Since gaining independence in 1960, Somalia and its people have suffered countless disasters, both natural and political. The country’s first president was assassinated just months into his term; Mohammed Siad Barre promptly took his place, a commander in the Somali military and an avowed socialist. Overnight, Barre transformed Somalia’s post-colonial democracy into a brutal dictatorship, purging the government rolls of non-socialists and executing potential rivals. Despite growing internal unrest, he continued to rule until 1991, when a concerted group of Somali clans forced him into exile. But, instead of order, anarchy and famine followed.
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In recent years, the quality of life for Somalis has plummeted to global record lows. As drought and famine continue to plague the country, particularly the Lower Juba Valley, the average life expectancy has dropped to 46 years. Even more alarming is the effect this healthcare crisis has had on Somalia’s mothers and children; 240 children die per 1,000 live births and 1,600 women per 100,000 live births. In the United States, those numbers are only 7 and 12 respectively. In addition to a dearth of basic health services, one gender-based Somali custom poses a particularly formidable threat to women’s health.
According to World Health Organization (WHO), obstructed labor and severe bleeding account for more than one-third of all maternal deaths in underdeveloped countries. In Somalia, a leading cause of both obstructed labor and severe bleeding is female genital mutilation (FGM). FGM involves surgically removing a woman’s clitoris, generally when she is not a woman at all but a pre-teen girl. In FGM’s most severe form, infibulation, the labia is also sewn together to cover the vagina. Though a small hole is left for the passage of urine, infibulation inevitably complicates childbirth, exponentially endangering both mother and child. UNICEF/USAID have estimated that as much as 97% of Somali women have undergone infibulation.
International Medical Corps (IMC) was one of the first humanitarian relief organizations to recognize the growing health crisis in Somalia following Barre’s ouster and, thanks to strong ties with community and clan leaders, has maintained a steady programmatic presence ever since. IMC staff now operate 89 health posts and 6 maternal and child centers, serving 600,000 Somalis – almost 8% of the country’s population. However, much remains to be done in the struggle to improve the health of Somalia’s mothers and children.
In collaboration with the United Nations’ Populations Fund (UNFPA), IMC will soon implement a new Safe Motherhood program in Somalia’s Bakool region. The program will prepare local staff to better treat the resultant complications of FGM, provide emergency obstetric training for local birth attendants and midwives, and supervise the distribution of UNFPA-supplied birthing kits. Furthermore, IMC plans to launch a comprehensive information campaign in collaboration with the regional authorities in all three of its operational districts. This campaign will address myriad maternal health issues, from the prevention of potential pregnancy complications to understanding the transmission of STIs and HIV/AIDS.
In the past year, Somalia’s political landscape has finally given Somalis reason to hope. Rival warlords and politicians recently joined forces to install a new Parliament and elect a new President. Still, forging a legitimate government will take years, and the women and children of Somalia do not have the luxury of time. IMC is committed to serving their needs, building a healthcare infrastructure that will continue to function years from now, after the rule of law has at last returned to Somalia.