“Seven months ago, my wife gave birth to twin boys,” says Kalimow Mohamed Nur, a father whose children are now receiving treatment for severe acute malnutrition at the Bay Regional Hospital in Baidoa, Somalia. The hospital, supported by Médecins Sans Frontières (MSF), is one of the few facilities in the region providing free, quality healthcare.
During childbirth, Kalimow’s wife suffered excessive bleeding, but with no money for medical care, he had to care for her at home. Meanwhile, their newborn twins, struggling to feed, began to weaken. “They were so small, and we could barely afford enough food. They kept falling ill, vomiting, and having diarrhoea,” he recalls.
With no access to healthcare in his village and his sons growing weaker, Kalimow was left with a difficult decision. “I had to take a loan of about $130 and travel 300 kilometres to Baidoa to find free medical care,” he says. Like many in the Bay region, poverty makes it nearly impossible for families to afford healthcare or transportation to reach lifesaving services.
The absence of health facilities in Kalimow’s village means residents must travel long distances for even basic medical care. Nearly half of child deaths globally under the age of five are linked to malnutrition, and in conflict-affected regions like Somalia, insecurity, logistical challenges, and dwindling resources have made the crisis even worse.
The recurring malnutrition crisis in Somalia, particularly in severely conflict-affected areas, highlights the urgent need for a decentralised and adaptable healthcare response. Poor living
conditions in both formal and informal displacement camps further endanger people’s health, while access to essential services continues to decline. Many international organisations operating in the region have been forced to scale down their activities due to a lack of funding, leaving the most vulnerable without support.
Now, Kalimow’s twins are receiving therapeutic food and medical care at the MSF-supported hospital. But he knows that many other families are facing the same struggle—unable to access even the most basic healthcare.
People in the region have been facing significant health and humanitarian challenges due to prolonged conflict, chronic instability, and climatic shocks that have led to severe droughts and flash floods. The crumbled healthcare system further exacerbates the situation, leaving women and children most vulnerable and depriving them of basic health services.
In the busy maternity ward of Galkayo South Hospital, Nuro Farah, 54, sits beside her daughter, Bishara Abdullahi, feeling a deep sense of relief. She glances at her daughter, then at her newborn grandson, before smiling. Bishara, only 18, gave birth to her first child by caesarean section after suffering obstructed labour. Her face, pale from exhaustion, reflects the resilience of many Somali women who endure so much in a country where maternal and child healthcare is scarce.
Their journey to this moment was nothing short of extraordinary. Nuro and Bishara come from Deeqlo, a village near the Somalia-Ethiopia border. “Fear and insecurity in our village have made the newly built health facility inaccessible, leaving us no choice but to travel to Galkayo for help,” Nuro says.
The journey took a difficult turn when a commercial vehicle left them stranded on the road because they had no money to pay. With no transport in sight and uncertainty hanging over them, Nuro and Bishara took shelter under an acacia tree, the only shade in the vast landscape, as the scorching sun beat down on them.
Then, by pure chance, an ambulance passed by. Nuro still remembers that moment – a glimmer of hope on an empty road. They waved it down, and the driver stopped, giving them the lifeline they desperately needed.
"If that ambulance hadn’t come, I don’t know what would have happened to my daughter," Nuro says. "Sometimes, we have to use camels to transport the sick. There are no proper roads, and ambulances are rare."
Women and children have to undertake arduous journeys of hundreds of kilometres to reach medical facilities. Pervasive insecurity along the way frequently obstructs their access, leading to critical delays that exacerbate health conditions and tragically, sometimes, cause death.
Bishara, who has faced both childbirth and the pain of divorce, cradles her newborn, grateful for the high-quality care she received at MSF-supported Galkayo South Hospital. As Nuro reflects on their struggles, she speaks of the harsh reality in Deeqlo, where insecurity forces many to make long, dangerous journeys just to get medical help.
The leading causes of death for pregnant women include blood-pressure-related complications, haemorrhage, and sepsis – all of which can be fatal without timely treatment. Late access to healthcare increases the risk of death for both mother and baby. Somalia’s fragile health system needs urgent improvement to bring essential services closer to those in need.
What It’s Like to Be a Patient with Tuberculosis in Somalia?
Lives On the Line: Drought and funding gaps deepen Somalia’s malnutrition crises
