Somalia is grappling with a worsening cholera outbreak, with cases higher than 50% compared to previous years. The increase is particularly intense in the capital city Mogadishu due to prolonged rainfall and flash floods and it is children who are suffering the most.
The disease claimed 137 lives between January and July 2024, with 59% of these being children under five. Cholera, a diarrhoeal infection caused by contaminated food or water, can cause severe dehydration and even death within a few hours if untreated.
A surge in cholera cases
There has been a spike in cholera cases in Somalia with 30 out of 74 districts being affected and the disease spreading beyond the traditional hotspots to northeastern districts.
A recent UNICEF report indicated that 17,246 new cholera cases have already been recorded this year. In comparison, 18,304 cases were reported in the whole of 2023 when there was a 15% increase in cholera cases compared to 2022 and half of those affected were children under the age of five, according to WHO.
Children also continue to be the most vulnerable group this year. According to UNICEF, 10,019 of the reported cases were identified in children under five.
The situation has taken a turn for the worse due to the unseasonably heavy rains which have resulted in prolonged flooding, creating unsanitary conditions that are ideal breeding grounds for the cholera-causing bacteria.
Prolonged flooding as a catalyst
The disastrous floods that have crippled most parts of Somalia are not an isolated event. They are part of unpredictable weather patterns that are heightened by climate change.
According to USAID, the country is at the forefront of the climate crisis, as it is estimated that average yearly temperatures will increase by about 1°C by the 2030s, and by about 2°C by mid-century.
Amid the ongoing cholera emergency, flooding has contaminated water sources and destroyed infrastructure, making it difficult for aid agencies to reach the affected areas. Additionally, many toilets and pit latrines have been destroyed thus forcing communities to resort to open defecation which increases the rate of infection.
The communities affected are already in a vulnerable situation since they have yet to come to terms with the aftereffects of the El Niño phenomenon which destroyed infrastructure and essential services in the country. This comes after the country faced a drought in 2022-23 which resulted in the loss of 43,000 lives due to hunger, malnutrition, and diseases caused by weakened immune systems. As a result, there is an increased vulnerability of children and families to the illness.
Health facilities are overstretched, underfunded
Somalia has a limited number of healthcare facilities, many of which are basic health posts with frequent shortages of essential medications. Reports from Médecins Sans Frontières and the International Federation of Red Cross and Red Crescent Societies reveal shortages of the oral rehydration salts, intravenous fluids, and antibiotics needed for the treatment of severe cholera cases leading to many people going untreated which results in preventable deaths.
The existing medical centers are overwhelmed with health workers describing the situation as a “ticking bomb”. Moreover, most people cannot access hospitals due to damaged roads and the ongoing insecurity caused by armed inter-clan violence which has displaced around 150,000 people. Humanitarian agencies are grappling with the increased demand for sanitation facilities, medical supplies, and clean water.
The funding needed to deal with this health crisis exceeds the resources available. The budget required is about US$1.6 billion but currently only 20% of this has been funded creating a substantial gap in meeting the needs of the affected communities. So far, UNICEF has contributed US$3,447,164 to assist in the emergency response to cholera while WHO has delivered 1.4 million vials of oral cholera vaccine at an estimated cost of US$2.5 million.
