Flying over the Gedo region of Somalia from Mogadishu, famine is evident from the skies. The land below looks dry with no signs of green vegetation.
This blog is written by Catherine Mumbi, who supports the Trócaire team (a Cordaid partner organization) in Somalia as a Communications and Advocacy Officer.
This is my second trip to Luuq in northern Gedo, my last one being in 2015 when I visited Luuq Referral Hospital, run and managed by Trócaire for the last two years through the support of Irish Aid and UK Aid.
Pre-famine crisis in Gedo
This visit is a bit different however, as I have been tasked with gathering information to help highlight the pre-famine crisis in Gedo.
Dr. Mohammed Dahir is my contact and from my first encounter with him, he looks overwhelmed. As the medical doctor in charge of the Luuq facility, he explains that they are chronically overstretched because of the Acute Watery Diarrhea (AWD)/Cholera outbreak. He and his team are trying to contain the situation as best they can.
Patients are flooding in from neighboring Elbon, Bay and Bakool. When I meet him on March 23, he has seen up to 347 new cases of AWD/Cholera. The first cases at the Luuq Cholera Treatment Center were reported on March 5, 2017.
Cholera Treatment Centre, currently providing medical support to patients and helping to contain the spread of the outbreak. Photos: Catherine Mumbi / Trócaire
Insufficient access to safe water
“Most of our patients are coming from inaccessible areas, therefore it’s very hard for us to treat the water sources,” says Dr. Dahir. He explains that insufficient access to safe water and poor sanitation are the major causes of the outbreak.
This was confirmed after I visited Dhuyacle camp for internally displaced persons located one kilometer away from Luuq town. The camp had just reported two cases of Cholera due to overcrowding, lack of clean water and sanitation. This is the first AWD/Cholera outbreak in 25 years. It is overwhelming for the staff as they had not anticipated such a high number of patients.
The local administration has provided a former cereal warehouse for use as an isolation center. Trócaire has expanded its regular hospital activities in Luuq and is supporting this center to deal with the influx of patients. Dr. Mohammed confirms that 16 patients have died, the majority on their way to the cholera treatment center, and some within hours of their arrival.
Fadhumo Isaack (left) with her kids at the Cholera Treatment Centre (CTC). Right: Doctors administer fluid replacement via an intravenous drip. Photos: Catherine Mumbi / Trócaire
The biggest challenge for our emergency response is access. It’s very difficult to get to some of the areas to treat patients and to treat contaminated water sources responsible for the spread of disease. The untreated water sources are a huge threat, and will very likely lead to a disaster on an even bigger scale than we are currently seeing.
Another major challenge is crowd management at the cholera treatment center, most of our patients are internally displaced people who are coming in for treatment with their family members. This has led to the spread of disease among families.
At the time of writing, the center has received 350 patients in just three weeks. The situation is dire since most of these patients have lost all their livestock and livelihoods, and have nothing left. Some have walked 30 to 50 km to access medical support at the center.
Through the support of the local business community the patients can afford three meals a day and for some, this is also the only place they can get that.
In search of food and water
Mohammed Ibrahim, one of the Dhuyacle IDP Camp leaders tells me how they had to walk over 50 km to get to Luuq in search of food and water. “We have not left our homes but only came this direction because we heard that in Luuq there is a river. Some of us were lucky to get here using donkey carts walking for 6 to 8 days from Baidoa.’’
Mohammed Ibrahim outside his makeshift tent at the Dhuyacle IDP Camp. Photo: Catherine Mumbi / Trócaire
He says that they normally plant sorghum and raise goats. However, for the last 2 years, they have not received any rainfall. People started dying due to lack of food and their remaining livestock (cows and goats) started dying too.
He points to two cow hides inside his makeshift house: “These hides we are using as our beddings are from two cows which died along the way.” The IDP camp is currently accommodating 300 households.
Makeshift tents that are now home to IDPs from Dhuyacle Camp in Luuq, Gedo. Photo: Catherine Mumbi / Trócaire
Earning a living
Many people at the camp are dependent on a small amount of support from the Luuq business community. Others have managed to get work on farms near the river, earning a living through cutting trees and mixing cement for house construction, and earning around five dollars on a good day. Mohammed at the IDP camp emphasizes that payment is not standard and that it depends on the employer.
Fadhumo Sharif Isaack, a new IDP says that, they are sharing the little they have to keep each other going, and that she had gone five days without food before her neighbors gave them some of the little they had. She adds: “There are times I cannot feed my three-year-old daughter and I am deeply worried about what to do when she cries from hunger.”
Most of these IDPs are also facing language barriers since they speak a different Somali dialect known as Maay Maay, making communication with the host community a challenge.
Dr. Mohammed at the center suggests that the situation today is worse than it was during the famine of 2011, which killed 250,000 people. He says in 2011 they only had to worry about food and water, but now they have to worry about AWD/Cholera.
Cholera can be treated simply and successfully by immediately replacing the fluids and salts lost through vomiting and diarrhea. Trócaire, with support from Cordaid, is providing Cholera patients with oral rehydration solutions (ORS) and antibiotics. Severe cases are being treated through fluid replacement via an intravenous drip.