Polio champion Maryan Jama Du’ale retires after 2.5 decades

Maryam Jama Du’ale at her retirement farewell ceremony hosted by WHO Somalia in Hargeisa, Somaliland. Photo credit: WHO/WHO Somalia31 July 2024 – In April 1998, certified nurse and public health officer Maryan Jama Du’ale was invited to a workshop to get familiar with a new initiative: the National Polio Eradication Programme. She made an impression at the event, which was hosted by WHO and the health ministry of the self-declared administration of Somaliland. Within a few weeks, Maryan joined the programme as a district polio officer in Hargeisa, Somaliland.

Her role included setting up surveillance sites to search for poliovirus in children aged under 15 years. She was also tasked with supporting the implementation of polio vaccination campaigns in Somaliland and supervising her teams to quickly address any setbacks.

When Maryan began her work, Somalia was engulfed in a civil war, its health infrastructure was in ruins and vaccine-preventable diseases, such as polio, were rampant. Back then, many people in the country did not know that polio existed – even though Somalia confirmed 12 wild poliovirus (WPV) cases in 1998.

Like many other communities around the world, many people in Somalia were afraid of vaccination. Limited awareness of polio-related activities also meant that some were initially sceptical about the need to collect stool samples from children presenting with acute flaccid paralysis (AFP), a common symptom of poliomyelitis.

“Community members thought vaccination would stop childbirth or that it was against our religion,” explains Maryan. “It took us a lot of time and effort to help people to understand that polio vaccines are safe and rigorously tested before use. Vaccine acceptance is much better now, although we face other challenges, such as complexities in reaching children in insecure areas. However, most people now understand that we collect stool samples from children with AFP to test for poliovirus.”

Inspired by a child to eradicate polio

Group photo taken with retiree Maryan Jama Du’ale at her farewell ceremony. Photo credit: WHO/WHO SomaliaEarly on in her work, Maryan met a child who had been paralysed by WPV in the village of Qool-buulale, on the Somalia–Ethiopia border. It was a meeting that shaped the rest of her career.

“That first encounter with a child paralysed by polio moved me. It made me understand the importance and impact of our work. I saw first-hand how our work could prevent further spread of polioviruses and protect children from lifelong paralysis,” she says.

The available health facilities, which were inadequate and far apart, could not address emerging cases and the need to provide vaccines.

“When we heard about polio cases, we often had to use donkey carts or camels to transport vaccines to reach remote villages or mountains. When a case was reported near the border, we would cross all kinds of terrain to reach children,” adds Maryan.

Over her career, Maryan and her teams helped ensure children received polio vaccinations and other health services. They did this with the help of dedicated medical doctors and trained health volunteers, and through social mobilization and outreach campaigns, among other strategies, backed by partners.

Owing to these immense efforts, the National Polio Eradication Programme made significant progress. Four years after the immunization programme was established, Somalia interrupted transmission of WPV, in 1998. Later, Somalia confirmed and closed a couple of imported WPV1 outbreaks, from 2005 to 2007 and from 2013 to 2014.

WHO Somalia Communication Officer Khadar Hared is pictured with Maryan Jama Du’ale after interviewing the polio champion about her experiences in Hargeisa. Photo credit: WHO/WHO SomaliaThe last time Maryan saw a child with WPV in Somaliland was in 2017 in Burco, Togdheer. In October 2017, however, Somalia confirmed an outbreak of variant poliovirus, which occurs in places where children have low immunity. Although Somalia has closed WPV and variant polio outbreaks before, the variant poliovirus that was detected in 2017 is still smouldering in the country. Maryan firmly believes Somalia will end this outbreak soon too.

“Witnessing that our collective efforts, alongside the government and partners, had contributed to stopping poliovirus spread, time and again, continuously filled me with immense pride and happiness,” adds Maryan.

Passing on the baton after 26 years of service

Gradually, by earning communities’ trust and working to expand the programme over the years, Maryan rose through the ranks to become a state polio eradication officer. In this role, she managed eradication efforts across Somaliland. She retired in January 2024, after 26 years of exemplary service.

Maryan’s story reveals the power of resilience and the unwavering commitment of the health workforce to end polio in Somalia, even amid great adversity.

Somalia has made great progress in rolling out COVID-19 vaccination and these efforts will be sustained as part of the Big Catch-up, a global WHO initiative to boost access to immunization. Photo credit: WHO/I. Taxta16 July 2024 – Since COVID-19 was first detected in Somalia in March 2020, the country has made remarkable progress in limiting its spread and rolling out COVID-19 vaccination. Thanks to support from partners including WHO Somalia, almost 50% of Somalia’s population is fully vaccinated against COVID-19, as at 30 March 2024.

But more must be done to protect Somalia from COVID-19 and to leverage the existing gains to strengthen immunization and the health system more broadly.

One such initiative is the Somalia COVID-19 Emergency Vaccination Project, which has been central to the COVID-19 vaccination efforts to date and is set to continue until September 2025. The Federal Government of Somalia implements the project through the Ministry of Health and WHO Somalia, with financial support from the World Bank.

Since July 2023, the project has supported Ministry of Health efforts to expand the coverage of COVID-19 vaccines and strengthen essential immunization services across Somalia. A crucial part of this work is strengthening the organizational capacity of the National Medicine Regulatory Authority (NMRA), as well as Somalia’s surveillance system for immunization.

To date, the project has supported the following efforts.

The administration of over 12 million doses of COVID-19 vaccines. As a result, 49.7% of Somalia’s population are fully vaccinated. This includes 60% of all internally displaced people in the country and 8% of the nomadic populations.

Surveillance of adverse events following immunization (AEFI) has been integrated into the existing health information management system.

Training of trainers on AEFI surveillance has been delivered to 267 health workers (60% female).

Building of NMRA’s organizational capacity, which has included development of a training plan; a study tour of Kenya and Uganda, to learn from their respective national regulatory authorities for medicines; and regular supportive meetings between NMRA and WHO.

Training on AEFI surveillance in Puntland, Somalia. Photo credit: WHO SomaliaThe Somalia COVID-19 Emergency Vaccination Project is expected to help the country achieve its target of fully vaccinating 70% of the population against COVID-19 by end 2024.

Over the next 14 months, to September 2025, the project will integrate COVID-19 vaccination within the Big Catch-up. This global WHO initiative aims to reinstate and enhance access to childhood immunization, which was disrupted worldwide during the COVID-19 emergency.

Dr Renee Van de Weerdt, WHO Representative to Somalia, said: “WHO has a long history of working with the Government of Somalia to improve access to routine immunizations that save lives. Since the start of the pandemic, we have stepped up our collaboration to improve surveillance and response capacities and then to ensure equitable access to COVID-19 vaccination.”

“It is heartening to see the strong results of this collaboration,” she continued. “Not only is the target of fully vaccinating 70% of the Somali population within reach, but systems have been built to ensure that Somalia is better prepared to face the next health emergency. We express our gratitude to the funders who have made this work possible, particularly the World Bank, as well as to the Government of Somalia for leading this initiative.”

For more information, please contact:

Madinur Saydahmat, Partnerships Officer, WHO Somalia
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Fouzia Bano, Communications Officer, WHO Somalia
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Related links

WHO’s response to COVID-19 in Somalia

Health for all is Somalia’s answer to COVID-19 and future threats to health (who.int)

USAID support leads to 47% of eligible Somalis being vaccinated against COVID-19

Dr Uday Raj Naidu Canchi Bhoopal (pictured in the middle), a WHO subnational Health Cluster coordinator, joins the Health Cluster strategic advisory group in a humanitarian fund allocation review exercise for partners in Jubaland. Photo credit: WHO/WHO Somalia3 July 2024, Mogadishu, Somalia – Ms Fatima Abdirazak Ahmed joined WHO in Somalia at the beginning of 2024 as a subnational Health Cluster coordinator in Hirshabelle state. Having just finished a meeting with 15 Health Cluster partners, she heads to the office of Hirshabelle State Ministry of Health. Here, she will brief and discuss with the Director-General the ongoing efforts of the Health Cluster to reach vulnerable and underserved communities with health services during the measles and cholera outbreaks across the state. Health Cluster partners thus play a crucial role in the collection and reporting of disease surveillance data.

Dr Uday Raj Naidu Canchi Bhoopal is a subnational Health Cluster coordinator based in Kismayo, Jubaland. He leads regular Health Cluster meetings to coordinate partners’ actions on humanitarian response, from provision of supplies to service delivery, particularly for measles and cholera outbreak response. He also coordinates critical training for Health Cluster partners. Recently, he facilitated training for 12 health professionals, from various health facilities, on clinical management of severe acute malnutrition with medical complications, and cholera case management. The latter gave health workers the knowledge and practical skills to manage cholera cases appropriately and promote infection prevention and control in cholera treatment units in line with globally recognized practices and protocols.

Along with Fatima and Naidu, 5 more state-level Health Cluster coordinators are deployed across Somalia to ensure subnational coordination among partners and with state ministries of health. These subnational Health Cluster coordinators play a pivotal role in emergency response – for example, understanding demand and coordinating the provision of essential supplies – and in health system strengthening. For instance, they promote the use of the Somalia Essential Package of Health Services (EPHS) as a harmonized standard for health service delivery and outbreak response efforts.

Importantly, the Health Cluster coordinators also work with the other clusters, including the Food Security, Nutrition, WASH (Water, Sanitation and Hygiene) and Protection clusters. This coordination enables integrated responses to people in need of humanitarian assistance.

In Somalia, the Health Cluster comprises 81 partners: 28 international non-governmental organizations (NGOs), 42 national NGOs, 4 United Nations agencies, 3 donors, 3 observers and a single national authority. It is co-led by WHO and Save the Children.

Initially, only the national-level Health Cluster Coordination structure was in place. WHO was able to recruit 7 subnational Health Cluster coordinators (4 international and 3 national staff) thanks to funding support from the United States Agency for International Development (USAID) Bureau for Humanitarian Assistance (BHA). Having a well-functioning subnational Health Cluster structure supports operational coordination much closer to the affected population and better adapted to its specific needs, enabling true localization.

Since the subnational Health Cluster coordinators were deployed, the regular Health Cluster coordination meetings have fostered stronger coordination and collaboration among health actors. The impact of the new coordinators’ efforts was showcased at a recent meeting of the Somalia Health Partner Group (SHPG). At the meeting, Erna van Goor, National Health Cluster Coordinator, based in Mogadishu, presented to the donors and partners illustrative maps produced and monitored by the Health Cluster. These maps show the locations and functionality of health facilities and current availability of health services across the country. This presentation vividly demonstrated the complexities and triumphs of the work of the Health Cluster and its coordinators, which was highly valued by humanitarian and development actors for their essential role in preventing duplication of efforts, monitoring service availability and quality, and addressing the health needs of the most vulnerable populations. 

For more information, please contact 

Erna van Goor, National Health Cluster Coordinator, WHO Somalia
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Madinur Saydahmat, Partnerships Officer, WHO Somalia
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MOGADISHU, Somalia, 30^th June 2024 – In a landmark step to accelerate progress towards ending polio in Somalia and accelerating immunization coverage, the Prime Minister of Somalia, His Excellency Hamza Abdi Barre, on 29^th June launched a national task force on immunization and polio and a child survival forum.

The Somalia Immunization and Polio Eradication Task Force (SIPE), which the Prime Minister himself will chair, will oversee polio eradication and immunization efforts across the country, mobilize financial to ensure that every child in Somalia is reached with lifesaving vaccines. The task force comprises key health officials at federal and state levels and international partners.

Speaking at the launch in Mogadishu, Prime Minister Barre reiterated his government’s commitment to stopping the transmission of polio by providing strong support and oversight of polio eradication and routine immunization interventions in Somalia.

“The establishment of the national task force on immunization and polio is a testament to my government’s commitment to this cause,” he acknowledged.” We commit to prevent the vaccine preventable diseases as a leading cause of child mortality and efforts to improve vaccination in Somali as priority for the Government”.

The task force signifies Somali’s commitment at a very high political level to stopping polio, which has been circulating in Somalia uninterrupted for seven years, and immunizing children against vaccine preventable diseases. South central Somalia is one of seven areas that have been identified by the Global Polio Eradication Programme as being ‘consequential geographies’ - they are prone to repeated polio outbreaks which are difficult to control because of overpopulation, fragile health systems, and conflict. The other areas are eastern Afghanistan; southern Khyber Pakhtunkhwa, Pakistan; Tete province and its hinterland in northern Mozambique; eastern Democratic Republic of Congo; northern Yemen; and northern Nigeria. Outbreaks in these countries are potentially exported to other countries. 

During the Launch, The FMOH DG, Dr Guled Abdijalil, presented recent prevalence of polio cases and immunisation status in Somalia in which Since 2021, Somalia has confirmed 16 cases of polio, all in the central south region. An estimated 1.5 million children have never been vaccinated and the country is one of five in the world with an under-5 mortality rate greater than 100 deaths per 1,000 live births. Without intensified efforts, Somalia is unlikely to meet its 2030 SDG target of 25 deaths per 1,000 live births. 

The Prime Minister also launched the Child Survival Forum, which review current progress and devise strategies and an action plan to accelerate progress in reducing child mortality. 

“I am proud to say that the Government of Somalia, along with our partners, has taken several steps to address these challenges, including initiatives such as Damal Caafimaad and Better Lives to ensure universal health coverage for all,” said Health Minister Dr. Ali Hajji Aadam Abubakar. “I call upon all to support integrated service delivery, especially for children.” 

Speaking virtually, Dr Hanan Balkhy, Regional Director for WHO’s Eastern Mediterranean Region appreciated the commitment of the honourable Prime Minister and the Minister of Health in addressing the pressing health challenges facing children in Somalia. “This high-level forum will be instrumental in addressing the protection of more than 1.5 million ‘zero dose’ children who have never received a dose of life saving vaccines and help in bringing the longest-running outbreak of variant poliovirus to an end,” she said.

With 77,000 children dying every year before their fifth birthday, and Somalia in urgent need of accelerated progress to reduce these deaths, the government has stepped up the much-needed leadership. Later this year, Somalia will introduce the pneumococcal and rota vaccines to prevent deaths caused by pneumonia and diarrhoea, two of the leading causes of child mortality. At the global level, a resolution initiated by Somalia calling for accelerated action to end maternal and child mortality around the globe was adopted by the World Health Assembly during its meetings in May 2024, placing Somalia among countries leading from the front in tackling maternal and child mortality. 

“The Global Polio Eradication Initiative is grateful for Somalia’s leadership and strong commitment to their children,” said Andrew Stein, deputy director on the polio team at The Gates Foundation. “Through the government’s leadership, in partnership with nongovernmental organizations, work to stop polio and increase access to immunization is more robust than ever. I am confident that Somalia will prevent thousands of cases of polio, measles, pneumonia, and vaccine-preventable diseases.”   

At the heart of intensified efforts is immunization, which alone can prevent two-thirds of child deaths. Yet, current immunization services in Somalia fall short of the scale and consistency required to make a positive impact on mortality. A recent assessment of health facilities found that immunization services were available in only 56 per cent of public hospitals, 68 per cent of health centres, and 19 per cent of primary health care units. 

“For Somalia to attain progress, immunization services need to be provided more widely and consistently in as many health facilities as possible,” said acting UNICEF Representative Charles Lolika. “We believe that with Somalia's resilience and determination, supported by partners and strategies and guidelines to enhance maternal and child health, rapid progress is possible.” 

The challenges facing Somalia are well documented. Decades of conflict have complicated service delivery, and climate-induced shocks such as droughts and floods have displaced millions of people who now live in overcrowded areas with limited access to services. The country’s health system remains fragile, with inadequate human resources and a limited network of cold chain facilities for delivery of vaccines especially in remote and hard-to-reach areas. 

Notes to editors

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For additional information, please contact:

1. Mohamed Osman, Head of Communication and Public Engagement, Federal Ministry of Health, ( Cette adresse email est protégée contre les robots des spammeurs, vous devez activer Javascript pour la voir. ).
2. Victor Chinyama, Chief of Communication, UNICEF Somalia, Cette adresse email est protégée contre les robots des spammeurs, vous devez activer Javascript pour la voir. .
3. Fouzia Bano, Communications Officer, WHO Somalia, Cette adresse email est protégée contre les robots des spammeurs, vous devez activer Javascript pour la voir.