• Tasnim Abdi

The Somali Health Care System

This past summer, I had the opportunity to travel to Somalia, my country of origin. It was my first trip there and I had no idea what to expect. Although I have grown up with people who once lived there and knew the culture intimately, I still felt anxious and shocked when I arrived there. This feeling is typical especially when people travel to a new place with different customs. This article will focus on my experience in Somalia’s healthcare system as a patient and will examine several challenges it faces to increase the quality of care.

I went to Somalia with the intention of going to discover new regions and meet all kinds of people. Within a few days, I fell sick. Unsure what it was, I decided to wait out. After almost a week, I went to visit a clinic where the doctor could not diagnose what I was experiencing. When he mentioned the word “malaria”, panic hit immediately. However, I was not convinced because the risk was not extremely high. He sent me to another building where someone would look into it further. It turned out that I did not have Malaria. Later, I met a woman who said that the same thing happened to her and that the practice was common.

This was my first moment in the healthcare system as a patient. Somalia is a large country in the Horn of Africa. The health care system had been in ruins and people had to rely on foreign aid to help with the demand in basic medical services. According to the World Health Organization, 94% of the health budget came from international aid in 1989. Within the last few years, it has been slowly rebuilding the foundations of the hospitals and bringing in doctors to fill in the gap. This dependence of aid from other countries slowed the creation of a domestically-funded healthcare system. Differences in the level of support varied from region to region because most of the hospitals and clinics were found in the capital (other cities struggled to find the help they needed to live). Back then, most services were free, but they were accessible to everyone. In 1990, it was estimated that 80% of the population did not have a local hospital or clinic in their area. The start of non-governmental clinics occurred when the government realized that it could not sufficiently provide care for everyone. There was also a shortage of medical professionals, such as doctors and nurses, to perform the most important operations since most of them immigrate overseas. The life expectancy is around 49 years old. Around 88% of childbirths took place outside of a hospital setting. There were few midwives to assist in the procedure. Sanitation created many problems for the people of Solalia, because some people did not have access to clean and safe water. This increased the risk of children developing preventable diseases by being exposed to unhygienic places.

Nowadays, most people are required to pay for their treatments, including prescribed medications. With high unemployment, the ability to pay strongly impacted one’s chance of getting help. People who lived on one dollar a day were not likely to see a medical professional. Another disadvantage to the private healthcare system was the idea of making money. There were doctors who could send patients to get work done, even if it was not necessary. This increased the incentive to continue this practise in order to receive a higher salary. As a result, patient care was compromised and the integrity of the medical professionals was also questioned. The challenges resulting from a lack of efficient hospitals were apparent to me because many patients had to be fit into small rooms and there were not many healthcare providers available to assist them. Individuals usually depended on the multitude of clinics owned by doctors. The doctors also work for the hospitals and were seen going from the hospital to their clinic. This made it hard for people to find a doctor close to them and they had to travel long distances to get the help they needed. Many of the services provided needed to be paid for once they were completed.

There are some developments on the healthcare system. More doctors are coming from different countries to train local doctors on how to improve the quality of care and apply new techniques. Recently, there have been new investments being made on building new hospitals and changing the way in which the rooms were designed by making them efficient.

My experience showed me the many aspects involving the healthcare system of Somalia and the problems it faces when it comes to making it convenient for the whole land and its people. Through the presence of high unemployment, lack of facilities and cost, there are areas that need to be focused on in order to make it successful.

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