamed Adawe, the district commissioner of Adado, one of the areas hardest hit.

However, some parts of the region are receiving the Gu (long) rains.

More than a dozen villages around Adado town, housing an estimated 35,000 people, are affected. Those with livestock are moving in search of pasture and water, while those who lost their livestock, the economic mainstay of the area, are moving to towns.

Many rural people are arriving almost every day "with nothing and camping on the outskirts of town", he said.

"In February alone, over 500 families [3,000 people] arrived in Adado town [some 620km north of Mogadishu]," he said.

The problem was most acute in Baá Dheer, 75km north of Adado; Goryale, 40km northwest of Adado; Hin Jilaabo, 40km southwest; and Ada kibir, 70km southeast.

"In many of these villages the wells and barkads have dried up and the only other option is water trucking, which is difficult and expensive," Adawe told IRIN. "Some villagers are going as far as 100km to get water."

Moalim Hassan, an elder in the village of Baá Dheer, told IRIN: "The closest water point is 75km away and a drum of trucked water costs 120,000 Somali shillings [about US$4], a sum of money most cannot afford."

The area has not had any rain for the past two years and the Gu rains - which should have begun - have failed.

In Ada Kibir, the situation is even worse. "We have been in a drought situation for a few years. We had very little rains or none at all in the last two years," Abdullahi Moalim, a resident, told IRIN.

Many residents have left the town. The one borehole had dried up and water was being trucked in from a borehole 60km away. "Those who are left in Ada Kibir are paying the equivalent of $4 or $5 for 200l of water."

Authorities in Adado were setting up a committee to deal with the influx of drought displaced, said DC Adawe.

"We are appealing to aid agencies and Somalis in the diaspora to come to the rescue of the people," he added.

He said there had been no reports of people dying, "but it is just a matter of time if the situation is not addressed soon".

ah/mw[END]

Offering migrants an alternative to death by water

Offering migrants an alternative to death by water

BOSASSO, 12 March 2010 (IRIN) - In an attempt to deal with a growing influx of migrants, authorities in Somalia's autonomous region of Puntland are adopting new measures to stop people from undertaking the hazardous journey to Yemen, officials said.

"The problem of migrants is not going away and the Puntland authorities, particularly in the Bari region [Bosasso area], had to come up with a new strategy to deal with this problem," said Mohamud Jama Muse, director of the Migration Response Centre (MRC) in the regional capital, Bosasso.

MRC was created in April 2009, under the office of the Bari governor, to "register and provide counselling and assist" the migrants. Between April and December 2009, it registered 7,223 persons.

"This number is smaller than the actual number," Muse told IRIN on 1 March. "You have to understand, a lot of these people are not very trusting of authorities, so they never bother registering."

According to the UN Refugee Agency (UNHCR), 78,487 Ethiopians and Somalis crossed into Yemen from Somalia and Djibouti in 2009, of whom 685 died.

So far in 2010, 5,032 have crossed and four have died, said Roberta Russo, spokeswoman for UNHCR Somalia.

Learning to fish

Muse said the government had adopted a two-track approach. Apart from the MRC, security forces had cracked down on smugglers and closed the ports from which they operate.

"With the help of IOM [International Organization for Migration] we started a pilot project with a local NGO, Red Sea Fishing Organization [RESFO], in skills training and income generation, for 100 migrants and locals to teach them skills to make a living," he explained.

The group is taught how to fish, process the catch, repair nets and keep books.

"We are even teaching some of them to swim," said Mohamed Said of RESFO. "The aim is to provide an alternative to boarding those boats [to Yemen]."

The project aims to integrate the migrants into the community, said Ahmed Muse Mohamed, IOM officer-in-charge in Bosasso. "We want to create opportunities here for them so they don't have to go on these dangerous journeys," he added.

Too weak to walk

"By the time they reach us they have walked over 1,000km and are dehydrated and almost starving," said Muse, and reports indicated some died on the way to Bosasso.

Abdi, not his real name, came from Ethiopia four months ago. He walked 760km to reach Bosasso, with the aim of going to Yemen.

He and six others had to avoid being stopped by security forces or attacked by bandits. "It is not a trip I would want to make again," he said. "It was too difficult and dangerous. By the time I arrived I was so weak I could barely walk."

He has registered with MRC but has not started the training yet.

Addis Tolosa, 30, an Ethiopian migrant who has been in Bosasso for a couple of years, went to Yemen but was intercepted by the Yemeni coastguard and returned to Bosasso.

He is now being trained by RESFO. "I don't have the means to go back [to Yemen] so I am now in this training to learn how to earn a living," said. "As soon we finish the training I will get fishing gear and go to work."

Some locals, however, insisted they would still like to go to Yemen.

Mohamed Hassan Shire, 23, from the coastal town of Kismayo, 2,000km south, arrived in Bosasso six months ago. He said he left out of fear he would be forcibly recruited into a militia.

"I came here because I was not safe in Kismayo," he said. "People I knew died trying to get there [Yemen]. I know also that what I am doing is like flipping a coin, but I will try it. I have no other option."

More help needed

The former Puntland Bari Governor Muse Ghelle (replaced on 6 March) told IRIN he was determined to help the potential migrants. "With the very little resources we have we are trying but we need help," he added.

He called on the international community to increase its support to Puntland to help it deal with the growing influx of migrants.

Puntland would not be able to cope on its own. "We need more meaningful help from the donor community," he said.

Muse of MRC said the migrants needed emergency food upon arrival, temporary shelter, a health centre and a reception centre to receive them.

"Most of these people are economic migrants and when they come here they have exhausted what little they had, so it is important to at least have somewhere where they can get some help immediately."

ah/mw

[END]

SOMALIA: Abdullahi Aden Ali, "From IDP to city trader"

Abdullahi Aden Ali, "From IDP to city trader"

BOSASSO, 10 March 2010 (IRIN) - Abdullahi Aden Ali, 32, arrived in Bosasso, commercial capital of the autonomous region of Puntland, 10 years ago from southern Somalia. His aim, like that of thousands of young Somalis, was to go to Yemen and on to Saudi Arabia. He first fled his home town of Baidao for the capital, Mogadishu, but was again forced out when fighting between warlords intensified.

Now Ali runs a wholesale clothing business in Bosasso. He spoke to IRIN on 28 February about his reversal of fortunes:

"We left Baidao in 1992 because of the famine and the fighting between different factions. My father thought we would be better off in Mogadishu but this was not the case; the fighting there was between warlords and there were gangs of freelance militias killing and robbing people.

"In 1998, highway robbers killed my father and I took over helping my mother.

"I heard from a friend that a lot of young people were going to Bosasso, taking boats to Yemen and from there going on to Saudi Arabia where they found jobs. I decided to try my luck.

"I reached Bosasso in August 1999 with 20,000 shillings [US$80 cents] and nothing else but the clothes on my back. I met some young men from the south who told me I would have to pay at least $50 to smugglers if I wanted to go to Yemen. I did not have the money so I had to work and save.

"A friend suggested that I could sell clothes for a city trader and make some money; the trader would set his price and I would sell the items for any price I could fetch, anything above his reserved price was mine. I gladly opted to go into the business and we often carried the clothes on our shoulders as we hawked them across the town. I would make a small cut for every item I sold.

"It was not easy at the beginning but I got used to it. I started hawking the clothes in nearby villages where I could charge higher prices and the competition was less.

"I was making fairly good money and I had $50 for the boat but then I decided I could make a better living here. I made enough money to buy my own clothes to sell instead of relying on the initial trader.

"By 2006, I made enough money to open a shop with some friends. I am now running this wholesale store. Six of us own it. We have one member in Dubai - we send him orders and he buys the goods and sends them to Bosasso. We are now supplying a number of retail businesses in Bosasso and other places.

"I am married with four daughters. By the grace of God, I am now able to take care of them and provide a comfortable life. We don't depend on anyone else. My first daughter is six years old and is about to start school.

"I may eventually go back to Baidoa if the situation improves but I will never cut my ties to Bosasso. It is where I became a man. Bosasso is now home and I am happy to be here."

ah/mw[END]

Too many patients, one mental health facility

BOSASSO, 9 March 2010 (IRIN) - The number of people seeking mental health treatment has increased in Bosasso, the commercial capital of Somalia's autonomous region of Puntland, despite the existence of only one small health unit, officials said. 
"We have only two rooms; one for males and one for females, with five beds each," Abdulkadir Khalif Ali, the nurse who manages the Bosasso general hospital's mental health wing. "The demand is rising; there are days when I have 20 or 30 patients, some requiring hospitalization, but I have to release them because there is no space."

Ali, the only qualified medical employee in the unit, told IRIN there was no psychiatrist. "I do almost everything a doctor would do," he added. "But we could do with one, no question."

The hospital recorded some 844 patients in 2009, despite the lack of mental health facilities and staff.

Francesca Rivelli of the protection sector, psycho-social support and mental health, of the NGO Gruppo per le Relazioni Transculturali (GRT), told IRIN the hospital was far too inadequate for the number of people it served.

"It is too small if we consider the inhabitants of Bosasso and moreover if we consider that the MHD [mental health department] at Bosasso hospital also serves people from all over Puntland and south-central Somalia," she said.

GRT set up the mental illness unit in 2004 and supported it up to 2008 when it stopped the support due to lack of donor funding. "There is support for malaria, TB and HIV/Aids but not so much for mental health," Rivelli.

Cases of post-stress traumatic syndrome have increased in Somalia mainly because there has been an increase in insecurity since the fall of the Siad Barre government in 1991, coupled with sporadic clashes, displacement and the daily uncertainty and violence in an impoverished environment, she said.

"In Somalia we're also talking about a long-standing and unique combination of harsh conditions..." said Rivelli.

Lack of interest

Ali said most of his patients displayed an array of mental illnesses such as psychosis, mood disorders, substance abuse, depression, neurosis and epilepsy.

Unfortunately, not many aid organizations in Puntland, he added, were interested in mental health issues. "I think they are more comfortable in other areas, such as FGM/C [female genital mutilation/cutting] and other easier-to-understand diseases."

Rivelli, however, said it should not be too difficult or costly to work in the mental health sector "through fine-tuned support initiatives at secondary health system level, namely strengthening the services provided by the local MHD.

"At the outset of the intervention, it is necessary to rely on motivated and qualified medical staff providing incentives both money-wise and in terms of motivation in coordination with the hospital system, to stop the turnover and brain-drain of the already few human resources," she added.

Secondly, having psychotropic drugs provided by international agencies and donors would boost the quality of treatment offered to the patients.

There was also a need to carry out the clinical and social work side by side with professional workers such as health workers and counsellors.

Running out of drugs

Ismahan Nur had brought her 30-year-old brother-in-law from the town of Galkayo, 750km south of Bosasso, to the hospital. He had been sick for more than two years and the family tried traditional means to cure him. "We tried everything but he only got worse. He stopped eating, was not sleeping and was suspicious of everybody."

They brought him to the hospital in January and he was put on medication for schizophrenia, according to Ali. "He is much better now. He is lucid, eating and sleeping well."

Ali, however, warned that the hospital was running out of drugs. "We have started telling people to buy the drugs from the town," adding that most of the patients could not afford medicines.

According to Rivelli, in the past three years only the European Union and World Health Organization had allocated funds to some interventions in mental health in Somalia; "thus the overall budget allocated is negligible compared to the needs".

Most of that supported running costs of existing but neglected facilities, drugs, training and education campaigns, such as the initiative to free patients from being chained.

A great deal had to be done to improve mental health in Somalia. "Referral mechanisms to bridge the gap between rural and urban areas; community-based mental health programmes and research on the use of khat, gender and mental health, ex-combatants and mental health," she said.

ah/mw[END]

Mamo Tukuye, "I would like to die at home with my family"

BOSASSO, 2 March 2010 (PLUSNEWS) - Mamo Tukuye, a migrant from Ethiopia, is one of thousands in Bosasso, commercial capital of Somalia's semi-autonomous region of Puntland. He came to Puntland hoping to reach Yemen and from there the Gulf States. He made it to Yemen once but was intercepted by Yemeni forces, who turned him away, and he returned to Somalia. 

In December 2009, Tukuye fell ill and went to hospital for a routine check-up. During consultations with the medical staff, he agreed to be tested for HIV and the test came back positive, which shocked him. He spoke to IRIN about the psychological turmoil he experienced when he learnt of his HIV-positive status:

"When the doctor told me that I was HIV-positive I was so scared I could hardly say a word. I have no relatives here [in Somalia], I am all alone and I know you cannot go through this kind of thing alone. Even the friends I had are running away from me, scared that I may give them the disease.

"The first thing that came to my mind was killing myself. I have seen and heard the suffering people go through when they have this disease; I do not know what to do. Even if I can get the medication for it, I don't have anything to eat. I did not have dinner last night and I did not have breakfast this morning. There are days I don't eat anything.

"I sometimes find myself going to the beach and want to walk into the water and let the sea swallow me up. I came here to look for a better life and look what I got! It is as if someone is playing a cruel joke on me. I want to live but without help I don't see how. If I got some help to return to my country I would.

"I would like to die at home with my family."

 ah/mw[END]

Hujale Jama, "I never thought I would depend on anyone but look at me now"

BOSASSO, 2 March 2010 (IRIN) - Prolonged and persistent droughts have drastically changed the fortunes of Hujale Jama, 80. Originally from the village of Has Wanaje, 480km east of Bosasso, commercial capital of the self-declared autonomous state of Puntland, Jama was once considered fairly well-off. Then the drought slowly decimated his livestock. Today, he lives with relatives in Bosasso, without any livestock to his name. 

Jama is one of thousands of people in Bosaso displaced by drought who have moved to urban centres where they depend on relatives. He spoke to IRIN in Bosasso:

"Three years ago I had 600 heads of goats and sheep and more than 30 camels. I was a man of means and would be asked to help those with less. I was one of the leaders of my community and never needed help, I was the one helping.

"Nowadays, I am the one asking people for help. I have seen many people lose all their animals but I never thought I would be one of them. It is not what I expected to be doing at my age. My livestock died one by one until there was nothing left.

"Unfortunately I am not the only one suffering. Many people in this town were once herders but have since lost everything. The droughts are becoming longer and more devastating. When there was no pasture or water in our area we would move to another part of the country but all areas are now the same; no pasture no water.

"If the situation continues like this, there will be no more people left in the countryside. The young ones can adjust and maybe find something to do but what is there for an old man like me? We are almost invisible; nobody is talking about rural people who are destitute.

"Today I am sick but I don't have the money to go to the doctor. I never thought I would depend on anyone but look at me now. I used to be a respected man but I don't feel like a man.

"What will I do? I cannot beg at my age."

ah/mw[END]