Today, there are some 60 MSF international staff and more than 800 MSF national staff working in Somalia, performing more than 300,000 outpatient consultations and admitting an estimated 10,000 patients every year. Throughout 2007, MSF increased its operations, opening several new projects in Mogadishu, Afgooye, Belet Weyne, Jamaame and Kismayo.

Related projects YEMEN: In Yemen, MSF started providing medical and humanitarian assistance to refugees and migrants arriving at the Yemeni coast in Abyan and Shabwa governorates in September 2007. On December 15, MSF teams discovered 56 bodies near Arqa on the Yemeni shore, over half of them women. Five children were also among the dead. MSF provided basic care to a group of 49 survivors on the shore.

BANADIR In Mogadishu, MSF is struggling to continue providing ongoing medical care, at times having to suspend its activities due to the insecurity. In the Dayniile area, MSF has been providing emergency surgical care in a 35-bed hospital since the end of September 2007.

In the Hawladag area of Mogadishu, MSF had been running a pediatric clinic since May 2007, but had to close and relocate its activities in November due to insecurity. The team is currently carrying out mobile clinics in IDP camps and has reopened its in-patient clinic in a new location, reaching an average of 150 people a day, mainly IDPs inside the city.

The main health problems are related to diarrhea and respiratory infections. MSF has been operating a primary health care clinic in the Yaqshid area of Mogadishu since 1994. In Balcad and Kaaran areas, a relatively more stable security situation has allowed some limited access to four MSF outpatient clinics. In November, MSF teams performed 12,061 consultations, the majority related to maternal and child health. In the same month, MSF teams saw a worrying increase of watery diarrhea cases, from 50 to 78.

In December, MSF opened a new 50-bed inpatient pediatric clinic in the Abdul-Aziz district. LOWER SHABELLE In Afgooye and Hawa Abdi, MSF has been providing medical care and delivering water and non-food items to tens of thousands of internally displaced persons (IDPs) since April 2007.

The majority of the 1,700 weekly medical consultations carried out by MSF teams is linked to precarious living conditions: severe malnutrition, diarrhea, and acute respiratory tract infections. MIDDLE SHABELLE REGION In Jowhar district, MSF runs four primary health care outpatient clinics and a maternity ward, providing primary healthcare including nutritional care, treatment of sexual violence, and expanded immunization programs.

Most of the target population is rural; some are part of the Bantu minority. MSF provided 108,000 outpatient consultations in 2006. MSF conducted a measles vaccination campaign and provided water and non-food items to an estimated 40,000 newly displaced. MSF regularly responds to cholera outbreaks in the area.

BAY REGION

In Dinsor, MSF runs a hospital providing an average of 4,000 outpatient consultations per month. The 85-bed inpatient department admits about 450 people per month. Twenty-five percent of consultations are for children under five. MSF teams in Dinsor provide therapeutic feeding, surgical care, and TB treatment. They also respond to disease outbreaks and emergencies.

LOWER JUBA REGION

In Jamaame, MSF opened a 30-bed hospital with a large nutritional program and outreach activities in March 2007. Since its opening, 950 patients received nutritional treatment. Each month MSF teams carry out 1,400 consultations. Four mobile medical teams screen between 300 and 1,000 children and pregnant women per day for malnutrition. The major health problems are malnutrition, pneumonia, and diarrhea. In Kismayo, MSF opened an emergency surgical project in September 2007, providing among others, emergency obstetrics care and vesico-vaginal fistulae surgeries.

MIDDLE JUBA

MSF teams offer primary health care with inpatient and outpatient services to over 3,500 patients in the Middle Juba region every month. In both Marere and the nearby village of Jilib, MSF is operating a nutritional program with therapeutic and supplementary feeding centers. In 2006, the supplementary feeding center treated over 2,800 children and the therapeutic feeding center treated 920. The team has the capacity to respond to outbreaks of cholera, meningitis, and measles. Treatment and support for victims of sexual violence is also available. BAKOOL REGION Opened in 2000, the 290-bed Huddur health center supported by MSF is the largest structure of its kind in southern and central Somalia. It provides a wide range of outpatient and inpatient services, treating kala azar, malnutrition, mother-and-child related illnesses, and tuberculosis (TB).

MSF also runs four health posts in the area: Labatan Jerow, El Garas, El Berde, and Rabdurreh. In total, more than 5,000 consultations are performed each month. The target population is the approximately 250,000 people living in this region, with some patients coming from outside Bakool. HIRAAN REGION MSF opened a hospital program in Belet Weyne in February 2007 with a focus on surgical care. MSF opened a pediatric ward and provides maternity care. The majority of IDPs fleeing violence from Mogadishu have, so far, been accommodated by relatives in town.

GALGADUD REGION

Since January 2006, MSF has been supporting the 80-bed Istarlin Hospital in Guri El town, approximately 450 kilometers northwest of the capital Mogadishu. Each month MSF teams carry out an average of 3,000 outpatient consultations, 50 lifesaving surgeries, and more than 80 deliveries. MSF also operates an outpatient clinic in Dhusa Mareb, the district capital of Galgaduud, with 600 to 1,000 consultations conducted per month.

MUDUG REGION

In a hospital in south Galcayo, MSF runs one of the few surgical programs in central and south Somalia, treating more than 500 victims of violent trauma yearly. The teams offer inpatient and outpatient services, pediatric and maternal care, and treats more than 3,500 patients on average each month. The team has the capacity to respond to outbreaks, such as cholera, measles, and meningitis. In south Galcayo, MSF also operates a therapeutic feeding center, admitting over 50 malnourished children each month. On November 23, MSF opened a new therapeutic feeding center in North Galcayo admitting 361 children in the first ten days. MSF also runs a TB program in North Galcayo.

PUNTLAND

In Bossaso, a nutritional emergency intervention was launched in late August 2007 in camps where approximately 15,000 IDPs and refugees, both Somalis and Ethiopians, gather before trying to cross the Gulf of Aden to reach Yemen. Since August, a total of 1,197 patients have been admitted to the nutritional program. MSF is also providing health assistance to the most vulnerable groups (Ethiopian of non-Somali origin) and assisting victims of sexual violence. MSF has worked in Somalia since 1991.