State of the World's Minorities and Indigenous Peoples 2013 - Somalia

Somalia emerged into a new political era in 2012, with substantial hope for improvement in the lives of Somalis, including the health status of the population. Military intervention, including African Union peacekeepers (AMISOM), Kenyan forces and Ethiopian troops, continued in 2012 and succeeded in pushing al-Shabaab out of several key areas, including Kismayo and Mogadishu. As the military operation moved forward, the process of designing a new constitution and new institutions of governance continued on a parallel track. The first formal Somali parliament was sworn in in August 2012 and the parliament voted in September to elect Hassan Sheikh Mohamud as president. As new governance arrangements were concluded, however, concerns remained that minority groups such as Bajuni, lower caste Midgan and Somali Bantus, as well as women were not sufficiently represented in the arrangements, a problem that has undermined previous governments. The perpetuation of marginalization into the new dispensation in Somalia raises concerns for minority rights in general in Somalia, including the right to health.

Although data on minority and indigenous communities in Somalia are difficult to obtain, in general, minorities experience more challenges in accessing health care and thus experience more negative health consequences. A UN OCHA (Office for the Coordination of Humanitarian Affairs) study identified several challenges related to access to health for minorities in Somalia:

• Conflict and insecurity makes it difficult for aid agencies to access vulnerable communities.

• There is a lack of adequate information regarding the health status of minority groups.

• There is a lack of adequate transport infrastructure, including land routes and water routes.

• There are insufficient numbers of health centres, including mother and child health services and tuberculosis clinics, in minority areas.

• Minorities in urban areas observe that their concerns are not given much consideration when establishing health centres. They say that local authority staff do not report serious health conditions in Dami and Gaan Libah, where many minorities reside.

Despite the positive political developments and enhanced security, many of these problems remain for minority communities.

However, there also are positive indicators in Somalia's health sector. The drought-induced famine in Somalia was officially declared at an end by the UN in February 2012. The ending of al-Shabaab occupation in many areas has enabled the government and its international partners to enhance health services. New health centres have opened and are offering service to approximately 1 million Somalis. Vaccination campaigns were conducted in 14 districts of southern and central Somalia between November and January for the first time in four years, inoculating more than 383,000 children under the age of five against polio and almost 80,000 against measles. Another campaign to provide health and nutrition services, including vaccines, reached about 275,000 children and 394,000 women in 26 districts in December. Despite this, cholera outbreaks in 2012 demonstrate the challenging health situation in many parts of Somalia. The World Health Organization (WHO) estimates that there are about 215,000 children who remain malnourished and at risk of complications from malnutrition.

In the past, minority groups in Somalia have faced substantial health challenges – they have been among the most vulnerable of groups because of their isolation and because of an inability to depend on the extended clan support system that is a critical feature of social protection in Somalia. Unless the new Somali government dedicates specific resources to addressing the health care needs of minority groups, they could be left behind in the new Somalia.