4 November 2024, Mogadishu, Somalia – Since the early 1990s, Somalia has suffered multiple outbreaks of cholera which, due to poor sanitary conditions, have affected a majority of the population living in internally displaced camps.

The latest outbreak occurred early in 2024 in the capital Mogadishu, with the districts of Dayniile, Dharkaynley, Wadajir, Kahda and Hamar Jajab particularly badly affected. In response, the Federal Ministry of Health and Human Services and the Banadir Health Administration, with the support of WHO, UNICEF and other partners, promptly embarked on a door-to-door cholera vaccination campaign targeting the affected districts to prevent the spread of the disease. Staff also conducted awareness-raising activities to educate residents on how to control the spread of cholera.

WHO polio programme assets and expertise were deployed to support the response activities. Hawa Abdullahi Ali, 55-years-old, who has worked on polio campaigns in Kahda since 1998, first as a vaccinator and then in her current position as District Polio Officer, was among the experienced team that WHO relied on to deliver relief to thousands of residents in the high risk district of Kahda in May 2024.

Hawa says the experience underlined the importance of delivering high quality interventions to vulnerable residents.

It is not the first time Hawa and her colleagues working in the polio programme have delivered on other public health priorities. They were also responsible for building coordination and strengthening surveillance during the COVID-19 pandemic response.

"The contribution of the polio workforce in responding to other public health emergencies is critical to the overall service delivered to vulnerable people. Protecting those most at risk, in the communities in the most at-risk areas, is key to reducing infections and saving lives,” says Hawa.

“By rapidly responding to the cholera outbreaks we were able to limit transmission, safeguard communities and prevent our health systems being overwhelmed.”

Through efforts like that of Hawa, the WHO polio programme, with the support of the Government and other partners, successfully vaccinated over 1 244 687 people aged one year and older with the oral cholera vaccine (OCV) across 12 districts in 5 states in May 2024.

“Our dedicated team, which included 244 district field assistants, 12 district polio officers, 10 regional polio officers, 5 state polio officers, state data assistants, national data managers, state SIA coordinators and over 2196 vaccinators and recorders, played a crucial role in this achievement,” said WHO Somalia’s Immunization Coordinator Dr Gedi Mohamed.

Hawa believes her team’s efforts not only protected locals from cholera but also inspired hope among vulnerable families who viewed the health workers as a lifeline during this critical time.

"As a team, we understood that every vaccine we delivered could mean the difference between life and death. The trust we've built within the community empowered us to reach more people than we imagined. It was incredible to see mothers lining up, knowing that together we were safeguarding the future of our children.”

Cholera remains a major public health challenge in Somalia, especially in regions affected by conflict and displacement, and with limited access to clean water and sanitation.

Over the years, cholera outbreaks have claimed many lives and placed immense pressure on Somalia's fragile health care system. Coordinated efforts by the Government of Somalia, WHO and partners have been instrumental in reducing the impact of the disease through rapid response measures, health education and vaccination campaigns.

In the last four weeks, 768 new cholera cases have been reported from 31 districts, with a rise in cases in the areas of Kismayu, Jowhar, Marka, Burhakab, Barawe, Borama and Baidoa. Of these cases, 399 (52.0%) were female and 407 (53%) were children under 5 years.

To control cholera and prevent future outbreaks, it is crucial that all stakeholders prioritize sustainable access to clean water and improved sanitation and support the widespread delivery of cholera vaccines. Together, these actions can protect vulnerable populations and ensure that life-saving health services reach those most in need.

27 October, Mogadishu, Somalia – In Mogadishu, one of the few cities in the world where the threat of polio persists, Hani Jilaow Mohamed, a dedicated polio vaccinator, has been working on the front lines of public health since 2005.

Hani’s blend of skill and courage has made her a pivotal figure in the ongoing fight against the disease.

The 36-year-old mother of 6 is one of thousands of health workers who vaccinate children against polio and other infectious diseases.

Before Hani embarked on a career in public health, she and her family were deeply affected by the civil war in Somalia when the long drawn out conflict tragically claimed her father's life. With the family deprived of its sole breadwinner, Hani was forced to drop out of elementary school. Later, though, she secured a place on a health training programme offered by the United Nations Children’s Fund (UNICEF).

After being trained on vaccination techniques in 2005, Hani was equipped with the skills needed to pursue a career administering vaccines to children and adults. "My goal was to learn a skill that could help me earn a living while assisting others. Since then, I have dedicated myself to this work," she says.

Overcoming challenges to immunization

The absence of a functional government made it difficult for aid workers like Hani and her team to deliver essential health services. "In August 2006, when the security situation in Mogadishu was dire,” she recalls, “gang members, probably unaware of our mission, came after me and tried to steal our cold boxes. Luckily, none of my team was injured. And today, thankfully, things have improved."

When Hani began working, the concept of vaccination was often misunderstood within the community. Undeterred, Hani and her team – including a supervisor, social mobilizer and recorder – persevered with their vital work.

“Initially, many people feared getting vaccinated. To build understanding, we worked with midwives, traditional leaders and religious figures to educate the community about the benefits of vaccination. Gradually, awareness levels grew, and acceptance of vaccines improved."

Currently, Hani and her team are working as part of the Big Catch-Up Initiative, a recovery plan initiated last year to close the immunization gaps that resulted from the COVID-19 pandemic.

At the Waberi Maternal and Child Health Centre (MCH) in Mogadishu, polio health workers assemble at 08:00 every day before embarking on door-to-door visits across the district.

"During vaccination campaigns, I leave my house in the morning, head to Waberi MCH and pick up my vaccine carrier and supplies and then vaccinate around 18 to 20 households each day,” says Hani, describing her daily routine which ends at 17:00.

Hani and her team say improved security and greater community acceptance of vaccines have made their work noticeably easier.

"Over the years, Somalia – formerly one of the most at-risk countries for polio – has made significant progress thanks to global efforts spearheaded by WHO. These initiatives have bolstered the fight against polio, and brought us close to the ultimate goal of eradicating the disease in Somalia."

Hani adds, however, that more work is needed to end the outbreak of variant poliovirus type 2 which began in 2017, and to strengthen routine immunization for children across the country.

24 October 2024, Somalia – This World Polio Day, the Government of Somalia, the World Health Organization (WHO) and the United Nations Children’s Fund (UNICEF) join in reaffirming their commitment to safeguard every child against polio.

Since the launch of the Global Polio Eradication Initiative (GPEI) in 1988, the incidence of polio has plummeted by 99 per cent thanks to the widespread use of vaccines. Engagement by Somalia's Federal Ministry of Health, state leaders, communities, parents and caregivers, and the support of health care workers, has been vital to the success of vaccination campaigns.

Achieving and maintaining a polio-free world means every child will be safe from being paralyzed by the disease. Today, as we mark the profound success of immunization against polio, we also call on all stakeholders to fund and prioritize vaccines in 2024.

Somalia successfully stopped transmission of wild poliovirus in 2014. However, the country is now facing the world’s longest running outbreak of circulating variant poliovirus type 2. Somalia is also facing recurrent outbreaks of measles and cholera spurred by drought and floods, underscoring the need for novel techniques to reach children in remote communities, expand vaccination coverage and enhance the health system.

“As we celebrate progress, we also recognize the critical work that remains. Incredible political commitment, demonstrated by the Prime Minister’s National Task Force on Immunization and Polio Eradication, along with the active involvement of ministers and state leaders in inaugurating polio campaigns, has been crucial in driving efforts to stop the current outbreak. Collaboration between the Somali government, health workers and international partners is paving the way towards a polio-free Somalia,” said the Minister of Health and Human Services of the Federal Government of Somalia Dr Ali Haji Adam.

"On this important day, we recognize the significant progress Somalia has made in the fight against polio through sustained immunization efforts, even in the country’s most remote regions, and strengthened surveillance systems that protect our gains. We remain committed to ensuring Somalia stays on track towards a polio-free future and will continue to provide support," said WHO Somalia Deputy Representative Dr Mohamed Ali Kamil.

Now is the time to end polio for good. But if we don’t stay committed the virus could quickly make a comeback. Somalia has been streamlining efforts to end transmission, using updated emergency action plans developed collectively by the Federal Ministry of Health and Human Services and GPEI partners.

"On this World Polio Day, we reflect on our journey and renew our commitment to reach every last child. With the tools at our disposal, we must intensify our efforts, innovate new strategies to reach those we’ve missed, and strengthen routine immunization," said UNICEF Deputy Country Representative for Somalia Nisar Syed. "No child should be paralyzed by or die from an illness that can be prevented through immunization. Investing in vaccines and a robust health system is a sure step to help protect future generations."

Immunization is one of humanity’s most remarkable success stories. In the last 50 years, immunization efforts have saved thousands of lives and helped significantly reduce infant deaths across the country. Together, we will work to secure a polio-free future for all Somali children.

For additional information, please contact:

Mohamed Osman, Federal Ministry of Health and Human Services, Head of Comms & Public Engagement, هذا البريد محمى من المتطفلين. تحتاج إلى تشغيل الجافا سكريبت لمشاهدته.

Khadar Hared, WHO Communication Officer, هذا البريد محمى من المتطفلين. تحتاج إلى تشغيل الجافا سكريبت لمشاهدته.

Lisa Hill, Communications Specialist, UNICEF, هذا البريد محمى من المتطفلين. تحتاج إلى تشغيل الجافا سكريبت لمشاهدته.

Solar panels at Dollow maternal child health centre, Dollow, Jubaland State. Photo credit: Tamarso.

22 October 2024, Mogadishu, Somalia – In 2023, the WHO Country Office in Somalia and the Kingdom of Saudi Arabia launched Every Breath Counts, a collaborative initiative aimed at improving health service delivery for children suffering from pneumonia and diarrhoea, the two biggest health threats faced by children in Somalia. With a financial contribution of US$ 2 million from the King Salman Humanitarian Aid and Relief Centre, the project focused on equipping health facilities with solar power and oxygen supplies, biomedical equipment and essential medicines.

The solarization of 26 health facilities was central to the project. The Ministry of Health and Human Services guided the selection of facilities and WHO contracted a renewable energy company based in Mogadishu to spearhead the solarization efforts.

A panel for the solar system at Galkayo maternal child health centre, Puntland. Photo credit: Tamarso.Seventeen maternal and child health centres have been equipped with solar power systems, ensuring a green, sustainable and affordable supply of electricity. The project also facilitated the installation of solar systems in 9 referral hospitals, with the goal of ensuring a constant oxygen supply for critically ill patients in emergency rooms and inpatients needing oxygen therapy at both primary and secondary care levels.

The project includes a 5-year after-sales service agreement, with maintenance scheduled twice a year, and routine maintenance training for health facility staff, including hospital managers and operators.

Solar panels at Horseed maternal child health centre, Baidoa, Southwest State. Photo credit: TamarsoOnly 28% of health facilities in Somalia have access to reliable, uninterrupted electricity. Half of primary health care units in rural areas have either no electricity or an irregular supply. Services provided by primary health care centres, including deliveries, pediatric emergencies and vaccine administration, are severely affected. In remote areas, health care workers often depend on kerosene lamps for light when conducting surgical operations, cesarean-sections and treating critically ill patients. Children can also remain unvaccinated due to the lack of cold chain facilities for the transport and storage of vaccines.

By providing solar power and reliable oxygen supplies, the initiative is expected to reduce deaths caused by pneumonia and alleviate the referral burden on hospitals.

Stable power supplies promote the delivery of Somalia’s essential package of health services, including maternal care and vaccination programmes, and contribute to progress toward universal health coverage.

For more information, contact:

Myriam Haberecht, Resource Mobilization Officer
هذا البريد محمى من المتطفلين. تحتاج إلى تشغيل الجافا سكريبت لمشاهدته.

Fouzia Bano, Communications Officer
هذا البريد محمى من المتطفلين. تحتاج إلى تشغيل الجافا سكريبت لمشاهدته.