Participants at the IDSRS workshop formed groups to discuss topics such as the importance of focused disease surveillance in the context of the health challenges facing Somalia

Why Somalia needed to implement the integrated disease surveillance and response strategy

As the COVID-19 pandemic has shown, the world is becoming a smaller place and travel across borders is becoming more accessible to growing populations, and the spread of diseases has become faster and more efficient. The pandemic has also shown that an outbreak in one country can quickly become a pandemic everywhere if the country’s capacity for early detection and effective response is weak. This has made it imperative for countries to prevent the spread of diseases both in-country and across borders, and for countries to act with speed and at scale each time an outbreak occurs in the interests of national and global public health.

Somalia has limited capacity to prevent, detect and respond to disease outbreaks and other acute public health events. This was demonstrated in 2018 by an International Health Regulations (IHR, 2005) assessment. The country’s current IHR capacity and health emergency preparedness index (a measure of IHR core capacity) is 31 out of 100 (at level 1 out of a maximum level 5), meaning that large gaps exist in the core capacities required to prevent, detect and comprehensively respond to public health threats.

Through sustained high-level efforts, led by the Somalia National Institute of Health of the Somalia Federal Ministry of Health, and supported by WHO, Somalia has adopted an integrated disease surveillance and response strategy (IDSRS) as the overall framework for strengthening disease surveillance, to step up efforts to prevent further spread of diseases and outbreaks.

First steps towards integrated surveillance and response: a workshop

As a critical step in the joint planning of IDSRS implementation in Somalia, the Federal Ministry of Health and National Institute of Health, with technical support from WHO, held a multi-stakeholder planning workshop for IDSRS implementation from 11 to 17 July 2021.

Over 60 participants participated in the workshop, including members of the National Institute of Health, Federal and State ministries of health and institutions of higher learning in the country, as well as staff from WHO headquarters, WHO Regional Office for the Eastern Mediterranean, WHO Somalia country office, the United Nations Children’s Fund (UNICEF), International Organization for Migration (IOM), United States Centers for Disease Control and Prevention (US CDC), and the Public Health Institute Sweden. Representatives from the ministries of health of Kenya, Nigeria, Tanzania (United Republic of) and Uganda also participated.

Objectives of the ISDR workshop

The objectives of the workshop included to sensitize the high-level officials from the National Institute of Health and Federal Ministry of Health on health security, public health emergency operation centres (PHEOCs) and the IDSRS. The workshop also aimed to consult on the updating of the country’s list of priority hazards to guide the drafting of the country’s all-hazard preparedness and response plans and contingency plans for the highest-ranking priority hazards. By bringing together stakeholders, the workshop worked to generate an overall consensus and agreement on the next steps towards the establishment of the IDSRS and PHEOCs in Somalia.

To engage participants, the workshop used a blend of physical and online PowerPoint presentations, groupwork sessions, tabletop exercises, and plenary presentations and discussions. Participants from Kenya, Uganda, Nigeria, Tanzania (United Republic of), Public Health Institute Sweden and US CDC shared their experiences to enrich the exchange of information.

Outcomes and outputs of the workshop

Participants gained knowledge on health security, health emergency concepts, and the main hazards and risk profile of Somalia, as well as on public health emergency operations, including plans, policies, procedures and risk assessment. Through technical groups, participants identified next steps and timelines for establishment of the IDSRS and PHEOCs.

Additionally, groups discussed the response to common challenges facing Somalia, such as cholera, flash floods, drought and armed conflict.

The key discussion points and themes for the IDSRS included optimizing good leadership and accountability, ensuring functional IDSRS design and country ownership, conducting high-level advocacy, ensuring constant availability of skilled health workers, institutionalizing IDSRS and PHEOC training into local institutions of higher learning, scaling up event-based surveillance and community-based surveillance, rolling out electronic IDSRS, providing feedback and information-sharing, and integrating the IDSRS into the broader national health information system.

Next steps towards creating a robust and effective IDSRS

To move the agenda forward, the National Institute of Health and Federal Ministry of Health, with support from WHO and other partners, will develop a costed three-year IDSRS operational plan, IDSRS technical guidelines and training materials.

A PHEOC roadmap and PHEOC plans, such as the all-hazards preparedness and response plan, and national-level and state-level hazard-specific contingency plans, will be developed in due course. To enable the States to develop focused preparedness and response plans, an assessment of hazards will be conducted at the subnational level.

The team working on the IDSRS has already finalized the national risk profile report and the handbook for PHEOC operations. Furthermore, the Federal Ministry of Health will identify and appoint PHEOC staff at national and state levels who will be trained with the support of WHO, and will procure and install the basic equipment required for PHEOC operations to ensure they are functional and efficient.

All these steps will ensure Somalia has in place a robust, effective and sensitive disease surveillance system that can nip in the bud outbreaks before they become a large threat to Somalia and the world.

The establishment of an IDSRS will go a long way towards safeguarding national health security through improvement in surveillance, detection and response to emerging and re-emerging infectious diseases, including all health threats which have the potential to cross borders and become a public health emergency of international concern.

WHO, with funding support from Canada through ACT-A Health Systems Connector, is implementing the IDSRS as part of health system building in Somalia.

The IDSRS workshop provided a platform for key partners to join together to establish a functional and extensive disease surveillance system in Somalia

Mogadishu, 10 October 2021 – For this year’s World Mental Health Day, the WHO global theme is ‘Mental health care for all: Let’s make it a reality’. Over the past year, there is no doubt that the COVID-19 pandemic has had a major impact on the mental health of millions across the world, especially health and other frontline workers, people living alone, and persons with pre-existing mental health conditions. Moreover, at a time when mental, neurological and psychosocial support services were perhaps most needed, there were significant disruptions to essential health care, including mental health services at all levels, owing to the COVID-19 pandemic.

However, there remains cause for optimism – with COVID-19 vaccine coverage improving, more people are accessing health services, including for mental health. Moreover, during the World Health Assembly 2021, governments from around the world recognized the need to scale up quality mental health services at all levels – a task towards which WHO continues to strive alongside governments worldwide, including in Somalia.

Somalia has particularly been impacted by mental health challenges owing to decades of protracted conflict, which has severely disrupted social cohesion, broken down social norms and led to nearly one in every three Somalis suffering from some form of mental health condition. In response, the Federal Government of Somalia and United Nations (UN) in Somalia joined forces to reiterate support for this year’s World Mental Health Day theme, as well as to convey one additional key message specific to Somalia: take bold steps and offer quality mental health care and services in the country.

“We all have a role to play in supporting one another as a society and to make mental health a reality in Somalia,” said HE. Dr Fawziya Abikar Nur, the Minister of Health and Human Services of Somalia. “We can support people, and listen to them, and their friends and relatives, who have been the worst victims of violence and conflict for years. We can also work with them so that they discuss their mental health problems with health care workers in confidence and also advocate and mobilize for quality mental health care services to be available at all levels, including at the primary level.”

The Honorable Minister added that communities needed to drop the stigma around mental health, seek the right support, and speak about their issues more openly to manage stress and improve people’s well-being.

To address these challenges, the Federal Government has worked with WHO to develop a mental health strategy for 2019-2022 and is currently finalizing a mental health policy. Also, with support from the UN Peacebuilding Fund from 2020-2021, and in a partnership between the International Organization for Migration (IOM), the United Nations Children’s Fund (UNICEF), Somali National University and WHO, the Federal Government has been leading the implementation of a mental health project in the context of ‘health for peace’ with focus in Baidoa, Kismayo, Dollow, Galkaayo and Mogadishu. This project has supported health care workers to understand, address and provide more care for people in need of mental health support, as well as raise awareness about mental health issues. The project is also generating evidence on the interlinkage between mental health and peace, a topic that has not been well researched or studied anywhere in the world.

“Now more than ever, Somalis need mental health support. As a resilient society, Somalis have endured the effects of protracted conflict, and one health emergency after another,” said Dr Mamunur Rahman Malik, WHO Representative to Somalia. “Together with the Federal Government and partners, we are making sure that the WHO Mental Health Gap Action Programme is integrated at all levels of care, especially at the community and primary level care.” 

“The conflict in Somalia is impacting millions of children. Continued exposure to violence, fear and uncertainty can have a shattering impact on their behaviour, learning, emotional and social development for years,” said UNICEF Somalia Representative, Mohamed Ayoya. “It is our collective job and responsibility to help these children recover and regain some sense of normalcy. Together with the Ministry of Health, WHO and partners, UNICEF is providing children – who have witnessed extreme violence and loss – mental health and psychosocial support.”

“No health system can be fair unless it provides mental health services to those who need them the most, so UNDP Somalia supports counselling and mediation for vulnerable groups, including women who face violence and families dealing with conflict,” said Jocelyn Mason, UN Resident Coordinator a.i. and UNDP Somalia Resident Representative.

During this year’s World Mental Health Day, the WHO country office for Somalia stands firmly behind the global theme of ‘Mental health care for all: Let’s make it a reality’ and will continue to work closely with the government and all partners to scale up quality mental health services at all levels across Somalia.

For more information, please contact: 

Khadar Hussein Mohamud
Head of Coordination and Communication
Federal Ministry of Health
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+252 615 602 637

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

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
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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
This e-mail address is being protected from spambots. You need JavaScript enabled to view it
+252619235 880