Nairobi, Jan 20—–Six months after the UN declared famine in parts of Somalia, worsening insecurity is creating more displacement and hampering the delivery of life-saving aid to tens of thousands of people. In Somalia, the UN estimates that more than four million people require urgent humanitarian assistance, 250,000 are at risk of starvation and nearly 1.4 million are displaced. Efforts to get assistance to people who need it have been undermined by ongoing warfare, clan fighting and a Kenyan military offensive in southern Somalia against Somali rebels whom they blame for attacks inside Kenya.
With the border between Kenya and Somalia closed since October, thousands more Somalis have fled into central Somalia and Mogadishu to escape violence, famine and drought, putting pressure on already stretched health care, food distribution and sanitation services.
“In the past two weeks alone, we’ve seen some 800 new arrivals in South Galkayo, in the central Mudug region,” says Kurt Tjossem, the International Rescue Committee’s Horn and East Africa regional director. “They’re arriving with few belongings, in very poor health, and heading to camps where there’s limited shelter, no latrines and shortages of other basic services.”
Tjossem says the IRC is providing food and cash vouchers, but much more is needed. Central Somalia is already hosting 84,000 displaced people.
In Mogadishu, two IRC-run health centers are treating increasing numbers of Somali arrivals from southeastern coastal areas where the Kenyan military operation has intensified. Tjossem says food, water, medical and shelter assistance must be boosted in the city where some 372,000 displaced people are seeking refuge.
The IRC is also concerned that more unrest in Somalia may lead to increased refugee flows into southern Ethiopia, where more than 180,000 Somalis are crammed into camps that are already at capacity.
The situation for Somali refugees who have made it to the sprawling camps in Dadaab, Kenya, is especially troubling. Recent bombings, banditry, kidnappings of aid workers and attacks on police have forced aid agencies to scale back essential services and restrict assistance to central areas of the camp.
This is having a direct and detrimental impact on the health of refugees, particularly those who settled on the outskirts of the camps where sanitation, medical care and water have become woefully inadequate.
“The IRC’s hospital in Hagadera is running at full speed, but it’s too dangerous to send qualified medical staff to outlying clinics or communities to treat ailments, refer sick patients to the hospital or conduct crucial follow-up exams,” says Tjossem.“This past month, seven children died of acute malnutrition in our hospital. They were already beyond help when they were admitted. Before the emergency began last year, there would be zero to two deaths a month.”
Aid groups like the IRC have been relying on dedicated refugee staff to fill in gaps as best as they can, but few have the experience to tackle outbreaks of disease, like cholera.
Dadaab is home to almost a half a million refugees who live in crowded and unsanitary conditions that are ripe for cholera. The UN and aid groups partnered to launch a swift response when a first case was detected in August. The IRC quickly distributed soap, water containers and ultimately treated nearly 300 cases of cholera. The insecurity has made response and prevention activities all the more challenging – often hindering efforts to deliver essential water, sanitation and hygiene services to remote areas of the camps. So far three people have died from cholera in the camps—the most recent in December.
“The violent conflict in Somalia and the humanitarian crisis in the region are far from over and millions of people remain at risk of disease, hunger and violence,” says Tjossem. “Unless humanitarian access improves, thousands of lives will be at risk.”
The IRC says it is paramount for the international community to maintain adequate support for life-saving assistance and long-term economic recovery programs and ensure that humanitarian assistance can safely reach those in need throughout the region.