World Report

Over half the country’s population is at risk of starvation
Letter from Somalia

Trócaire Cholera Treatment Centre, Luuq, Gedo Province, Somalia.

Abdi Tari Ali

I was on my knees fixing IV drips to patients’ arms as they lay on the ground in a makeshift treatment centre in the town of Luuq in Gedo Province, southern Somalia.

I have treated cholera before, but I have never seen anything like this in terms of volume of sick people and lack of facilities.

Having previously trained as a doctor, I felt I couldn’t just watch as the staff were overwhelmed with patients, so I scrubbed up to offer a helping hand. There is no question of normal working hours. Staff are working 24-hour shifts to save lives.

Somalia is facing two major challenges: hunger and cholera. If the long rains don’t come now in April, it will be a catastrophe and there is an urgent need to get the spread of cholera under control. 

I work for Trócaire, which has been providing humanitarian and development support in Somalia since 1992. The locals call Trócaire ‘mother’ as our long-term commitment to Somalia has helped Trócaire become a trusted actor in this volatile country. 

We provide the only public health service available to over 220,000 people across five districts and have started a 12-month emergency response in Somalia that builds on our ongoing health, nutrition and education programmes to meet the increased and new needs.

A famine in 2011 left over a quarter of a million people dead, but the current situation is far more severe and protracted with millions on the brink of starvation. 

Crops destroyed

Drought has destroyed crops and many villages are without water. Most Somalis in Gedo are farmers, but their animals have been wiped out. People are walking 90km in search of clean water or are fleeing to Ethiopia, but the border has been recently closed, so they are living in overcrowded makeshift refugee camps.

The UN estimates that half of Somalia’s population do not have enough food to eat and are at risk of famine; over 363,000 children are acutely malnourished and 70,000 others are in need of urgent life-saving support.

We have seen over 40,000 cases of sick children in our hospitals and health centres, malnourished with diarrhoea, or respiratory infections because they are sleeping without proper shelter. Our feeding programme for children has increased from 9,000 to 12,000 and we have scaled up our response in a further 13 villages.

But we are completely overstretched. Children are the first victims of hunger. You see straight away from their puffy faces, thin hair and swollen bellies that they are malnourished. If you press down on the skin, you leave a dent. There is no elasticity left.

Trócaire focus on the most vulnerable yet there is a growing need for food aid across the board. 

As this crisis worsens, Trócaire will, in tandem with nutritional support in clinics, be delivering food aid to schools. In 2011, increased school dropouts correlated with high levels of famine, and food interventions at school level are critical to keep children in education and protect the future of this country.

However, widespread hunger is not our only challenge: cholera cases are soaring. Conditions in the refugee camps are often unhygienic, there is a lack of clean water and people are weak from hunger. One case of cholera can quickly infect a whole camp or village.

Yet cholera is treatable once sufferers are reached promptly. People are being carried 20kms on stretchers or camels. 

We don’t know how many have died on the way. If the patient doesn’t receive assistance within six hours, they die. 

Cholera kills quickly – children die even quicker.

Trócaire has established two cholera treatment centres, where people receive antibiotics and are rehydrated. The 30 beds in the acute diarrhoea and cholera treatment centre I visited in Luuq are sadly not enough for the hundreds of cases flowing in at an alarming rate. Medicine is used as soon as it arrives with none to spare. The lucky ones have a bed, but many more are treated on the floor or outside in the open. 

In 2017, no one should die from hunger or lack of clean water.  

Trócaire has been in Somalia for decades, we harness local knowledge to access those who are most vulnerable. We were here before the crisis, and will continue to support families as they recover.  


*Abdi Tari Ali is the Somalia Programme Manager with Trócaire. You can donate to Trócaire’s relief effort at



Somalia is one of the poorest countries of the world. It is also a very complex and fragile country, which had no effective government from 1991 until 2012. 

Over those 20 years, there was extreme violence and lawlessness in the country, with almost all of its social, economic and political structures breaking down. 

The new government has brought some hope that Somalia will become more stable but the country still faces major challenges.