Surviving motherhood and infancy in Somalia is a tenuous thing given what the country’s healthcare professionals are up against.
Fifteen-day-old Faadumo lies quietly with her big, dark eyes wide open. Her tiny head and dainty fists rest on a nest of blankets, starting with a black shawl. A second one adorned with white dots is layered on top. She is then tucked in a bigger, thicker blanket in a maroon and creamy colour. In between these wrappings is one more layer that is smooth, reflective and uncharacteristically thin for a blanket. It is a black plastic shopping bag.
Faadumo was born prematurely at seven months. Her mother, who was only 15, died during childbirth. The plastic bag is to keep her warm, as is the single-bed room with no window that she is staying in. A premature baby like her should, of course, be kept in an incubator. But here in Bosaso General Hospital in the state of Puntland, Somalia, a plastic bag and many blankets are the best doctors can do to keep her warm – and alive.
“We need incubators and our staff also need training on how to use them,” says Dr Mohamed Said, the pediatrician at the hospital.
Besides being premature, Faadumo is also malnourished. She weighed 1kg at birth, and weighs not much more – 1.1kg – now.
‘Too many’ challenges
When asked about the challenges his ministry faces, Abdirizak Hersi Hassan, Director-General of the Ministry of Health in Puntland, sums them up in two words: “Too many.”
Poor infrastructure, shortage of personnel, equipment and inadequate training, the list goes on and on. The indicators tell the story of what Abdirizak and his ministry are up against:
The risk that a Somali woman will die during childbirth: third highest in the world (1 in 22).
Under-five child mortality: third highest in the world (137 per 1,000 live births).
Immunisation coverage: less than 50%.
Female genital mutilation: highest in the world (98%).