Free Clinic Offers Relief in Somalia
Nine-year-old Marian's stomach looks like a balloon. It's not bloated from overeating or even undereating. But it sticks out almost a foot further than it should.
CRS helped obtain the medication young Marian needs to treat her life-threatening disease.
Marian arrived at the CRS-supported Caritas Somalia clinic after walking more than 15 miles with her father to the town of Baidoa. Her 4-year-old brother has the same condition, but his symptoms are less severe, so he didn't make the long journey.
Fortunately, the Caritas Somalia clinic is a free health care facility that serves anyone who shows up at its door. Unfortunately, the line of patients waiting to receive treatment begins forming at 4 a.m. and crowds the narrow lane leading to the clinic courtyard. Sometimes people wait up to two days before they are seen.
This outpatient facility, however, is a blessing for all who come. Since the collapse of the Siad Barre regime in 1991, Somalia has fallen into an unending cycle of brutal violence. Warlords attack members of rival clans, and forces supporting the transitional government fight against those opposing it. In early 2007, violence in Mogadishu increased dramatically, driving nearly 400,000 additional people from the capital. Another 300,000 have crossed into neighboring countries seeking safety as refugees.
Inescapable Insecurity
Thousands of the people who left Mogadishu this year trekked 140 miles to Baidoa. Families fled with whatever belongings they could carry.
"Richer families were able to pay for vehicle transport, but the majority had to ride in donkey carts or walk," explains Dr. Annie Sparrow, the health and nutrition technical advisor on CRS' emergency response team, who recently visited the region. "Many faced dangers on the road, including theft, rape and even murder. The poorest who had to travel on foot suffered the worst at the hands of opportunistic bandits."
Once in Baidoa, those with family in the area join their relatives. Those without must cobble together a shelter from whatever materials they can find. Makeshift hovels made of just a few sticks covered with torn sheets or plastic and clustered into camps for security now serve as home.
Trained health care staff provide free treatment to all who come to the CRS-supported Caritas Somalia clinic in Baidoa.
Children and the elderly have fared poorly. Unsanitary living conditions compound injuries, illnesses and malnutrition sustained while fleeing. Providing aid isn't easy, however. Corrupt businessmen and powerful clan groups sometimes set up fake camps on community land and force displaced families to pay "camp fees" to stay.
A Beacon of Hope
In the midst of this chaos, the Caritas Somalia clinic provides some relief. The clinic serves 120 patients a day who travel up to 75 miles to receive the free care. The facility takes patients on a first-come, first-served basis, maintaining impartiality by serving anyone who waits in line.
"In spite of limited resources, the Caritas Somalia clinic provides quality service. Great care has also been taken to avoid being seen as favoring one clan over another," Dr. Sparrow explains. "By making health care available to all — including local residents, those displaced 15 years ago, and newly arrived displaced families — the clinic improves community health and helps promote peaceful relationships between clans."
Because insecurity limits people's willingness to travel, many patients wait a long time before seeking treatment. Minor problems become severe cases, with a cold, for example, turning into pneumonia by the time a patient arrives. To help the clinic serve more people and provide more advanced services, CRS is providing critical financial and technical assistance. UNICEF is also providing equipment and working with clinic staff to increase services offered.
"Finding a doctor to hire is really difficult because most skilled people have either left the country or set up private fee-based clinics," Dr. Sparrow explains. "The dedication of the Caritas Somalia staff is exceptional, and we are working with them to expand their capacity."
Fortunately, young Marian arrived before her disease turned fatal. Bitten by a sand fly, she contracted kala-azar, a parasitic illness also known as leishmaniasis. This disease causes profound wasting that leads to death if left untreated. With assistance from Trocaire — our Caritas sister agency from Ireland — CRS helped the Caritas Somalia clinic obtain the necessary one-month drug regimen and arrange for daily injections.
Unfortunately, Marian's nomadic family has yet to return to the clinic, but the drugs are available when they do. In the meantime, nine more patients have been diagnosed with the same disease and are on the road to recovery.
