Our work is very big

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December 2010: Deeqa and I wound our way through a maze of hundreds of dome-shaped shelters, pitched so that there was barely space to walk between them. Our first appointment was at a flimsily constructed hut of sticks, rags, and cardboard. Inside the low-roofed hut, Iftin Adam squatted in the dim light, her three-month-old baby in her arms and a small boy at her side. Their possessions were sparse: a mattress on the floor, a suitcase in the corner. She motioned for me to sit on a broken jerry can now serving for a seat. “Here, we have nothing,” said Iftin, who fled here to escape the conflict in Mogadishu. “We don’t have proper shelter or enough food and water. But at least it is peaceful.” On the Rounds with DeeqaEarlier that day, Deeqa and I had arrived at the ’15 May’ camp for displaced people, situated on the outskirts of Burao, Somaliland. Most of its 900 camp residents have fled here from war or drought, leaving all their possessions behind. They are some of the most vulnerable people in the Horn of Africa. Deeqa Noor Khalid, a Medair-trained maternal volunteer, is well-known at the camp because she makes regular house-to-house health visits. At Iftin’s home, Deeqa got straight to work enquiring how the baby was doing. Iftin told her the baby had diarrhoea. Deeqa then confirmed with Iftin that she was breastfeeding and reminded her that poor hygiene can cause diarrhoea. Iftin’s older son leaned over and kissed the baby tenderly. “He used to suffer from malnutrition,” said Iftin, speaking about her older son, “But he was treated in Medair’s feeding programme and has since returned to a healthy weight. Medair also paid to transport me to Burao hospital when I was in labour, so that my new baby could be delivered there.” Medair’s Impact in SomalilandSomaliland’s Togdheer region faces chronic poverty, drought, and a massive influx of displaced people, particularly people like Iftin and her family, displaced by the violent conflicts in south-central Somalia. With so many people crowded into an area where resources were already so scarce to begin with, Togdheer has been identified as a “Borderline Food Insecure (BFI)” zone, with high risk for humanitarian emergency. The Medair team works in Todgheer’s Burao town and the surrounding rural area (population approximately 100,000), home to approximately 30 displacement camps like the ’15 May’ camp. We work to address the most critical needs through the provision of life-saving health, nutrition, and WASH (water, sanitation, and hygiene) services to the most vulnerable people. Medair runs 10 outpatient therapeutic programmes to treat children with severe malnutrition, and supplementary feeding programmes for children with moderate malnutrition. We provide health support such as vaccinations, and we promote improved child care, feeding practices, and dietary diversity. Our WASH team improves access to latrines, safe drinking water, and hand-washing facilities for the people who need it most.Until recently, Medair was one of the only international NGOs with a permanent presence in Burao town. However, the sheer scope of this region’s suffering has led to a rise in international concern and support, and more humanitarian agencies are now arriving to bring vitally needed relief and rehabilitation to Somaliland. Medair works in close association with the local government and with these arriving NGOs to help ensure that the most critical needs of the vulnerable population are addressed as effectively as possible. A Grassroots ApproachFor Medair, maternal volunteers like Deeqa help fill a crucial health gap because they teach women basic practices that can help their families avoid easily preventable conditions. Medair’s maternal volunteers conduct health education sessions one day a week plus they make regular house-to-house visits.This grassroots method is effective because, as local women, volunteers like Deeqa are trusted by the community, which enables them to bring messages that sometimes contradict commonly held beliefs. The maternal volunteers communicate to women through simple concepts. Teaching hygiene, they might quote a Somali proverb: “If you don’t have clothes, it’s poverty. But if you don’t stay clean, it’s foolishness.” “There have been many changes learned,” said Noora, a camp committee member. “Our children are now well-nourished with porridge, ‘plumpy nut’ biscuits, and green leaves. The maternal volunteers have taught us about hygiene: when we get up we wash our children’s hands and faces, and when we use the latrines we wash our hands.”Our Work is Very BigOn my trip to ’15 May’ camp last December, Deeqa and I paid a visit to Fadumo, a mother who was nine months pregnant and about to deliver any day. She greeted us in the doorway of her shelter. As Deeqa checked inside Fadumo’s lower eyelids for signs of anaemia, Fadumo told her she was referred to the clinic but didn’t go because she didn’t know where it was. “Prepare yourself,” responded Deeqa, “and on Saturday I will go there with you.” After inquiring about vaccinations and nutrition, Deeqa insisted that Fadumo must try to eat some green leaves and, if possible, some meat and eggs. She reassured the mother-to-be: “I will give you my phone number,” said Deeqa. “When you get labour pains, you must send word to me.” As Deeqa made arrangements with Fadumo, another woman approached and told us she delivered twins less than a month ago. Now one of them was very sick, and she herself had lower abdominal pain. Without hesitation, Deeqa arranged to take the woman to the clinic as soon as possible for postnatal care. Women were now crowding around Deeqa waiting to speak to her, so we didn’t even need to go from house-to-house anymore. “Everyone knows me here,” smiled Deeqa. Suddenly, a man pushed through, calling out for Deeqa to see his pregnant wife who had been bleeding for the last three days. We hurried across the camp but when we entered his shelter, we saw the woman lying on the ground listlessly. After gently examining her, Deeqa told me she had miscarried. The bleeding had now stopped but she still had a mild fever. We learned that this woman already had 11 children living with her in her desperately inadequate shelter. Deeqa tucked the woman’s blanket around her and made arrangements to take her to the clinic the following day. At this point, I was due to return to the base, though Deeqa’s work was far from done. “Our work is very big,” she had told me before we set out. “We work day and night.” Now I’d seen it with my own eyes. March 2011: In response to the need for better health care in the camps, Medair has begun supporting four maternal-and-child health centres in Burao, including the one nearest to the ’15 May’ camp. Supporting these clinics maximises the impact that Deeqa and other maternal volunteers can make in the community. Now, when mothers like Iftin need essential medicine, or when women like Fadumo need to give birth, they can receive free health care at the Medair-supported clinic. With a rise in new humanitarian and governmental initiatives in Somaliland, and an increase in international support, this troubled region is now at a crucial turning point. We need to keep this momentum driving forward to ensure that support continues, and that we reach the most vulnerable people with life-saving aid and put an end to the suffering of countless families. With your support today, Medair will be able to expand into new rural communities in Somaliland where no one else is providing relief. Please make a donation today.Medair’s Somalia/Somaliland programme is supported by the Department for International Development (U.K.), The United Nations Children’s Fund, the World Food Programme, and private donors. Medair has been working in Somalia and Somaliland since 2008. In Burao, Somaliland, Medair provides nutritional support, health services, and improved access to water, sanitation, and hygiene to people severely impacted by chronic drought and conflict. Somaliland declared itself independent from Somalia in 1991. Its independence has not been recognised by the international community.This web feature was produced with resources gathered by Medair field and headquarters staff. The views expressed herein are those solely of Medair and should not be taken, in any way, to reflect the official opinion of any other organisation.