Transcript Mass Migrations and General Health Issues

Mass Migrations and General
Health Issues- Somalia
Dr Abdisamed H Mohamed
Turkish-Somali Coordinator MOH.
Yardimeli children and Maternal Hospital- Mogadishu Somali
Somalia
• Population: 12 millions (estimated).
• Somalia shares its borders with Ethiopia on the
west, Djibouti to the northwest and Kenya to the
southwest.
• Its long coastline connects it to the Gulf of Aden to
the north and the Indian Ocean to the east.
• Somalis share a common ethnicity, language, and
religion that also transcends across borders.
• Despite the homogeneity, clan affiliations are a
deep and divisive component of cultural identity.
• The major clans are the Hawiye, Darood,
Dir/Isaaq, and Rahanweyn (Digil and Mirifle)
(see map 1). The Isaaq clan primarily in the
northeast (Somaliland) and The Haarti (a
subset of the Daarood) is located in the east
(Puntland)
• The Bantu, Benadir, Gaboye and Bajuni groups
form part of Somalia’s ethnic minorities.
Human Development
• Even before the state collapse and years of civil
conflict, Somalia was already among the poorest
countries in Africa;
• The 2012 Human Development Report estimates
Somalia’s GDP at USD 284 per capita, which is
significantly lower than the sub-Saharan African per
capita average of USD 1,300.
• During the conflict, Somalia maintained an informal
economy, based mainly on livestock, remittance, and
telecommunications.
• Livestock, hides, fish, charcoal and bananas are
Somalia’s principal exports
Human development
• livestock is the mainstay of the economy and is
estimated to create about 60 % of Somalia’s job
opportunities and represent 40 % of its GDP.
• The export of livestock and meat generates 80 %
of foreign currency.
• External humanitarian and development aid has
accounted for USD 75 per capita, which is more
than double the per capita average for other
fragile states.
• Over 73 per cent of the population is under the age
of 30 yrs.
Factors drive voluntary and crisisinduced mobility in Somalia
• The main factors that drive Somali’s to migrate
are political crisis, clan-based warfare and lack
of development.
• The country’s traditional mobility patterns
– property loss,
– resource degradation,
– or from the socio- cultural impacts of generations
in crowded settlements or urban environments.
The result…
• As a result of the insecurity, low economic
opportunity and natural climaties such as drought
and flooding:
– about 14 per cent of the population – or more than
one million Somalis live as part of the diaspora.
– about 1 million Somalis are refugees in mainly
neighboring countries;
– no fewer than 1.1 million people have been displaced
internally.
REFUGEES
• The current estimate of the number of Somali
refugees is 1,023,722, located primarily in:
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Kenya – 474,483;73
Ethiopia – 235,316;74
Yemen – 231,064;75
South Africa – 26,190;76
Djibouti – 18,725;77 and
Egypt, Eritrea, Tanzania, and Uganda also host.
Women and children make up about 70-80 per cent
of all refugees and IDPs.
INTERNALLY DISPLACED PERSONS (IDPS)
• Most IDPs originate from south-central Somalia and have
remained within the region, likely in close proximity to their
places of residence.
• In Somaliland, some of the IDPs were originally refugees
that had fled to Ethiopia during the 1987 civil war.
• As of February 2013, the estimates of IDPs in Somalia
ranged between 1.1 million and 1.36 million. The
geographic distribution of IDPs regionally is:
– South-central Somalia-920,000, of which 372,000 are in
Mogadishu;
– Puntland-130,000; and
– Somaliland-84,000
• Europe is currently experiencing an
unprecedented influx of refugees, asylum
seekers and other migrants
• 1.5 million people arrived in the European
Union (EU) in 2015, fleeing countries affected
by war, conflict or economic crisis.
• Mostly from Syria, but also from Afghanistan,
Eritrea, Iraq, Nigeria, Pakistan, Somalia, as well
as the Western Balkans.
Labor migrant and diaspora
• Approximately one million Somalis are
estimated to be concentrated mainly in the
Horn of Africa and the Arabian Peninsula but
now also in Western Europe and North
America.
The Health Crisis
• The widespread conflict and political strife
have crippled the health system and essential
infrastructure, resulting in sub-standard and
inadequate health services and water
provision in Somalia.
• The capacity of health authorities is limited,
and the country faces chronic shortages of
qualified health personnel and equipment.
• No trained nurses or midwives (traditionally
trained are present)
• In the rural and nomadic areas and overall
there is an estimated 1.1 nurses and
physicians per 1,000 people.
• Access to adequate health care and referral
services are thus very limited particularly for
those in hard-to-reach locations.
• The country bares the highest under-five
mortality rate and the second highest
maternal mortality ratio globally .
• Reports showed that some Somalis cross the
border and seek treatment for multi-drug
resistant tuberculosis (MDR-TB) and/or other
health care services in Kenya.
• More than three quarters of the population lack
access to proper sanitation safe drinking water.
• The severe water scarcity has been another driving
factor for internal displacement.
• Existing water sources are inadequate in regards to
accessibility, quantity and quality for human and
livestock consumption.
• Less than 20 % of the populations in rural and
pastoralist communities have access to improved
drinking water, while 45 % of the urban population
has access to improved water sources, which are
mainly in the form of piped or potable water.
• For the past two years, the consecutive lack of
rain coupled with poor water and available
pasture in the rural areas has worsened the
humanitarian situation.
• Along with consistently high temperatures,
this has led to dried-up shallow wells and long
water-trekking expeditions to reach existing
boreholes.
• Access to and availability of safe water is
critical, limited, and is a potential cause for
both conflict and internal migration.
Health
• The country severely struggles to achieve the
Millennium Development Goals (MDGs)
particularly in the areas of
– under-five mortality and maternal health
– Communicable diseases (tuberculosis’ etc.)
– illiteracy,
– gender disparity and
– malnutrition among many other indicators.
According to government officials MDG progress
reports, it is unlikely to meet most of the MDG targets
by 2015
Health problems
• Migrants tend to be in relatively good health when
their journey begins.
• Aspects may have a negative influence on their health,
throughout the process of migration:
– pre-departure: traumas suffered from war, conflict,
violence, torture, etc.
– during the journey ( duration of the journey): -strenuous,
perilous, crammed; lacking basic health necessities, etc.
– upon arrival in host community:
a) Injuries and other conditions suffered during migration:
accidental injuries and small wounds, burns and
blisters, sunburn, dehydration, and musculoskeletal
problems.
b) Communicable (or infectious) diseases :
foodborne diseases such as - salmonellosis,
hepatitis A virus infection and cholera.
Vulnerable groups – children, pregnant women
and the elderly – are particularly susceptible.
vector- borne diseases such as: malaria,
leishmaniasis, relapsing fever, rickettsial diseases
and typhus.
c) Non-communicable (or chronic) diseases:
cardiovascular diseases, cancers, chronic
respiratory diseases and diabetes. high rates of
hypertension that have been observed
In 2011
• Turkey's Prime Minister and current President
Recep Tayyip Erdogan and his family have
arrived in Somalia's capital to highlight the
need for greater famine relief.
2011
• A fund raising campaign for
building and equipping
Somali Hospitals started in
Turkey
• Turkish government, Turkish
and Somali NGO’s’
Yardimeli, Turkish and
Somali Ministry of health
have jointly started working
together.
10/04/2017
@Dr Abdirizak Hassan Mohamed
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Health problems specific to women
d) Mental health issues: psychological problems
such as post-traumatic stress disorder (PTSD), mood
and anxiety disorders, and panic attacks, with
symptoms of sleeplessness, nightmares and
flashbacks.
e) Problems related to reproductive health, such as
complications with pregnancy and childbirth, as well
as the risk of exposure to (sexual) violence and
abuse.
• Somali migrant face post-migrant problem
that affect their well-being.
• Somali migrant generally meet mental health
problem(mental disorder)- Jinni or
evil,abnormal behaviour.
• They also have pyschiatric and pyschological
problem(major depression,distress or
generalized anxiety)
• Thank you very much