WHO and partners responding to the immediate needs of the populatio

Up to 2 million people in Somalia, 1.46 million of whom are displaced, are in need of humanitarian assistance. South Central Somalia is the area most affected by conflict and the resultant displacements of population, disruptions of services and restrictions on movement. Combined with the absence of safe drinking water and sanitation and the low level of immunization coverage, these factors represent major threats to health. The more than 200 sentinel sites across the country ensuring disease surveillance and early response to outbreaks have shown a rise in vector-borne diseases (malaria), and vaccine-preventable diseases (measles). Added to this, acute watery diarrhoea is endemic is most parts of the country. There is thus a high burden of preventable death and disability among the vulnerable population.

The availability of health services is severely limited, relying almost exclusively on NGOs for delivery. Service delivery is hampered by the weak public health system and the lack of infrastructure (including supplies, equipment and amenities), health facilities and skilled health workers. The frail emergency health system is overburdened by the ongoing fighting: in Mogadishu alone, at least 7000 people have been wounded in 2010 (a quarter of them children), and WHO estimates that more than 500 have been killed.

The Health Cluster received approximately half the funds requested in the 2010 Consolidated Appeals Process (CAP) for Somalia. Of the funds received, 70% were channelled directly to the NGOs implementing outreach activities in the field.

The polio network is among the most valuable pillars of WHO’s presence in Somalia. Although access is overwhelmingly difficult and often unpredictable, the network provides contact with the population and allows outreach activities.

In 2010, Health Cluster partners’ life-saving interventions included the provision of emergency surgical care and the distribution of almost 40 metric tons of supplies. More than 1100 health workers were trained in emergency and emergency obstetric care, as well as in outbreak response.

WHO’s strong presence in Somalia has allowed the Organization to continually assess the situation of hospital infrastructure, supporting service delivery through the provision of essential medicines and targeted rehabilitation. WHO has also focused on the early detection and timely response to outbreaks and emergency preparedness, coordination and information sharing.

The 2011 CAP for Somalia launched on 1 December appeals for US$ 58.6 million to fund 45 projects from all health cluster partners. Most projects focus on emergency care, including maternal and reproductive health, outbreak control and response, and coordination. WHO will continue working with Health Cluster partners to extend essential health services to IDPs and other vulnerable communities. The Organization also requires US$ 15.6 million to fund 7 projects. Activities will continue to focus on:

• Strengthening health cluster coordination and emergency preparedness
• Improving and sustaining access to quality primary and secondary health care services for vulnerable people
• Outbreak preparedness and response

Predictable and timely funding from the beginning is essential to ensure solid and valid activities.

Source: http://www.who.int/hac/crises/som/highlights/december2010/en/index.html

People died for hunger and dehydration in Hobyo district of Mudug region

Galkacyo: 29 Dec 2010: Four people have been reportedly died in Hobyo district of Mudug region where acute drought affected human beings and animals.

According to appeals from Galmudug administration and local elders in the area, severe drought is hitting South Mudug where the worst scenarios reported in the coastline areas.

Nevertheless, in the past hours deaths of 4 people of whom two are children under age 5 have been reported as a result of hunger and dehydration.

Commissioner of Hobyo district, Mr. Said Aden Ade held press conference for the local and international media journalists based in Galkacyo in which he declared that extreme drought the area never experienced for 50 years is exacerbating the livelihoods and well being of communities in Hobyo district which so far caused massive loss of livestock.
Mr. Adde asserted that current droughts might generate serious illness for humans and hence appealed Humanitarian organizations and donor communities to take close attention to the impacts of the droughts and expedite emergency humanitarian response.

It was early December when an interagency drought assessment mission of UN and NGOs surveyed severe affected areas in south Mudug of which are Hobyo and Galkacyo districts. The mission emphasized existence of droughts in the assessed areas.
However, Droughts become repeatedly occurring phenomenon which exhausted huge funds each year. Unless proper strategy that ensures preparedness mechanism and proper management of ranges for prevention of loss of humans being and livestock, huge resources will continue exhausted and which could have been useful in long term and sustainable projects.  

Written by Elias

Refugees fear increased police harassment

NAIROBI, 22 December 2010 (IRIN) - Somali nationals living in the Kenyan capital say they fear increased harassment by the police after a deadly grenade explosion at a bus station on 20 December.

"Whenever incidents occur, such as the explosion, the first people targeted are Muslims in general and Somalis in particular," Ali Mohamud, a member of parliament in Somalia, told IRIN in the district of Eastleigh, where many Somalis live.

"This has adversely affected refugees because they tend to get arrested whether or not they have legal documentation [ http://www.irinnews.org/Report.aspx?ReportID=87891 ]," he added.

While Kenyan police have identified one of the bombers as a Tanzanian national among the would-be passengers of the Uganda-bound bus, officials in both Nairobi and Kampala suspect the blast, in which one bomber died and dozens were injured, may be linked to Al-Shabab, the main Islamist insurgency fighting the transitional government in Somalia.

Al-Shabab claimed responsibility for twin suicide bombings that killed 79 people in Kampala in July. No clear link was found between the group and a 3 December blast caused by a similar Russian-made grenade in Eastleigh, in which one policeman died.

Mohamud dismissed as nonsense the perception that many Somalis in Eastleigh supported Al-Shabab, pointing out that the insurgency was the very reason many people had fled Somalia for Kenya.

Police spokesman Eric Kiraithe told IRIN the force had stepped up law enforcement with regard to illegal immigrants because there seemed to be a wave of increased arrivals from neighbouring countries.

"In the last two weeks alone, we have netted over 300 illegal immigrants and over 800 in the last three months," Kiraithe said. "In fact, there is no crackdown as such; this is just normal law enforcement, only that we have increased our efforts to protect the citizens against the threat of terrorism."

In Eastleigh, IRIN spoke to several Somali refugees who said they felt unfairly targeted whenever incidents such as the grenade explosion occurred.

Arrests

Mohamud said it took about two to three days to be released from police custody even when a refugee was legal. "I don't see why someone should be arrested when they have documents; the police should let them go once they establish that they are in the country legally," he said.

Jama Osman, 37, a football coach who is also a human rights activist, told IRIN: "I have personal experience of these 'arrests'; it once happened as I went to Kenyatta National Hospital to seek treatment, I showed them [the police] my documents from UNHCR [the UN Refugee Agency] but they insisted I had no right to be in the country. They then took me to a side street and one of them held my neck tightly as the other one took all the valuables I had in my pockets. I was then released."

Osman said he later informed UNHCR and the Refugee Council of Kenya, a non-governmental advocacy group, but nothing came of it.

"For us now, we are living in fear of increased harassment and it does not matter whether one has papers or not, you will only be released once you have parted with some money," said Osman.

Somali elders in Eastleigh are arranging to contact the Kenyan government, through the Refugee Council of Kenya, seeking action over police harassment, Ali Mussa said.

"As Somali elders, we would like to let the Kenyan government know that we are unhappy about the barbaric acts of some policemen," he said. "We would like to see the government take action on Somalis who have committed crimes but it is unfair to target only Somalis when attacks occur whose perpetrators are yet to be identified."

Blow to business

Mohammed Mohamoud Gutale, a member of the Eastleigh Business District Association, said the police action had negatively affected business.

"Nowadays, because of some of these crackdowns, Eastleigh has acquired a reputation of a place of lawlessness, an area with smugglers, money launderers and many other criminals," Gutale said. "This has put off many of our customers and affected business and the livelihoods of the people who live in Eastleigh."

Gutale said the business association had contact the Nairobi provincial police officer and the permanent secretary in the Ministry of Internal Security and presented their complaints, "but no further action has been taken".

On 10 December, two NGOs, the International Rescue Committee (IRC) and Kituo Cha Sheria - a centre for legal empowerment - expressed concern over the police's "indiscriminate" raiding homes of refugees and random arrests of those suspected of being in the country illegally.

Laban Osoro, legal advocate and coordinator with Kituo Cha Sheria, which partners with the IRC to aid urban refugees, said: "They are using the excuse of needing to verify documents to arrest people and keep them detained for longer. This is extremely worrying."

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All to play for in unifying football tournament

NAIROBI, 21 December 2010 (IRIN) - Holding a football tournament with teams from 15 regions of Somalia is an achievement in itself - but the organizers hope it will do more than only bring players together.

"The footballers taking part in the tournament have never known a unified Somalia; this is an opportunity for them to interact," Abdirashid Hassan Baki, the deputy president of Somalia's Football Federation (SFF), said. "We hope the tournament will also boost peace and reconciliation in our country."

Somalia has been embroiled in conflict since 1990, with more than 1.4 million displaced and 600,000 refugees in neighbouring countries. The UN estimates more than two million Somalis need humanitarian assistance.

"The fact that we are even holding this football tournament for the first time since 1987 is in itself an achievement. This, to me, is a miracle and a beginning for peace and reconciliation. This is sport at its best. It reminds me of the 'ping-pong' between China and the US [when the US and China started their rapprochement under Richard Nixon]."

At least 290 young Somali football players are taking part in the 20-day tournament, which opened on 15 December in Garowe, capital of the autonomous region of Puntland. It is jointly organized by Puntland, northeastern Somalia and the SFF for Somali youths from 15 of Somalia's original 18 regions.

Somalia has, over the years, split into three distinct areas. What was the northern region of Somalia is now the self-declared republic of Somaliland, the northeastern regions are now the autonomous regions of Puntland and the south and central are controlled by the Transitional Federal Government (TFG) and large parts of it by Islamist Al-Shabab and Hisbul Islam groups.

Baki said many of the players came from regions controlled by different groups "but they all allowed them to come and participate".

Emotional opening

Abdisamad Sheikh Hamud, a footballer representing Nugal region of Puntland, told IRIN the tournament's opening ceremony was very emotional for many players.

"There were a lot of people crying, mostly the older people who could remember [a unified] Somalia," Hamud said. "It is the first time for the majority of us to attend anything that brought Somalis together. We all felt like true Somalis. No clans or regions."

Hamud said the tournament was an opportunity "to meet young people like us from across Somalia, who we may never have met otherwise. I hope to make lifelong friends."

Ahmed Egal Awale, the Puntland deputy minister of sports, said most of the tournament's participants were born after the collapse of the Somali state in 1991. "It is their first experience of an all-Somali affair. Today in Garowe you will see youth from Mogadishu or Baidao, with others from Nugal or Sool. I don't think they ever thought they would get such an opportunity.

"I have no doubt that this will contribute to peace and reconciliation in our country. It is bringing us together. It is a wonderful feeling."

Baki of the SFF said many of the youth from south and central Somalia were for the first time playing football without being afraid of shells or bullets - "a new thing for many".

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Accusations traded over rising casualties at Mogadishu market

NAIROBI, 2 December 2010 (IRIN) - Civilian casualties of fighting between government forces, backed by African Union peacekeepers, and Islamist insurgents are rising in Somalia's capital, Mogadishu, with civil society sources accusing the peacekeeping mission of being responsible for the bulk of them.

The African Union Mission in Somalia (AMISOM) has rejected claims it is responsible for most civilian casualties, particularly those in the Bakara Market area. Bakara is the largest open-air market in Somalia and has seen heavy fighting in the past few years.

In a 1 December statement [ANY LINK?] AMISOM said "no indirect fire" was targeted at Bakara Market on 30 November as alleged in the local media. The term "indirect fire" refers to the use of weapons when there is no direct line of sight to the target. It is commonly applied to the use of mortars and field artillery.

Col Michael Ondoga of the Ugandan contingent command, said in the statement: "Our rules of engagement permit appropriate use of force, including indirect fire, in the protection of our [own] forces or civilians. Bakara Market is a force-registered `No Fire Zone' and no commander can authorize any indirect fire into this area."

During the 30 November incident, Ondoga said, mortars were fired "at identified military targets in the area of Boondhere [northern Mogadishu - about 2km from Bakara Market], where extremist forces were massing for an attack".

Ali Muse, the head of the Mogadishu-based Lifeline Africa Ambulance Service, told IRIN AMISOM targeted Bakara during the incident: "We picked [up] eight injured people and three dead from the clothes section of the market on 30 November."

Muse said most shelling of Bakara Market comes from areas under the control of AMISOM troops. "I have no doubt in my mind as to who is responsible for the attacks on Bakara," he said.

"Not a day passes without the market coming under attack and almost all of the shelling is done by AMISOM," said a civil society activist who requested anonymity.

The source said many parts of the city were shelled daily "and in some areas you can apportion blame and accuse all sides of responsibility, but there is no dispute as to who is targeting Bakara Market."

Muse said by the end of November, the ambulance service had recorded 6,024 injured and 2,318 dead in Mogadishu since January 2010. He said the number of casualties could be higher, due to the fact that many people are buried where they die, and many injured are looked after by relatives unable to get them to hospital.

AMISOM regret

In a statement on 23 November AMISOM regretted the killing of two civilians by its forces.

Force Commander Maj-Gen Nathan Mugisha said: "AMISOM would like to reassure the public that we are here to support and protect you. We have many soldiers here working night and day to make Mogadishu safer. This incident is sad and regrettable. We understand people may be angry, but it is an isolated incident."

Abdullahi Shirwa, a civil society activist, said AMISOM and Somalia's Transitional Federal Government (TFG) need to face the fact that they are responsible for much of the shelling in Mogadishu and if they are to defeat the insurgents, they need to win the population over.

"Perpetual denial is not going to convince anyone. AMISOM are the only ones who have the heavy weaponry that can target at long distances," he said.

Another source saw a glimmer of hope in AMISOM's acceptance of the 23 November incident. "Maybe this is the start of a new policy on their part, but they need to go further and allow an investigation into who is causing the heaviest casualties in the city. I know of no one who likes the insurgents, but the indiscriminate shelling from AMISOM is not going to win the government any support. I hope their statement is not a public relations stunt but a serious effort to mend fences with the local population."

The activist noted that Al-Shabab, the leading insurgent group, use civilian areas to launch attacks on AMISOM and government positions.

On 29 September, Human Rights Watch (HRW), in a statement to the UN Human Rights Council, said opposition fighters had unlawfully deployed in densely populated civilian neighbourhoods and at times used civilians as "shields" to fire mortars at TFG and AMISOM positions, "attacks conducted so indiscriminately that they frequently destroy civilian homes but rarely strike military targets".

HRW added: "Often AMISOM or TFG forces respond in kind, launching indiscriminate mortar strikes on the neighborhoods from which opposition fighters had fired and then fled, leaving only civilians to face the devastation that ensues."

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Baby steps towards a PMTCT programme

NAIROBI/HARGEISA, 29 November 2010 (PLUSNEWS) - Many African countries are struggling to eliminate mother-to-child HIV transmission, a vital component of the universal access to HIV prevention target, but in Somalia a programme to prevent such infections is just getting started.

In 2008, only six Somali women received prevention of mother-to-child HIV transmission (PMTCT) services, although more than 2,600 women were estimated to need them. Not a single health centre delivered the complete PMTCT package which includes HIV counselling and testing, antiretroviral prophylaxis and infant feeding support.

Earlier this year, however, a programme finally got off the ground, with PMTCT services starting to be offered at 21 sites in all three Somali regions - Puntland in the northeast, Somaliland in the northwest and south-central Somalia.

Faisa Abdirashid, HIV officer with UNICEF in Puntland, explained that women who test positive receive psychosocial support and are referred to hospitals where they receive antiretrovirals to prevent transmission as well as advice on infant feeding options.

In addition, UNICEF and its partners are strengthening Somalia's weak health system by renovating health facilities and training health workers.

Progress

The PMTCT programme aims to reach 5,000 pregnant women annually with a comprehensive package, but so far, uptake has been slow.

In the first half of 2010, 1,344 women were tested at the PMTCT sites, 10 of whom tested positive (HIV prevalence in Somalia is comparatively low at 0.7 percent, according to the latest figures from UNAIDS).

Abdirashid said although uptake of services is low, it has been increasing every month. In Eldere and Harardhere (in south-central Somalia), for example, the number of pregnant women who accepted HIV counselling and testing nearly doubled during the July to September period compared to previous months. In total, 41 percent of the 2,185 women who came for antenatal visits agreed to be tested.

Challenges

Abdirashid noted that health services remain unavailable in most villages and that most Somali women still have very low awareness of HIV.

"I know that a mother can transmit [HIV] to her child, but I don't know how," said Hibo Osman, a mother of one from Hargeisa, capital of Somaliland.

According to the latest UN General Assembly Special Session on HIV/AIDS report from Somalia, a knowledge, attitude and practice baseline survey conducted in Puntland's Mudug region in 2008 found that less than 1 percent of respondents identified PMTCT as an important intervention for preventing HIV transmission to an unborn baby.

According to Abdirashid, stigma is also a major barrier to PMTCT efforts.

"Some of the women who refused the HIV testing did so because they feared the stigma that an HIV-positive diagnosis would bring, especially within their own families," she said.

Anwar Abdirahman Warsame, executive director of the Sahan Network, a local NGO working in the field of HIV in Somaliland, confirmed that people with HIV are severely discriminated against, often by their own families and communities. "It is very necessary to give more education of the disease and its transmission to the public," he said.

Efforts to expand the PMTCT programme are also limited by the country's poor health infrastructure and continuing insecurity in south-central Somalia. In areas that are particularly difficult to work in, UNICEF is partnering with local NGOs to ensure women can access services.

"UNICEF and partners plan to scale up the number of [PMTCT] sites," said Abdirashid. "Awareness-raising will also be increased - messages are passed on at maternal and child health centres, through radio and other education and communication materials."

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