20100413
africanews

Amid Mogadishu's ongoing violence, the World Health Organization recently sent a specialized trauma surgeon to the Somalia capital to train dozens of local health professionals in treating trauma cases and delivering emergency care to pregnant women.

The training of 33 doctors, nurses and midwives aims to improve the skills of the Somali health workforce responding to the escalating conflict in the city that is stretching an already weak health system.

In March 2010 alone, at least 900 conflicts related injuries and 30 deaths were reported at Mogadishu's three main hospitals.

Children aged under 5 years accounted for 10% of reported injuries, which included shrapnel and gunshot wounds, fractures and crush injuries.

"We were able to conduct this training successfully, despite the obvious security threats and resource constraints," said Dr Omar Saleh, the WHO surgeon and the Organization's Emergency Preparedness and Humanitarian Action focal point for
Somalia. "This training is essential as its boosts the skill levels of the very health staff who see on almost a daily basis victims of the conflict, as well as expectant mothers needing emergency obstetric care. It shows that despite enormous challenges, the international humanitarian community is still making a difference for Somalis."

At least 3.2 million Somalis are affected by the country's almost two decade-long humanitarian crisis and Somali women and infants are among the world's most vulnerable people. Some 1400 women die per every 100,000 live births, and at least 86 in 1000 infants die before reaching their first birthday.

The crisis has also impacted on the country's health workforce. Doctors and other health workers are among those killed and wounded in the violence, while other doctors have left Somalia to escape the insecurity and seek better work opportunities.

About 250 qualified doctors, 860 nurses and just 116 midwives work today in Somalia, home to the lowest number of health workers of any country within WHO's Eastern Mediterranean Region. At 0.11 health workers per 1000 people, its health system is well below the 0.23 threshold required to conduct essential health services, such as providing appropriate maternal health and ensuring 80% immunization coverage. In comparison, Tunisia, which has a similar sized population, has more than 13,300 doctors and over 28,500 nurses, according to the 2006 World Health Report.

Many health workers who remain in the country lack specialized training in trauma management, and many do not receive the opportunity for additional training on medical and surgical advances.

Health action in crisis

But WHO's surgical training program works to overcome this. It is part of an ongoing effort by the Organization to improve the skills of Somali healthcare workers so they can save lives amid the current crisis. In the past year, WHO has trained over 100 health workers in emergency medical services.

One doctor commented that the training had provided her with new skills and experience, and that she wanted to receive further training from WHO and health partners. The approach highlights how on-the-job training within the ongoing humanitarian response can be integrated within the delivery of life-saving services, at the same time as building the capacity of the national health workforce.

WHO and its health partners are seeking US$46 million in the 2010 Consolidated Appeals, which would support further training, provide essential medical supplies, undertake monitoring and assessments of the health situation on the ground, and lead activities of the Health Cluster.