Hiiraan Online

DJIBOUTI — A perfect storm of geopolitical factors may bring a new major disease outbreak to the Horn of Africa. Somalia health officials worry the region could see a new disease outbreak due to the combined challenges of severe drought.

When earlier this year, forces aligned with the Somali government liberated areas, it was a cause for celebration. The port of Harardhere and other communities in the vicinity (notably Galcad) had been under the control of the ISIS-aligned terrorist group Al-Shabab for over a decade, was finally free.

To their dismay, the Somali government was quick to discover that many of these people were in dire need of medical care. The health crisis in these recently liberated areas of Somalia and elsewhere makes clear the struggle against terrorism in one of the world’s poorest countries will continue long after the shooting stops.

The population of this area remains unvaccinated to COVID-19 and other devastating diseases, in particular cholera and measles. Aid workers working on the Horn of Africa who spoke to Zenger News warned that Somalia could become a breeding ground for a major communicable disease outbreak.   

“ This area of Somalia liberated after many years has had no medical service,” said Ali Haji Adan, the Federal Government of Somalia’s Minister of Health told Zenger News, “we need help from humanitarian and donor agencies who can stand with us to establish health services in these liberated areas. We must build a resilient health system and humanitarian institutions, not one based around humanitarian aid.”

In the country’s last major cholera outbreak in 2012, close to 260,000 people died – with half of them being a child. In response to this crisis and a pressing famine in the Horn of Africa then President Obama relaxed some restrictions on humanitarian groups providing aid to Al-Shabab controlled areas of Somalia in late 2011. 

“ Al-Shabaab largely outsourced essential services to NGOs and aid agencies, although they tended to be ad hoc arrangements determined by the whims of [Al Shabab leadership]… These operations were subjected to heavy ‘registration fees,’ and all activities were closely surveilled, with relief workers often being forced to disclose sensitive budgetary and logistical details,” wrote one West Point study analyzing Al-Shabab’s approach to healthcare. 

Elsewhere Al-Shabab sought to undermine the Somali state by attacking health infrastructure. The group is believed to have been behind the murder of Seven health workers and a pharmacist May 2020 who was working for an aid agency.

While Al-Shabab was able to blame the lack of medical care on its war with the central government. Somalia’s government has no such luxury and must figure out a new strategy to govern its newly limited areas in a country that already is one of the lowest-ranked countries in the world in terms of health indicators. 

As such, Somalia’s President Hassan Sheikh Mohamud recently convened a meeting of federal leaders to discuss the way forward in the country’s war with Al Shabab. Yet, the issue is one of more is about more than just strategy, resources remain the primary question. The Federal Government of Somalia earns some $250 million in annual revenue a figure subsidized by foreign donations. Conversely, Al-Shabab is estimated to earn some  $100 million in revenue it generates annually.

“We are fighting Al-Shabab, drugs, and the pandemics all these challenges we need support from our friends and our partners, that’s why I am here,” said Haji Adan on the sidelines of a conference organized by King Salman Humanitarian Aid and Relief Center in Saudi Arabia, “we need help from our partners to meet these challenges and before they spread elsewhere.”