Located in bone-dry central Somalia, the city of Galkayo is divided by warring militias and separatist regional governments that continuously clash in armed confrontations. Since MSF was forced to evacuate its international staff in 2008 due to insecurity, MSF’s Somali staff have continued to provide medical care to people trapped in a conflict with nowhere else to turn.
Quickly changing into his green surgical gown, Dr. Maslah hurried to the operating theatre in South Galkayo hospital to perform an emergency operation on a young man who had been stabbed. "The call came at 8pm," he said. "By 10pm we were in theatre and by 11pm we had managed to stabilise the patient."
Dr. Maslah, MSF Surgeon, at work in the operational theatre. As one of 144 Somali staff working for MSF in South Galcayo hospital, Dr. Maslah has played a crucial part in keeping surgical activities running. Oct 09 Photo by MSF
The following morning, relatives of the patient gather in the hospital, chatting and even laughing, as they receive news that the young man is going to be fine. They reassure friends and other relatives who rush in fearing the worst.
Without the dedication of MSF's Somali staff, thousands of people would have been left without free, life-saving medical care.
Nightime telephone calls for urgent operations are a routine part of Dr. Maslah’s work, as South Galkayo hospital is the only one to provide free emergency surgery in the area. "Every month I’ll perform around 40 operations on people with abdominal injuries, gunshot and stab wounds, injuries of the colon, and people who’ve been in car accidents," says Dr. Maslah.
Surgery is just one of the services MSF provides in South Galkayo hospital, where some patients come from as far away as Ethiopia to receive care. The hospital includes an outpatient unit, an inpatient ward, a busy maternity ward and a tuberculosis centre. MSF provides almost 4,000 outpatient consultations each month, admitting around 120 people for inpatient care and delivering more than 100 babies.
Prolonged drought and high food prices, coupled with the ongoing violence, means that the therapeutic feeding center is often filled to capacity. Indicating a queue of women holding weak, dehydrated babies waiting to be admitted, nutritional supervisor Jibril explains: "Every month we admit several cases of diarrhea, measles, dehydration and sometimes meningitis. But now severe malnutrition is the most common problem. We are currently treating 90 patients in a space meant only for 60."
Somali women wait to have their children weighed and measured at the MSF therapeutic feeding centre, South Galcayo Hospital. Oct 09 Photo by MSF
The exhaustion on the mothers’ faces reveals the long and costly journey that most have made to reach the hospital. As one mother says, "Many in the village know that there is free treatment here, but the biggest problem is the journey. It can take many days and is often very expensive - costing around 500,000 Somali shillings (about US$10). A lot of people can’t afford it, so they stay at home and some die in the village."
Burn marks on the bodies of a number of young babies show that many mothers first turned to traditional healers for treatment and only come to the hospital as a last resort.
In sharp contrast to the group waiting in line is a woman with a big smile, standing at the door of the feeding center. In one arm she carries a healthy baby and in the other she holds a bag of food rations she has been given by MSF to take home. She raises her voice above the clamor of crying children to thank a member of staff. "She has been here for quite some time and today she is returning home with a healthy baby," says Jibril.
MSF staff like Jibril and Dr. Maslah work around the clock at South Galkayo hospital, alongside many other committed Somali staff, to provide health care to a community in dire need. "The staff at this hospital save many lives," says Dr. Maslah.
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South Galkayo hospital is one of the few centres in central/south Somalia that offers surgical care - both lifesaving emergency obstetric care and treatment for the many people wounded by violence. During 2008, MSF staff treated 470 victims of violent trauma and provided 43,781 medical consultations, including the treatment of more than 3,000 severely malnourished children. They delivered 936 babies and vaccinated 17,650 people. In addition, 269 patients were started on treatment for tuberculosis. The team also has the capacity to respond to outbreaks such as cholera, measles, meningitis, and nutritional crises.