International Medical Corps has been operating in Somalia since 1991, when it became the first American non-governmental organization (NGO) to arrive in the war-torn Somali capital of Mogadishu after the overthrow of President Siad Barre. Throughout the past two decades, International Medical Corps has implemented health; nutrition; livelihoods; and water, sanitation, and hygiene (WASH) programs in multiple locations of Somalia, implementing programs that build local health care capacity, while serving the immediate health needs of the most vulnerable men, women and children.
In October 2012, heavy rains in south central Somalia caused the region’s main river, the Shebelle, to reach its highest levels in 50 years, resulting in burst banks and unprecedented flooding. Beledweyne, a city with a population of 144,000, was one of the worst-affected areas and suffered severe damage to a wide range of critical public infrastructure and homes, which resulted in the extensive displacement of families.
The floods have had a particularly devastating effect on this community, which was already struggling to recover from the 2011 drought that destroyed their farms, livelihoods, and homes. An estimated 34,602 people displaced by the drought and then the flood currently reside in Beledweyne, and generally depend on shallow wells and boreholes to meet their domestic water needs, most of which were destroyed and/or heavily contaminated by the severe flooding. On average, these people must now travel 3-4 miles by foot to find clean water, as sourcing water from the Shebelle River and shallow wells now exposes them to dangerous, water-related diseases.
Over the last 18 months, International Medical Corps, with support from Global Giving and other donors, implemented a program in Beledweyne to ensure that the most vulnerable, including displaced persons, women and youth, have increased access to safe and reliable water supplies. To achieve this goal, International Medical Corps identified and rehabilitated three water sources; and trained local residents to act as water management committee members to ensure the rehabilitated water sources remain clean while also educating the community about proper water handling, storage and treatment techniques.
In order to deliver this program, International Medical Corps’ team in Beledweyne first conducted an assessment, in collaboration with the local community, to select the three most effective water points for rehabilitation. Selection criteria included:
The three communal water points selected for rehabilitation are located in three different communities in Beledweyne, helping to ensure access to clean water for the greatest number of people. Overall, the rehabilitation of the three wells now provides access to safe water for more than 1,500 households -- approximately 7,900 people!
The next step of the program was to select and train water management committee members to maintain the rehabilitated wells and teach the community proper water handling techniques. After consulting with community leaders, 15 water management committee members were identified from the villages with rehabilitated water sources (5 committee members per rehabilitated well).
Between March 11 and 12, 2014, the committee members took part in a comprehensive training, based on internationally-accepted standards, on water source management. In addition, they completed a one-day training on hygiene promotion together with community leaders selected in collaboration with village elders. The key tasks of these water management committee members includes promotion of safe water and sanitation practices and maintenance of the rehabilitated wells.
In addition to training water management committee members, teams provided a one-day training workshop to the communities surrounding the wells on March 12, 2014. Participants in this workshop included key community leaders from the areas most affected by waterborne diseases in recent years, including Buntaweyn, Kooshin, Hawataako and Hawlwadaag. A total of 21 participants received training on the effects of consuming contaminated water, and how to spread community awareness of the issue and treatment of contaminated water. Other topics covered included the importance of hygiene, for individuals and households, the importance of using safe water to clean and prepare food, and proper waste disposal.
Finally, International Medical Corps, in collaboration with other organizations working in Somalia and the previously trained community leaders, provided training to communities to increase awareness of the importance of protecting water sources. During this one-day community mobilization meeting, International Medical Corps used a hands-on, participatory approach to inspire action and encourage community members to take leading roles in the planning, management, monitoring and evaluation of their water sources.
Through the generous support of Global Giving and other donors, International Medical Corps was able to provide desperately needed clean water to communities affected by the 2011 drought and 2012 flooding in Beledweyne, Somalia benefitting 1,500 households and 7,900 people. With better access to clean water, families will be exposed to fewer waterborne diseases, improving their overall health. Moving forward, community members now have the skills to ensure that the rehabilitated water points continue to provide clean water for years to come and that hygiene messages and training are spread throughout the communities. Embedding skills in the community lies at the heart of International Medical Corps’ mission: building self-reliance.
Since 1998, International Medical Corps has worked alongside the Ministry of Health in Kenya to implement a variety of programs in underserved communities throughout the country, including health care, nutrition, tuberculosis and HIV/AIDS prevention care and treatment, and water, sanitation and hygiene (WASH). Using a multi-pronged approach, International Medical Corps’ programs not only provide relief, but also enable self-reliance through education and training.
In 2007, International Medical Corps began work in the semi-arid regions of northern Kenya, including Samburu District, where water is very scarce and women and children walk miles to collect water on a daily basis. Samburu suffers from uneven rain across the district during the four months of rainy season. The people of Samburu are nomadic pastoralists, dependent on livestock and access to water for their livelihoods. Failure to obtain sufficient water for grazing livestock can mean the difference between life and death. The drought and famine crisis in 2011 created an emergency in Samburu, and the region has been fragile ever since. With support from generous donors, International Medical Corps is continuing its work in Samburu District and the region, aimed at improving provision of access to adequate and quality water, improving access to adequate and quality sanitation facilities to vulnerable community members, and improving the health and nutrition status of mothers and children.
In several rural primary schools in Samburu, International Medical Corps is implementing integrated activities aimed at improving the sanitation and hygiene of young children. Lolkunyian Primary School serves 247 students, drawing students from up to a three-hour walk away. Before International Medical Corps’ intervention, the male and female students had to share only three latrines, with no available hand washing stations and no access for disabled students. In response, International Medical Corps recently built two blocks of same-sex latrines, with three to four standard stalls and one stall specifically for persons with disabilities. Additionally, a hand washing station and water harvesting system has been installed to further promote hygiene-related health.
In Donyo Wasin Primary School, which serves 340 students, International Medical School has encouraged the formation of a Health Club to improve the hygiene practices of the students as well as the surrounding community. The Health Club, which is made up of 58 students (30 male and 28 female) from grades one through eight, performs songs and plays which teach sanitation and hygiene techniques for fellow students and the community. As a result of these activities, International Medical Corps has noted significant improvements in beneficiaries’ health, with fewer students visiting the school nurse with complaints of water related illnesses and a decrease in the practice of open defecation in the community.
In Nkutoto, villagers from the surrounding area travel great distances, particularly in the dry season, to reach the only viable water source that is located in the mountains. Unfortunately, this natural spring is unprotected, and is frequently contaminated by wild animal and livestock waste when they use the spring to drink. This contamination resulted in a small-scale cholera outbreak in 2013. After consulting with the community and the Ministry of Health, International Medical Corps constructed a pipeline to bring the water down the mountain, and is currently constructing a cover for the natural spring to protect it from future contamination. With the newly constructed water tap, the community no longer has to walk up the mountain, often with livestock in tow, to reach the water source.
Although the drought crisis has largely passed, International Medical Corps continues to engage the vulnerable population of Samburu District with water, sanitation, and hygiene programs designed to address both their immediate and long-term needs. International Medical Corps’ program is providing schools with improved sanitary facilities and promotion of appropriate hygiene practices, with the help of the health clubs, which will help to improve the quality of life of the children and the teachers, contribute to decreasing school dropout, and reduce communicable diseases such as diarrhea. In addition, the improved water sources, combined with training on how to protect and manage them, will help ensure a modest yet sustainable water supply for the community, improving the lives of mothers and children in this extremely water-scare environment.
International Medical Corps has been working in Somalia since 1991. At the height of the drought and famine crisis in 2011, International Medical Corps resumed operations in Mogadishu after several years of being unable to access the city due to the control of various armed groups. Since then, International Medical Corps has provided critically needed primary health care services to affected populations, particularly internally displaced persons (IDPs).
With the support of generous donors, International Medical Corps began directly managing two permanent clinics in the Wadajir and Wardhigley Districts in Mogadishu. International Medical Corps has provided extensive training to clinic staff to improve their short- and long-term ability to provide high-quality health care to Mogadishu’s residents. International Medical Corps recently upgraded these two primary health care clinics in Mogadishu into health centers, which offer IDPs and other vulnerable populations an integrated, comprehensive package of primary health care services including comprehensive antenatal care and planned basic emergency obstetric and neonatal care.
On December 30, 2013, an 11 month old baby girl named Ikhlaas, who was suffering from oral thrush - a fungal infection in the mouth - and abdominal pain, was brought by her mother to see the consultant nurse at the International Medical Corps supported health center in the Wadajir District. Ikhlaas's family is currently living in the Siliga IDP camp that is located next the health center. Her entire family including her sisters, brother and mother have accessed health care services from International Medical Corps’ clinic including vaccination services (Expanded Program on Immunization), free treatment services and health education sessions.
Unfortunately, this is not the first time little Ikhlaas has had to visit International Medical Corps’ clinic. The first time she was seen, Ikhlaas was only six months old and was successfully treated for dysentery. During this particular visit, Ikhlaas was examined by our physician, treated and discharged on the same day. Ikhlaas’s mother continues to recognize International Medical Corps’ health center as the best place for her to seek health care services. She expressed her satisfaction of the services offered while adding that these crucial services are essential to the overall health of the IDP community.
Over the next 5-6 months, International Medical Corps will continue its operations in this clinic and others like it serving the IDP community. In addition to supporting services at the health center, International Medical Corps plans to support implementation of a vaccination campaign with supplies provided by U.N. Children’s Fund (UNICEF), engage the clinic staff in the national polio campaign, and contribute to the coordination of health activities in Mogadishu.
While the drought crisis has largely been resolved, the IDP population in Mogadishu has not significantly decreased due to continued unrest in the county, and the needs of IDPs remain high. Compounding this problem, the recent reduction of NGO operations in Mogadishu and across Somalia have resulted in higher demands on International Medical Corps’ clinics. Therefore, International Medical Corps intends to remain operational in Mogadishu for the foreseeable future, despite security challenges, in order to continue providing services to those beneficiaries in need.
Fadumo resides in Bokolmanyo camp in Ethiopia’s Dollo Ado refugee complex with her husband and five children. She and her family came from Somalia on foot, an immensely difficult six day journey, fleeing the increasingly dangerous conflict and a drought that has cost many lives in recent years. Fadumo’s relatives and neighbors were killed in the conflict, and she and her family lost many of their animals in recurring drought, leaving them with little opportunity to earn a living.
“Life,” Fadumo says, “was very difficult in Somalia.”
She had to travel about 1.2 miles to get to the nearest water point, where she waited 1-2 hours to collect water with her single 3-liter jerry can. This amount was not even sufficient to meet her family's drinking needs. Further, Fadumo had no personal hygiene items such as soap or toothpaste, making it difficult to maintain even a basic level of health. Diseases such as diarrhea, pneumonia, eye and skin infections, cholera and typhoid can be prevented with reliable access to clean water and the use of basic hygiene items.
After a week in Dollo Ado’s transition center, Fadumo and her family were assigned shelter in Bokolmanyo camp. During that time, International Medical Corps built latrines and bathing shelters for individuals living in the camps, including Fadumo and her family. Recognizing that the majority of Bokolomayo’s residents like Fadumo could not afford to buy hygiene items from the market, International Medical Corps has also started working with the communities to ensure that those in need have adequate access to hygiene items by distributing nonfood item kits given by donors.
“It is only from International Medical Corps that I have received these things during my stay in Bokolomayo,” Fadumo notes.
International Medical Corps now provides toothpaste, toothbrushes, towels, nail clippers, and body soap as part of hygiene kits donated by generous organizations. Our Community Hygiene Promoters provide information on how to use the kits’ contents and access other health services available to residents.
Fadumo notes, “I am grateful to International Medical Corps that I received the personal hygiene items for free which will enable me and my family to have good personal hygiene.”
International Medical Corps implements hygiene and sanitation programs in three of the five refugee camps in the Dollo Ado corridor—namely Kobe, Melkadida and Bokolmanyo camps. Since 2003, International Medical Corps has operated programs throughout Ethiopia, strengthening local capacities and delivering services in HIV/AIDS and infectious disease, reproductive health, nutrition, psychosocial support, maternal and child health, water, sanitation and hygiene services, and livelihood security.
July 15, 2013 — International Medical Corps' work with drought victims spans many sectors, providing a well-rounded approach to assisting vulnerable communities.
In Ethiopia, our programs work to educate the population through local staff and volunteers, One volunteer, Azeb, is an engaging young woman. Quick to laugh, people warm to her easily and she reciprocates shyly but with confidence. At 25, Azeb is the leader of an ever-growing network of youth groups in Damut Pullasa, Wolayita who are trained by International Medical Corps to educate their communities, and the youth in particular, on sexual and reproductive health.
Azeb's group, which has grown from 30 to 150 members in just 6 months, meets bi-weekly and discusses issues related to young people’s health and wellbeing. Trained by International Medical Corps, Azeb leads sessions on sexually transmitted infections, pregnancy, HIV/AIDs and more.
Azeb also acts as a “big sister” to some of her flock, who turn to her when things go wrong. She mentions a younger member of the group who, upon realizing that she was pregnant, turned to Azeb for help, recognizing the strength of the support system of which she was a part. Azeb helped the girl to understand her options and worked with her and her family to help her through the difficult time.
“Times,” says Azeb, “have changed...women are not seen as a thing now; we have equality.” This is one of the issues that she is eager to help her sisters with—to look to a future not only of marriage, but to make something of themselves. With International Medical Corps’ help, Azeb is learning the skills necessary to become a true leader for her community, as well as a role model for girls who sometimes feel lost or without choices.
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Resource Development Officer