In Somalia, maternal mortality rates are among the highest in the world<a href="https://www.unicef.org/somalia/health.html">UNICEF Somalia</a>. One in 12 women is likely to die during pregnancy, childbirth, or the postpartum period because of a lack of access to health services. Infant mortality is exceptionally high with one in seven children not reaching the age of five.

Since May 2018, Médecins Sans Frontières (MSF) has supported the Bay Regional hospital in Baidoa, in the South West State of Somalia, to address the health needs of women and children. From May to December 2018, over 4,000 women received antenatal or postnatal consultations and over 1,500 women were admitted to the maternity ward. A total of 686 babies were delivered in that eight month period.

Halima’s story

Halima, 18, lives in a village some 100 kilometres south of Baidoa. She is among the first women to have benefited from free maternity services for pregnant women and new-borns at Bay Regional hospital since MSF started our support in May 2018.

“I was planning on giving birth at home but after two days of labour I passed out, so my relatives put me on a donkey cart and got me to a nearby health centre in Qansah-Dhere district,” says Halima. “When I arrived, I was in very bad shape and the medical staff were unable to help. They kept me there for one night but I was still in a coma so they decided to send me to Bay Regional hospital in Baidoa.”

The next day, Halima was still unconscious and loaded onto a bus headed to Baidoa. The journey takes a full day but a few hours into the journey, Halima went into labour.

“The baby started coming out; I was still unconscious and nobody knew what to do,” Halima says. “I was told that by the time I reached the hospital I had been in a coma for eight days. I lost my baby but the doctors in the hospital managed to save my life.”

It took Halima another two days to come out of the coma and she has since been recovering in the inpatient ward of Bay Regional hospital.

“Since the hospital is the main referral centre in the region, most of the cases we receive are already very complicated ones, whether women have been referred by other health facilities or are self-referred,” says Asma Aweys, MSF’s medical manager at the hospital.

Building up obstetric services

The first phase of our intervention, aimed at establishing a fully functioning, comprehensive obstetric unit, will involve supporting the hospital’s capacity to deliver antenatal and postnatal care, and ensure normal and complicated deliveries. It will expand in coming months to include a neonatal unit and support to paediatric inpatient, outpatient and emergency room services.

“MSF is committed to helping women during childbirth,” says Himedan Mohammed Himedan, MSF´s Head of Programme for Somalia. Ordinarily this is a very difficult period in a woman’s life, but given that the fighting has destroyed many health structures, the challenges of giving birth are even greater.”

“We need to get the word out to the whole community, so that expectant mothers know that they can receive quality care from MSF during this period,” says Himedan.

MSF humanitarian medical activities supporting Somalis

MSF resumed activities in Somalia in May 2017, after an absence of close to four years due to extreme attacks on our staff and other serious concerns.  Since our return to Somalia, we have been supporting the Bay Regional hospital in Baidoa and the Mudug Regional Hospital in Galkayo. Our teams have also provided humanitarian assistance in the displaced camps of Galcayo, nutritional support in Dollow in Dhusmareeb, and periodic visits to Jubaland to support child healthcare and prepare for outbreaks in Dhobley, Bardhere and Garbaharey.

We have conducted cataract surgery eye camps in collaboration with local agencies in Ergavo, Las Anod, Buhodle, Galcayo, Baidoa and Bardhere.

“Across Somalia, MSF is looking to ensure that people have access to medical care in areas where needs are critical and where the security conditions permit. The need for free quality healthcare is very high in Somalia and our strategy is to steadily increase our support to existing structures to improve the services,” says Gautam Chatterjee, MSF’s country representative for Somalia. “While the context is certainly challenging, we can rely on dedicated local staff, often medical staff who have already worked with MSF, to build the capacity and ensure improved access to healthcare services in Somalia.”

In Somaliland, we are supporting the diagnosis and treatment of patients with drug-resistant tuberculosis at health facilities in Hargeisa, Borama, Burao and Berbera. We are also planning to support other health structures in Las Anod.