As Somalia continues rebuilding after decades of war, political strife and humanitarian crises, its needs are many.
These needs extend into the country’s health sector, which falls far below the minimum global expectation of doctor/patient ratios.
According to the United Nations health agency, the World Health Organization (WHO), there are currently only eight skilled professionals – such as doctors, nurses and midwives – for every 10,000 people in Somalia. The minimum recommended by WHO to achieve the world’s Sustainable Development Goals’ health targets is 44.5 professionals for every 10,000 people.
In addition, one out of every 25 women dies due to causes related to pregnancy, and one out of every ten Somali children dies under the age of five.
For some health workers, the need for healthcare could mean a lucrative career in a busy urban clinic or a regional hospital.
Not so for Mohamed Hassan Mohamud, also known by the nickname ‘Arab.’
For Mr. Mohamud, his attention is fully on the health needs of the thousands of women and girls at the Jowle Internally Displaced Persons (IDP) Camp, located on the outskirts of Garowe, the capital of Somalia’s northern Federal Member State of Puntland.
“The Jowle IDP camp hosts a large number of people, and one or two health facilities cannot easily cover this vast need, but we strive to provide daily healthcare to the needy, particularly the most vulnerable, such as mothers, children, and the elderly,” he says.
Beginnings
Unlike the southern parts of Somalia, Puntland is relatively safer than other parts of the country. But it still plays host to a considerable number of people displaced by conflict and humanitarian crises from other regions.
According to the Office of the UN High Commissioner for Refugees (UNHCR), there are some 500,000 internally displaced people in Puntland – of these, some 50,000 of them are in the Jowle IDP Camp, located on the outskirts of Garowe.
The camp has a clinic that provides health and nutrition services to residents. Initially established by the United Nations’ International Organization for Migration (IOM), the clinic is now managed by a non-governmental organisation, Save the Children International.
Mr. Mohamud started at the camp in 2013, when he was 24 years old and before even starting his tertiary education. Serving as a volunteer, he started as a community health worker.
“I had a tremendous desire to help marginalized people living in underdeveloped and distant villages in Somalia. My knowledge in the field of public health enabled me reach out to those I wanted to aid,” he adds.
Mr. Mohamud was born in 1989 in the country’s capital, Mogadishu. The growing tensions there, which soon led to the outbreak of the civil war, caused his family to return to Puntland – from where his family hailed and where he subsequently grew up in Garowe.
There he graduated the Gambool Secondary School, finishing in 2008, before later going on to earn a Bachelor of Nursing degree from Bosaso University in 2018.
The Jowle IDP Camp’s sole health facility offers basic services such as vaccinations, treatment for communicable diseases and mother-and-child care, as well as an outpatient therapeutic feeding programme for severely malnourished children, and a targeted supplementary feeding programme for young children.
“Our services are wide-ranging, and they include providing healthcare and nutrition to children under the age of five and pregnant mothers,” Mr. Mohamud notes.
“Patient records and follow-ups at this facility are under my supervision,” he continues. “For those needing immediate medical care, I act as a bridge between the feeding centre and the supporting organisations. I also train health workers and advocate on their behalf, particularly during illness outbreaks.”
Personal development
The past decade of work at the IDP camp has not meant that Mr. Mohamud has rested on his laurels – far from it.
Over the years, the father of four’s responsibilities have grown. He now oversees the entire health clinic, managing a team of a dozen employees who deal with an average of 100 patients on a daily basis.
But he is determined to keep growing in his chosen field, and is putting in the effort now for his own long-term development, as well as long-term benefit of the displaced people he cares for. Mr. Mohamud is currently enrolled in a Master of Science in Healthcare Management programme at UNICAF University, which he hopes to complete in 2025.
It is not always easy balancing work, study and family responsibilities, but Mr. Mohamud is determined.
“It is difficult for a young person like myself, who lives in a city with a pretty high quality of life, and has a wife and children, to work for an extended period of time separated from my family. Fortunately, my family fiercely have supported me while I have dedicated my time and energy to serving the disadvantaged population of the Jowle IDP camp,” he says.
Perhaps unsurprisingly, his work and personal life have merged to a certain degree.
“During my time with this community, they became like a part of my family. We got to know each other, and I became their advocate,” Mr. Mohamud says.
“I always feel welcome the moment I step foot in the camp for the first day of work. Instead of treating me like an unfamiliar doctor, the residents of this camp seem more like family,” he says. “Health and nutrition support requests began pouring in as soon as word gets out that we are open. All these wonderful things have made me proud, but I do feel bad that I can’t provide all the services they need.”
On top of his work and studies, his area of work has been changing.
“My primary responsibility is to provide health and nutrition to the Jowle IDP community, but things evolve in this sort of setting, and now I also raise awareness about other issues, including domestic violence, rape, early marriage, and female genital mutilation (FGM),” Mr. Mohamud says.
“We face daily problems that men impose on girls,” he adds. “For example, I remember how surprised I was to learn that underage marriage is common in this camp, with girls as young as 13 forced to marry with their guardians’ permission.”
Mr. Mohamud’s perspective on the plight of the camp’s residents – as well as those in other camps around Somalia – has evolved.
“Under both domestic and international law, internally displaced people have the same rights and freedoms as other citizens of their country, with full equality,” he says. “So, asides from my health specialty, I have also been advocating for IDPs to fully integrate with host communities to enjoy the same rights.”
As for the long-term, Mr. Mohamud hopes to see IDPs in Puntland fully integrate with their local communities and receive basic social services such as health care, education and security.
“Many efforts are already ongoing to integrate these persons directly into the host community in Garowe, but there is still a long way to go. Their current living conditions are marked by inadequate and poor housing, and insufficient education,” he says.
National challenge
According to UNHCR, the UN entity responsible for aiding displaced people, there are 3.8 million individuals currently displaced in Somalia due to conflict, insecurity and the effects of climate change such as cyclical droughts and floods.
Along with other UN agencies, funds and programmes, UNHCR is working to ensure that the voluntary repatriation of Somali refugees is sustainable and that returnees are effectively integrated into their communities.
Efforts by Somalis like Mr. Mohamud are appreciated – and necessary.
“He is one of the most energetic and effective young health workers in the Jowle IDP camp. The camp considers him a son! He remains with us, offers support, and advocates for us. I don’t want to single him out for praise, but his performance definitely deserves it,” says Abdirashid Garane Awl, one of the Jowle IDP Camp’s managers.
“I recall one significant event that is related to him: three months ago, there was an outbreak of diarrhea in which some members of the community perished,” Mr. Awl continues. “In response, he performed an excellent job of mobilizing health personnel and informed the Ministry of Health – his response saved numerous lives.”
In 2022, following a panel’s report into the matter, the UN Secretary-General’s so-called Action Agenda on Internal Displacement was issued, reflecting the growing importance of the matter.
The Action Agenda has three overarching goals: helping IDPs find a durable solution to their displacement, better prevention of new displacement crises from emerging, and ensuring that those facing displacement receive effective protection and assistance. It sets out 31 commitments by the UN system to better resolve, prevent and address internal displacement crises.
According to the United Nations, the three goals are inextricably linked as no solution is sustainable if another crisis is looming, no assistance will be sufficient if underlying drivers of displacement remain unresolved, and prevention cannot succeed if past crises have not been addressed.
The UN Secretary-General’s Special Adviser on Solutions to Internal Displacement, Robert Piper, visited Somalia in 2023 – the country is one of the 16 UN Member States selected to pilot the Action Agenda.
Distributed by APO Group on behalf of United Nations Assistance Mission in Somalia (UNSOM).