Andreï Neacsu in Mogadishu/Nairobi
In Somalia, life expectancy is just 47 years; every day 45 Somali women die as a result of complications during pregnancy or childbirth; only one in ten infants is fully immunised against all major diseases; nearly 15,000 new tuberculosis cases are registered every year.
These are figures one might expect from a country ravaged by over a decade of war. But they would probably be even worse if it were not for a nationwide network of 49 Red Crescent clinics, which represent the only reliable source of basic health care for thousands of Somalis.
"In a country without a health infrastructure and with the worst health indicators in the world, the work of the Somali Red Crescent is invaluable, as it serves nearly one million beneficiaries every year,", said Ahmed Gizo, Head of International Federation's delegation in Somalia.
Gizo was speaking during a meeting in Nairobi - held under the auspices of the Somali Red Crescent, the Federation and the World Bank - on Community Health Services in Somalia. The meeting, the first of its kind, was attended by United Nations agencies, non-governmental organizations and members of the diplomatic community.
It is being seen as an important step towards building closer partnerships for the creation of a coherent and sustainable health system in Somalia.
"Without an appropriate and adequate public health network, health conditions will remain appalling, and may even deteriorate as unsustainable, externally driven health programmes are abandoned or closed," warned Nur Hassan Hussein, Secretary General of the Somali Red Crescent Society.
International support has helped to maintain minimal public health services. But a decade of short term programming has produced little in the way of recovery.
Investing in the transition from war to peace and relief to development has frequently been advocated as the way forward in rebuilding war-torn societies, but aid organizations lack the financial backing to deliver programmes that harness the dynamics of recovery at local level and help bridge the gap between survival and renewal.
Since 1993, 49 Mother and Child Health out-patient clinics, run by the Somali Red Crescent, have provided health services to the most vulnerable groups in the community, mostly in rural and nomadic areas. Twelve are located in the northeast region of Puntland and a further six in the north-western region of Somaliland. The remaining 31 are spread throughout central and southern Somalia.
The clinics are supported by the ICRC and the International Federation. In addition, the Federation supports one community hospital in Garowe, while the ICRC supports two hospitals in Mogadishu and one in Baidoa. UNICEF, the United Nations Children's Fund, provides the clinics with much needed medical supplies.
Two years ago, a "community management" model was developed in collaboration with UNICEF and the World Health Organisation, and a project supported by the World Bank was set up in the village of Qarhis, near Garowe in Puntland. The local community contributed up to 44 per cent of the running costs of the clinic. The Somali Red Crescent intends to replicate this model in clinics elsewhere in its network should it prove to be viable during the pilot phase.
"Ordinary Somalis - men and women, the children and the elderly - do not, and cannot, wait for the signing of peace agreements or the creation of transitional authorities. For them, life goes on regardless of policies, interventions or the support of the international organizations", said Sean Deely, manager of the Federation's recovery project.
"Therefore, a more clear commitment is required from the international partners of the Somali Red Crescent. It is essential that pledges by communities to provide significant proportions of the running costs is reciprocated by the international partners", he added.
Related links:
Somalia: appeals, updates and reports
Women's and children's health
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