Over view of health care system in Somalia
Prior to 1991, Somalia had a public health care system, but the civil war and conflicts in the wake of the war destroyed these services. Hospitals and other health care facilities were looted, and the buildings were occupied by internally displaced persons and other homeless persons. The authorities in South Somalia offer certain basic services. For example, vaccinations and basic health care services for mothers and children. There is no health insurance system in any region of the country. Public hospitals and health centers are funded, operated, and partly staffed by international or local organizations.
There are eight referral hospitals, ten regional hospitals and 26 district hospitals in South Somalia, but none of them can offer specialist services of significance. There are also 198 health centers / mother-child clinics providing basic services. Moreover, there are 269 health clinics intended to provide minimum services for the local population, but many of them are inoperative.
What happens if you want to see a doctor?
Firstly, it is not easy to meet with a qualified doctor in Somalia. The health sector of Somalia was destroyed by the civil wars and instability and high-level poverty conditions in the country. Hence, there is a great disparity in the ratio of doctors to patients. Some data collected implies there is only one doctor for every 26,000 patients.
The doctors are mostly found in peaceful regions and large cities like Hargeisa, Mogadisho,Garowe, Burao,Buhodle, etc. The rural areas and unrest regions are so weak in health care and health care centers and doctors are mostly absent.
The people who are suffering chronic disease such as Diabetes, Heart attack, Cancer, HIV AIDS and Blood pressure face a dangerous situation Since they don’t get specialized doctors or physicians who majored in these diseases.
Who decides what doctors can prescribe?
Normally, every country has its own authority for food and medicine controlling, but after the collapse of the central government of Somalia, everything – including medicine – is independently imported without control and fully managed by local importers. This leads tons of outdated medicines coming into the country and they are available in every pharmacy. Somalia’s weak administration is unable to hold health professionals accountable.
Practically, what is it like to live with type1 diabetes in Somalia?
Diabetes is a health problem in Somalia, even though the prevalence among adults in the 20-79 age brackets is lower than in many other countries. This is not necessarily only due to a lack of access to insulin. Both tablets and insulin injections are available, but insulin must be stored in refrigerators – which many people do not have. Moreover, many Somali diabetics develop serious or even fatal complications because they fail to follow medical advice or treatment plans. Because many of the type one diabetes patients have died due to complications, aid workers have found that most diabetic patients who seek hospital treatment have type two diabetes. Diabetic patients without complications can be treated at the hospitals, whereas complex cases with complications cannot be treated in any of the country’s hospitals. Those who can afford it therefore seek treatment outside of the country.
Proper education and instruction in how to manage diabetes, is beneficial for diabetics in their daily lives. Nevertheless, even highly educated individuals with good knowledge of their own condition will face the same challenges as other diabetics in Somalia: an almost non-existent public health care system, unreliable access to medicines, lack of technical equipment, and expenses that many will have difficulty paying, even those with a stable income.
What about getting admitted to hospital?
In Somalia when patients are admitted to the hospital for a diabetes diagnosis, the treatment may depend on the patients’ health condition. If the patient is in a severe situation, he or she might be in the hospital around ten to twenty days depending his or her financial capability since there is no public or government funded hospitals.
On the other hand, outpatient people take tablets or insulin injection from the hospitals if they have the income ability, while some others face very hard circumstances to buy insulin due to lack of income. Sometimes they use herbal medicines instead of insulin injection which may lead to death.
How does diabetes care vary throughout Somalia?
There is a lack of efficient coordination and regulation within the health care sector, which has contributed to rural-urban disparities in the access to basic health care services, and disparities between the different regions. Urban and secure areas benefit the most from initiatives by charity organizations and private actors, due to poor security and lack of access to other regions of the country.
Generally, in Somalia the diabetes care varies a lot throughout the country. It is hard to find a diabetes care in rural area and small towns, so it is very dangerous or impossible to live in rural area with diabetes. On the other hand, in the large cities there is insufficient diabetic care. The private hospitals provide better care compared to public ones in terms of consultation hours, insulin availability and other medications needed for diabetes, although the visit cards, supplies, and other services are unaffordable by all.
We are so grateful to Osman Suleiman for providing information about Somalia for our map.
Last updated 2017
