CISP Somalia Newsletter                                              May 2012                                                                              Issue n. 2

MOGADISHU, April 2012 – Fatma, a 42 year old mother, moved away from her home in a village in Galguduud region that was badly affected by drought. “Most families lost all their livestock there. We were struggling to feed our children”, she said, “So I decided to leave my home and try to find a place where we could get something to eat”.

At the beginning of the drought crisis, the Diaspora supported the community in Galgaduud with much needed food, water and fuel supplies, by sending trucks from Mogadishu. As the trucks were returning to Mogadishu, which is 300 km away, many people jumped on them, trying to reach a better place. Fatma was one of them.

Hassan, CISP’s Field Education Supervisor, recently met her in Wardhigley, an area of Mogadishu, where she arrived in September 2011 with her 6 children,“3 girls and 3 boys. The youngest is 3 years old and the oldest is 13 years old”, she proudly said. Hassan knew her already: her children used to attend one of the schools supported by CISP in CeelDheer area. They have not been in school since they moved. “In the village, four of my children were going to school without paying any fees. But there is no free education in Mogadishu”.

The drought crisis in Somalia has had evident effects on people’s health, with dire malnutrition threatening the life of millions of people, particularly children. Less visible have been the consequences of the crisis on children’s education.

Girls in Taleex IDP settlement – Bondhere, Mogadishu – March 2012 © CISP

From the beginning of the drought in Somalia, attending school has been a challenge for thousands of children, weakened by hunger or unable to afford school fees. As food availability deteriorated, many families migrated from rural areas to urban centres, to find food. It is estimated that 85,000 people moved to Mogadishu in 2011, with drought being the main reason for the displacement. For children, an almost immediate impact of displacement is school drop out. “Of course, when food is not enough, school is quickly sidelined. But without education the poverty cycle is perpetuated and, with it, people’s inability to cope with shocks”, says Brianna O’Connor, CISP’s Education Coordinator. Children in the Internally Displaced People (IDP) settlements in Mogadishu face extreme hardships: inadequate nutrition, lack of basic health care, poor sanitation facilities and limited access to education. CISP’s intervention is aimed at encouraging children’s enrolment, particularly among the IDPs, while reducing the financial burden on families. Halima Ibrahim, CISP’s Field Coordinator, is currently in Mogadishu to set up the programme: “We are targeting 6,000 boys and girls in Mogadishu and another 2,000 children in Hiraan and Middle Shabelle, in a total of 18 schools”.

IDP Schools in Mogadishu

In addition to drought and displacement, the ongoing conflict has taken a heavy toll on Somalia’s education system, with schools heavily damaged, no government funding to alleviate the cost of schooling for parents and almost non-existent teacher training. CISP’s programme includes rehabilitation and construction of classrooms, payment of incentives and training for teachers, distribution of school kits and food vouchers. “But it will not be limited to that”, says Brianna O’Connor, “Child protection, gender equality, as well as sanitation and hygiene interventions will also be integrated into the programme, in accordance with the multi-sectoral approach to education that CISP has adopted over the years”.  

CEEL DHEER AND XARARDHEERE, March 2012 - CISP considers it critical to integrate HIV/AIDS prevention, treatment and care into the overall health care assistance to the Somali people. Its intervention in Somalia started in 2005 in Ceel Dheer hospital, with Voluntary Confidential Counseling and Testing. “In the first three months, only 3 patients came in for voluntary testing. Now we have 700 patients per quarter and more than 20 thousand people have been tested up to now”, says Abdi Tari, CISP Health Coordinator.

During the first year, 10 cases were identified and referred to Merka hospital for treatment, since no other treatment centre was available in the area. As Merka is located 400km from Ceel Dheer, accessing the treatment and follow-up care proved a major challenge. In view of the need for HIV/AIDS treatment and care in the area, in 2005 CISP trained nurses and staff and provided medical supplies to Ceel Dheer hospital, which then became a regional referral centre for Anti Retroviral Therapy. In 2007, Xarardheere hospital was also equipped to administer ART therapy and support to people living with HIV. To see what CISP is doing in Ceel Dheer and Xarardheere, watch the video “Fighting HIV in Somalia”

MOGADISHU, March 2012 - Poor hygiene practices are the main reason for the spread of water borne diseases, particularly cholera. "During the rainy season, cases of outbreaks tend to increase especially in communal spaces such as schools", says Abdi Tari, CISP’s Health Coordinator. “In 2011, 4 out of 5 cases of cholera seen in CISP health centers in Ceel Deer were contracted in schools”.

At the beginning of the Gu (long) rains, CISP launched a hygiene promotion campaign in 10 primary schools in Mogadishu, 7 of which are located in IDP settlements. The initiative, dubbed “Keep your school cholera free”, was launched on the occasion of World Water Day (22 March), and reached over 4,500 pupils, 70 teachers and their families.

Key messages were not only taught to children in class, but also through interactive activities so as to make learning fun for them. Poems, music, drawings, drama performances and awareness contests were used, and the children participated enthusiastically.

PHOTOGALLERY – Keep your school cholera free – WORLD WATER DAY 2012

MOGADISHU – Twenty years of armed conflict, combined with recurrent droughts, make children in Somalia extremely vulnerable to abuse, neglect and exploitation. According to Human Rights Watch, "Children continue to be killed or maimed as a result of indiscriminate shelling, gunfire, widespread insecurity, and the targeting of schools".

Forced displacement contributes to the erosion of the traditional protection system, and can further expose children to serious violations, such as gender based violence and recruitment into the armed conflict. A child protection assessment by the Inter Agency Sector Committee (November 2011) confirmed that young boys between 5-14 years are at high risk of recruitment when they are at schools or during social gatherings.

To mitigate these risks, CISP continues to work to create a protective environment for children, as well as to

prevent and respond to violations committed against them. “Protection measures have been adopted in the schools that we support”, says Francesco Kaburu, CISP’s Protection Coordinator. “The teachers receive training to collect data, identify cases of abuse, and refer the victims to the appropriate services”.

But more needs to be done: “Children who survive violations related to the conflict need to be provided with holistic solutions”, continues Kaburu. “If you offer psychosocial support without improving livelihood opportunities, recruitment into armed groups may remain an appealing option for some children.”

Economic reintegration plays a fundamental role for the recovery of the survivors of conflict. CISP is currently addressing the livelihood needs of vulnerable youth, through initiatives such as the existing Vocational Education and Training for Accelerated Promotion of Employment (VETAPE).

CISP will also provide psychosocial assistance, to mitigate the traumatic effects of armed conflict and forced displacement. 20 child friendly spaces are being set up, to provide boys and girls with safe locations to gather, play and access psychosocial support. In the centres, trained animators will help identify boys and girls who have experienced violations and are in need of care and protection. The spaces will be run with the participation of the local communities, to enhance the community based protection system.

GALGADUUD AND MUDUG, 2012 - Malnutrition in Somalia reached unprecedented levels in 2011, when two failed rainy seasons led to the worst food crisis in the last 60 years.

Between August 2010 and September 2011, CISP was able to treat over 4,200 children for malnutrition and to provide much needed nutrition support to more than 7,500 pregnant and lactating women.

As the drought persisted, the number of people in need of nutrition help increased in Galgaduud and Mudug regions. “The area registered a high influx of IDPs and lots of them were in really dire conditions. Malnutrition rates were worsening, thus the decision to establish 7 supplementary feeding centres in the Maternal and Child Health (MCH) centres supported by CISP”, said Abdi Tari, CISP’s Health Coordinator.

CISP is currently expanding its nutrition programme in 8 additional health centres in Central Somalia, as well as in three district health facilities in Mogadishu.

To see the maps, pictures and activities that CISP carried out in each feeding centre, check the Nutrition Activity Updates

April 2012 - Somalia has one of the lowest school enrollments in the world. According to UNICEF, only one out of every five children attend primary school, and most of them do not go to school for more than a total of 2 years. Since the beginning of the civil war in 1991, almost an entire generation has missed out one of the fundamental rights of childhood: primary education. Conflict, poverty, lack of facilities, family displacement, and gender discrimination are among the main causes for this.

CISP - 20 years of support to education in Somalia

CISP believes that education is key for Somalia’s peaceful future and economic development. Its education intervention started in 1992 with basic literacy programmes in Mogadishu, and for the past 20 years it has implemented projects in Banadir, Galgaduud, Mudug, Puntland and Middle Shabelle.

CISP currently supports 60 primary schools, reaching almost 16,000 boys and girls, who otherwise might not afford to go to school. The programme ensures quality education for the children through rehabilitation of learning spaces, training of teachers and Community Education Committees, as well as provision of learning materials.

CISP’s education programme aims at ensuring children in rural areas are able to access basic education. “The majority of the schools are concentrated in the urban areas”, says Hassan Shadoor, CISP’s Field Education Supervisor. “But most of the children live in the rural areas, so they are unable to go to school”. In 2011, over 90% of the primary schools supported by CISP were located outside the main towns.

Displacement is a major cause of disruption of school attendance. The IDP settlements offer limited schooling opportunities. Most of the existing education infrastructure was destroyed by the conflict and limited resources are available to meet basic needs. In 2012, CISP is supporting 10 IDP schools in Mogadishu and 5 in Guriceel.

The Early Childhood Education component aims at creating links between the traditional Early Childhood Education centres and the formal primary schools. In 2011, CISP supported 40 Early Childhood Education centres, where basic literacy and numeracy are integrated with religious teaching.

CISP has always witnessed remarkable levels of cooperation with the local communities and the diaspora. In times of funding disruption, the continuation of the project has been possible thanks to the financial support of the local diaspora, which also funded the construction of a secondary school in Ceel Dheer in 2009. To encourage community participation, CISP establishes and trains Community Education Committees, and raises awareness on the importance of continuous school attendance, with particular attention for girls.

One of the key objectives of CISP’s education programme is to improve girls’ school attendance. In Somalia, parents often prioritise spending on boys’ education, while girls are kept at home to take care of household chores and prepare for an early marriage. CISP works to raise awareness on the importance of sending girls to school amongst the parents and the communities, provides appropriate sanitary supplies to girls to limit attendance disruption, recruits and trains female teachers to ensure gender balance within school staff. In 2011, half of the pupils enrolled in CISP’s supported schools were girls.

Primary school children in CeellDheer

In 2011, more than 10,000 boys and girls benefited from CISP’s education intervention in Mudug and Galgaduud regions. CISP supported 50 primary and 40 Early Childhood Education centres, in the areas of Ceel Dheer, Xarardheere, Galcad and Dhuusamarreeb. To see the maps, pictures and a description of the activities that CISP carried out in 2011 check the Primary Education 2011 Activity Updates.

GALGADUUD and MUDUG, December 2011 – In Mudug and Galgaduud, an area of Central Somalia that is as big as Bulgaria, there are only four hospitals. For a majority of the region, obtaining basic health care is a cumbersome and sometimes impossible task. Recurrent natural disasters and ongoing conflict have strained the population, particularly women and children, and made them extremely vulnerable to malnutrition, disease and violence. In a country where maternal and infant mortality continues to be among the highest in the world, essential and emergency health care centres become crucial to fill the gaps.

With this in mind, CISP is supporting 9 Maternal Child Health (MCH) centres in Mudug and Galgaduud, where remote communities can access basic health care. There, trained medical staff ensure that women and their babies receive medical assistance, and are treated for potential complications. These centres also provide antenatal care to pregnant women, safe delivery, as well as treatment of communicable diseases and nutritional support.

From July to December 2011, over 57,000 medical consultations were performed in the CISP’s supported centres. Antenatal care, nutrition screening, treatment of malnutrition, basic obstetrician care, immunization and essential medical assistance were some of the services provided to 11,000 women and 20,000 children below the age of five.  

Despite the significant efforts, thousands of mothers and children are still unable to reach the health facilities for treatment, particularly in the rural areas.“Certain villages are 40-50 km away from the health centres”, says AbdiTari, CISP’s Medical Coordinator. “In these places, means of transport are mostly unavailable, and when they exist, they are unaffordable for the patients”. Usually pregnant women seek medical assistance only when there are major problems, and their only chance to reach the health centre is on a camel, a donkey or by walking.

Often, by the time they arrive to the centre, medical complications have arisen, and the baby can only be saved through cesarean section. However, the MCHs lack the facilities and the equipment required to perform this life-saving surgical operation, and the patients need to be referred to a hospital. Unfortunately, the closest hospital can be as far as 250 km. “In some cases, we understand that the mother would not survive the journey”, continues Abdi Tari, “So we have to make a decision whether to save the baby or the mother.” It is a difficult choice.

Long distances, precious time – Safiya’s story Sunset on the road from Budbud to Gaalkacyo - South Mudug © CISP. After being seen at Budbud MCH, Safiya (not her real name) was referred for urgent treatment to Gaalkacyo hospital, 180 km north along a bumpy road. No vehicle was available in Budbud, so the 26 year old had to travel on a donkey. “The road was so dusty I could hardly breath”, she said. A CISP’s mission heading to Budbud met her 4 hours later, on her way to Gaalkacyo. She was lying beneath the shade of a tree, exhausted. She had already been in labour for 12 hours, the pain was excruciating and she had neither water, nor food with her. A CISP doctor, who was taking part in the mission, realized that her condition was critical. “She had lost a lot of blood, and she needed immediate surgery to stop the hemorrhage, or she would have died within hours”, said the doctor. Vaccination of a child in an MCH supported by CISP in Galgaduud © CISP. The CISP team rushed Safiya to Gaalkacyo hospital, where she underwent an emergency operation. It saved her life, but it was too late for her baby’s. To assist mothers like Safiya, CISP provided a much-needed ambulance stationed in Gaalkacyo, serving the 4 MCHs supported by CISP in South Mudug (Budbud, Bitaale, Hobyo and Ceelgula). However, one vehicle is insufficient for such a vast area. “When an MCH refers the patient to the hospital, the ambulance stationed in Gaalkacyo has to drive all the way to the MCH, collect the patient and come back”, says Abdi Tari. Precious time is lost, which could save many lives.

CISP’s primary health care programme is currently supporting a total of 16 MCHs in Galgaduud and Mudug and three in Banadir region. Nutrition, reproductive health, immunization, communicable diseases and health infrastructure are the key areas of CISP support in this sector, together with health education and capacity building of health workers and communities.

To see pictures and descriptions of the activities that CISP carried out in each MCH in 2011, check the Primary Health Care Activity Updates .

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The International Committee for the Development of Peoples (CISP) is a Non Governmental Organization established in Rome in 1983 to engage against the impact of poverty and denied rights worldwide. CISP has been active in over 30 countries worldwide: in Africa, Latin America, the Caribbean, Asia, the Middle East and Europe. CISP has been operating in Somalia since its inception and is currently implementing projects in the sectors of Education, Health, Water and Sanitation, Protection and Livelihood, in Benadir, Galgaduud, Hiraan, Mudug and Middle Shabelle.