29 September 2021 – Three decades after a civil war and several natural and manmade disasters, the resilience of Somali communities and health workers have been put to test many times. Each time the sound of an explosion reverberates across a city or town, under-resourced health facilities scattered sparsely across the country can expect to receive an influx of mass casualties.

At their end, health workers managing these health facilities are usually under-prepared, with limited access to modern tools, equipment and skills, that limit their response and reaction to mass casualties and resulting trauma, which is ubiquitous. A primary assessment conducted by WHO across 142 hospitals in Somalia found that trauma poses a heavy burden on the health system and communities, and that conflict contributes to around half of all civilian cases of trauma.      

Introducing modern tools, techniques and thinkings through mass casualty management courses

In 2020, in recognition of the situation and to support hospital teams in mounting a more efficient and effective response to mass casualties, the Federal Ministry of Health and Human Services of Somalia partnered with WHO Somalia, WHO headquarters and the WHO Regional Office for the Eastern Mediterranean, with financial support from the Pandemic Emergency Financing Facility (PEF) of the World Bank.

After a few weeks of planning, the WHO Academy conducted 2 of their very first 5-day mass casualty management courses throughout January and February 2021, where 10 expert trainers from different parts of the world trained 74 Somali doctors and nurses in Mogadishu and Hargeisa. This was the first WHO Academy certified course held in Africa on mass casualty management.  

“Although nearly all of the trainees were aware of the concept of a mass casualty plan, few had any experience of one and many had no real idea of what a plan entailed. By the end of the course, the trainees were more familiar with the concept of working in a team and the design and implementation of a mass casualty plan. Most importantly, after 5 days of training, it was possible to see an evolving understanding of underlying concepts and an ease with communicating with colleagues in the language of mass casualty,” said Dr Neil Shorney, Consultant Anaesthetist, WHO Trauma Operational and Advisory Team Expert Adviser, WHO Academy Mass Casualty Management Programme.

Feeling more prepared to deal with mass casualties

As a member of the Somali Medical Association and the Somali Paediatric Association, and currently serving as a paediatric doctor at the SOS Children’s Village in Somalia for the last 8 years, Dr Abdirahman Osman Mohamud knows how important it is for children to receive timely attention. After all, according to the primary assessment that WHO carried out, about a third of all casualties are children aged under 15 years.

At the mass casualty training he attended in Mogadishu, Dr Mohamud learnt how to activate mass casualty management phases, prepare a plan for mass casualties, and work with different zones appropriately, should the health facility ever receive children involved in an incident.

Dr Zainab Abdirahman Ali from South Galkacyo Hospital reiterates the same messages. Before the training, none of the participants had plans to deal with mass casualty incidents, but the training helped health workers and, as a result, medical and non-medical staff, to use triage points to prioritize people’s needs. A practical session, whereby participants had to draw a plan of the hospital and divide it into triage points, also helped them discuss ideas. Dr Zainab feels the training motivated her and other fellow doctors and nurses to save more lives.

In Hargeisa, when he was young, Dr Saddam Hussein Abdi couldn’t understand how so many people he knew fell sick and died within no time. It was and still is a norm. Years later, as a participant in the mass casualty management training being run by the WHO Academy, Dr Hussein explains to facilitators how education is a key ingredient in a health system and will help the new generations of health care workers, like him, to help their communities.

“For now, thanks to WHO and the World Bank, we have had a chance to learn about important topics like dealing with mass casualties and hospital management that will make us more efficient at what we do. I have been one of the lucky ones. But all doctors need opportunities like these and more.”

WHO Academy groundbreaking ceremony

On Monday, 27 September 2021, WHO Director-General, Dr Tedros Adhanom Ghebreyesus, joined H.E. President Emmanuel Macron of the Republic of France, at a groundbreaking ceremony for the WHO Academy in Lyon, France, to inaugurate the construction of its futuristic campus. At the event, President Macron asked a Somali surgeon and WHO Academy certified mass casualty management trainee, Dr Siyad Mohamed Abdi, about his learning experience.   

Dr Abdi, who works at a number of hospitals in Galmudug State in Somalia, explained that the training had enabled health professionals to respond better to mass casualties and emergencies, by prioritizing the needs of casualties and allocating resources for such events. He shared an example of how the hospital team was better prepared to deal with the casualties from an explosion after they had acquired skills from the training.   

Photo: Dr Siyad Mohamed Abdi (bottom right) addresses Dr Tedros, President Macron and WHO Academy Executive Director, Dr Agnès Buzyn (top right) during the groundbreaking ceremony, 27 September 2021, while health professionals from other countries listen to the discussion.

Related links

French President and WHO Director-General commend Somali doctors who participated in WHO Academy certified training course on dealing with mass casualties

WHO Academy Groundbreaking Ceremony Expanding Access to Critical Learning

For further details, please contact:

Mr Kyle DeFreitas
WHO Somalia
External Relations Lead/OIC Nairobi Liaison Office
This e-mail address is being protected from spambots. You need JavaScript enabled to view it    

Ms Fouzia Bano
WHO Somalia
Chief of Staff ai, Communications Officer
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Photo: Dr Siyad Mohamed Abdi (bottom right) addresses Dr Tedros, President Macron and WHO Academy Executive Director, Dr Agnès Buzyn (top right) during the groundbreaking ceremony in France, while health professionals from other countries listen to the discussion, 27 September 2021

MOGADISHU, 29 September 2021 – The World Health Organization (WHO) Academy held a groundbreaking ceremony, in the presence of the President of France, HE Mr Emmanuel Macron, the WHO Director-General, Dr Tedros Adhanom Ghebreyesus and Executive Director of the WHO Academy Dr Agnès Buzyn to inaugurate the construction of its futuristic campus in Lyon, France, on 27 September. At the event, President Macron addressed Dr Siyad Mohamed Abdi, a Somali surgeon and trainee of the WHO Academy certified training course on mass casualty management held in Mogadishu, to hear about his learning experience. 

The WHO Academy developed and organized an operational, context-specific and team-based training course for Somali health workers in January and February 2021 that prepares them to respond effectively and efficiently to mass casualty incidents. This was the first certified course of WHO Academy organized in Africa on mass casualties management to be organized by WHO Somalia country office, with funding from the World Bank’s Pandemic Emergency Financing Facility. As part of the course, 10 international master trainers from the WHO Academy trained 74 doctors and nurses in mass casualty management in Mogadishu and Hargeisa.

Dr Abdi, who works at a number of hospitals in Galmudug State in Somalia, explained the training enabled health professionals to design and upgrade their own hospital mass casualty plans, to be more effective and efficient, work as teams, and exchange best practices and experiences with one another.

“Somalis witness road traffic accidents, bomb explosions, and natural disasters so often. Additionally, conflict causes around half of all civilian trauma cases,” added Dr Mamunur Rahman Malik, WHO Representative and Head of Mission to Somalia. “We are thankful to the World Bank, the WHO Academy, the WHO headquarters and our Regional Office, as well as to several other partners who gave Somali doctors and nurses the well-planned and evidence-based learning opportunity to rethink their response, both individually and collectively, to casualties. This course offered them skills and practical simulations that will help them plan for, respond to, and cope with mass casualties, which will inevitably save more lives.” 

“The quality of the health workforce is the key to resilience during a health crisis,” said President Macron. “Investing in health systems is the best way to prepare for future pandemics. Success requires unprecedented coordination of all actors. WHO is, of course, a key player and its Academy will be an essential platform for disseminating learning.” 

“The ambitions of the WHO Academy are not modest: to transform lifelong learning in health globally,” said Dr Tedros. “The COVID-19 pandemic is a powerful demonstration of the value of health workers, and why they need the most up-to-date information, competencies and tools to keep their communities healthy and safe. He added, “The WHO Academy is an investment in health, education, knowledge and technology, but ultimately it’s an investment in people, and in a healthier, safer, fairer future.” 

Representatives from the Government of the Republic of France, Federal Republic of Somalia, UN, international organizations, academia and the health, academic and economic sectors participated in the event. It was broadcasted live on the WHO website and on social media (Twitter, YouTube, Facebook).

NOTE TO EDITORS

The World Bank, through its Pandemic Emergency Financing facility, provided support to the Mass Casualty Management training in Somalia.

The WHO Academy is a state-of-the-art training institution that aims to bring the lifelong learning revolution to the health sector and reach 10 million learners around the world by 2023. For additional information, please see the WHO Academy website and press release for the ceremony.

For further details, please contact: 

Mr Kyle DeFreitas
WHO Somalia
External Relations Lead/OIC Nairobi Liasion Office
This e-mail address is being protected from spambots. You need JavaScript enabled to view it
+254-782-501-324    

Ms Fouzia Bano
WHO Somalia
Chief of Staff ai, Communications Officer
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+252619235 880 

Mogadishu, 17 September 2021 – While commemorating World Patient Safety Day yesterday, the Federal Government of Somalia, in collaboration with the World Health Organization (WHO), United Nations Children’s Fund (UNICEF) and United Nations Population Fund (UNFPA), urged health facilities, health care workers and other stakeholders to step up efforts to ensure mothers and newborns remain safe.

This message echoes this year’s theme for World Patient Safety Day — ‘Safe maternal and newborn care’ — and comes at a time when the coronavirus disease-2019 (COVID-19) has disrupted continuity of already overstretched essential health services across the country.

A national ‘pulse survey’ conducted by WHO over seven months in 2020 and 2021 to determine the continuity of essential services in Somalia found that, during May–September 2020, 33% of essential health services had been disrupted (one out of three services), while during January–March 2021, there was continued disruption of 12% of essential health services (six out of 51 services), indicating that substantial disruptions persisted even after one year of the pandemic. Six of the major essential health services where significant disruptions were noted include reproductive, maternal, newborn, child and adolescent health services, that experienced between 5 and 50% disruption, and immunization services, disrupted by between 5 and 20%.

Even before the COVID-19 outbreak was confirmed in Somalia, the country was known to have one of the highest maternal mortality rates in the world, at 692 maternal deaths per 100 000, and a neonatal mortality rate of 40 deaths per 1000 live births.

“Before the COVID-19 pandemic, 68% of women did not visit health facilities for antenatal care and only one third of births were delivered with the help of a qualified health care practitioner,” said Dr Fawziya Abikar Nur, Minister of Health and Human Services for Somalia. “Since the COVID-19 pandemic was confirmed in Somalia, women have been making even fewer visits to seek help. I would like to encourage all our partners to reconsider their strategies to ensure more pregnant women access health facilities for antenatal care, deliveries, and immunization, to offer young children a safe start to their lives.”

As part of this year’s World Patient Safety Day commemorations, all partners, including WHO, are urging all stakeholders to “Act now for safe and respectful childbirth.” Ensuring appropriate and respectful treatment to delivering women and their babies will increase trust in health facilities, utilization of services and support by the communities.

“At the points of care, we need to continue to develop the capacity of health care workers, while maintaining the highest standards of hygiene and safety to prevent any potential spread of diseases and to ensure patients recover,” said Dr Mamunur Malik, WHO Representative to Somalia. “At the same time, we need to encourage family members, including men, to bring pregnant mothers to their nearest health centres for regular antenatal care and delivery, to prevent women and children from dying of preventable causes and unsafe care. With concerted efforts, we can save more lives, but we all need to act now to make a change.”

“Having a skilled pair of hands – a well-trained doctor, nurse or midwife – present during pregnancy, birth and beyond, is key in giving every Somali child a chance to survive and thrive from the very beginning,” said UNICEF Somalia Representative, Mohamed Ayoya. “UNICEF is proud to partner with the Government of Somalia to enhance its efforts to reach vulnerable women and children, living in the most disadvantaged areas and enduring the harshest conditions, who need the support most, amid the COVID-19 pandemic.”

“Every mother has a right to a safe delivery through skilled birth attendance at birth. This is a service that can be scaled up to reach the underserved and underprivileged population across the country. This can be achieved through the ongoing engagement of the public sector and the services provided by the non-government sector,” said UNFPA Representative, Mr Anders Thomsen.

Mr Thomsen said skilled birth attendance is an evidence-based public health intervention to reduce maternal and neonatal mortality and morbidity. “UNFPA continues to invest in this effort in close partnership with the Ministry of Health, by supporting health facilities providing life-saving skilled birth attendance at birth as well as ensuring the production of qualified midwives who provide the best option in Somalia for truly reaching the most underserved population in the country with safe and life-saving care,” said M Thomsen.

Introduced in 2019, World Patient Safety Day aims to promote understanding of patient safety, increase public engagement in health care safety, and promote global action to prevent and reduce avoidable harm in health care. This year, on the World Patient Safety Day, WHO, UNICEF and UNFPA committed to support the Federal Ministry of Health and Human Services to introduce new interventions and measures across the health facilities in the country, which will ensure safer maternal and newborn care every year.

Related link

Press release in Somali

For more information, please contact:

Khadar Hussein Mohamud
Head of Coordination and Communication
Federal Ministry of Health
This e-mail address is being protected from spambots. You need JavaScript enabled to view it , +252615602637

Fouzia Bano
WHO Chief of Staff ai, Communications Officer
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+252 619 235 880

Eva Hinds
UNICEF Communication Manager
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+252 613 642 635

Pilirani Semu-Banda
UNFPA Communications and Partnerships Specialist
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+254 734 500 439

Editor’s notes

World Patient Safety Day was established in 2019 by the 72nd World Health Assembly through the adoption of resolution WHA72.6 – “Global action on patient safety”. The Day is firmly grounded in the fundamental principle of medicine – first do no harm.

The findings of the second round of the national pulse survey conducted by WHO on the continuity of essential health services during the COVID-19 pandemic for Somalia are available at the interactive dashboard.