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    Somalia: MSF Hospital Caught in Center of Fighting in Mogadishu

    The international medical humanitarian organization Doctors Without Borders condemns today’s shelling of Daynile Hospital in Somalia’s capital, Mogadishu.

    Fighting began in the morning in Daynile, a neighborhood located in an outlying area of Mogadishu. The shelling struck the hospital’s emergency room and a portion of the surgical ward, causing significant damage. MSF has worked in the hospital since 2006.

    There were no casualties among the hospital’s 19 patients or staff, comprising 36 medical personnel and 12 guards. All patients and staff sought shelter from the shelling in the internal medicine department.

    MSF calls on parties to the conflict in Somalia to respect the neutrality of Daynile Hospital, along with that of all medical facilities in the country, and to respect the safety of patients and hospital staff.

    Photo: Somalia 2011 © MSF A building in a refugee camp in downtown Mogadishu, not far from the MSF hospital at Daynile, bears the scars of the conflict.

     
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    Somali Refugees: Ongoing Crisis, New Realities

    Newly released report from Refugees International. 

    The United Nations has declared that famine conditions in south-central Somalia no longer exist. But the ongoing conflict in the country, coupled with a precarious food situation, will keep large numbers of Somali refugees from voluntarily returning anytime soon – this despite the rising insecurity in refugee-hosting areas of Kenya and Ethiopia. This insecurity poses a serious threat to protection and services for refugees. However, it also provides an opportunity to shake-up the unsustainable way that agencies have delivered services for decades. Despite security restrictions on access, donor governments must maintain their level of focus and funding for refugee operations in the region. 

     
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    Somali Refugees in Dadaab Struggle On

    Though the international spotlight has moved on, hundreds of thousands of Somali refugees in the Dadaab camps in northwestern Kenya, the largest refugee camps in the world, continue to struggle amid harsh conditions and pervasive malnutrition, particularly among children. Aid has been too slow in coming, however, and longer-term solutions are nowhere to be found.

     
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    Somalia: Measles Takes its Toll

    Measles is sweeping unchecked through parts of southern Somalia. The disease is highly contagious and unvaccinated children are at great risk, especially if they are also malnourished. The war in southern Somalia is a key factor contributing to ongoing widespread malnutrition, low vaccination coverage, and lack of access to health care services. All of these factors aggravate the spread and severity of diseases like measles.

    In some Doctors Without Borders programs, the number of measles cases has sharply increased in recent days and weeks. Many patients arrive in severe condition.

    “Over the last weeks, we diagnosed and treated over 300 patients for measles—mainly children—in the towns of Haramka and Marere in Lower Juba Valley,” said Silvia Colona, Doctors Without Borders’s project coordinator for southern Somalia. “We also set up a measles treatment unit in the city of Kismayo last week, and it filled up immediately with critically ill children.”

    Somalia 2011 © Martina Bacigalupo
    A four-year-old boy suffering from measles and malnutrition waits for his medicine in Banadir hospital in Mogadishu.

     
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    In Somalia, education is a dream for many

    “If the young Somalis learn something while they are young, then they will be able to take part in the progress of their mother country.”–Ahmed


     
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    Abukar Hasan Mohamud Kadaf, the former director of private radio station Somaliweyn, was shot dead by unidentified gunmen on Tuesday evening in front of his home in the Wadajir district of Mogadishu. He was buried on Wednesday in the capital.

    He was reportedly working with a youth and peace organization after Radio Somaliweyn was raided and closed down by the al-Shabab armed group in May 2010.

    He is the third journalist to be killed in a targeted attack in the last two months in Mogadishu, despite the city now being under the control of the Transitional Federal Government (TFG) and African Union forces.

    Amnesty |Attacks against Journalists Somalia must Stop|… 

    “Security will not be achieved in government-controlled areas until those who are responsible for attacks on media workers and activists are held to account,” said Michelle Kagari, Deputy Director for Amnesty International’s Africa programme.

    “Every effort must be made to stop a re-emerging pattern of targeted killings against civil society actors. This includes conducting thorough investigations into the murders, ensuring that perpetrators are brought to justice in fair trials, and re-establishing the rule of law.”[…]

     
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    A lot of the people we saw had never seen a doctor. Ever.

    Nenna Arnold, who was an outreach nurse supervisor in Dadaab, Kenya from August 2010 – May 2011.

    She continued:

    “Doctors Without Borders was already running a hospital and four busy health posts inside the crowded Dagahaley refugee camp when hundreds of people fleeing Somalia began to arrive. But there was no room for them in the camp. It was already extremely overcrowded, with 100,000 people living in a space created for 30,000. So the refugees began to settle on the outskirts of the camp. They had no access to food, water, and shelter and built small huts out of twigs, cloth, and cardboard.

    The first thing I did was to organize a group of community health workers to find the children and pregnant women who needed medical attention. Every day our vehicle was filled with patients, including many malnourished and sick children. We’d deliver them to one of the health posts or the hospital, depending on the severity of their condition.

    At times I felt overwhelmed by the enormity of this growing crisis, but I extended my stay for an extra three months because I felt there was still so much more I could do. I loved the people and our medical action was so critical.

    In the Dadaab camps of northerastern Kenya, which collectively form the largest refugee camp in the world, life is becoming more difficult every day and hundreds of thousands of refugees are facing a humanitarian emergency. Their health is at risk of deteriorating rapidly but humanitarian aid agencies are struggling to provide meaningful assistance on an ongoing basis. Learn more.

     
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    Ethiopia: “There Is Still So Much to Improve”

    In early 2011, there were some 40,000 Somali refugees in Ethiopia. By the end of 2011, that number had more than tripled, to 142,000, following a mass exodus triggered by a terrible drought that killed crops and herds in a country already wracked by 20 years of conflict. The numbers alone, however, do not tell much about the days, or even weeks, Somalis spend walking to reach and cross the border with barely any food or water. It does not reveal the dire malnutrition affecting the children in the camps, nor does it express the effort made by humanitarian agencies to fight hunger and exclusion and reduce emergency levels of child mortality. José Luis Dvorzak, an MSF doctor in Liben, reminds us that there is still much work to be done.

    You have worked as a doctor at different times in the past two years in the Liben camps.

    I first arrived in June 2010. There were three international workers and 35 national employees. We carried out nutritional activities in the two camps, in Bokolmayo and Malkadida (40,000 refugees) and the Dolo Ado health center. The second time I arrived in September 2011, the change had been enormous: we had 50 international workers and over 800 national employees. By then, new camps had been opened, Kobe and Hillaweyn, each sheltering 25,000 new refugees that had arrived from Somalia in the worst of conditions, with very high mortality rates. At one point there had been up to 13,000 people admitted in our feeding program. In September, after months conducting a nutritional intervention, we managed to reduce mortality to levels below the emergency threshold.

    How would you describe the medical situation endured by the population at present?

    We still have children admitted in our stabilization centers suffering from severe malnutrition complicated with other diseases such as pneumonia or diarrhea—some 45 kids (during the emergency peak this figure rose to over a constant 150) weekly. The most common pathologies amongst the population are respiratory infections, diarrhea, intestinal parasites, and skin diseases. Currently, we are also implementing mental health and epidemiological surveillance programs using community health workers.

    Read the rest of the interview with José Luis Dvorzak.

    Photo: Ethiopia 2011 © Michael Tsegaye
    An MSF staff member uses a feeding tube to treat a malnourished child in Liben’s Hiloweyn camp.