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“I was on my knees fixing IV drips to people’s arms as they lay on the ground,” said Abdi Tari Ali, who works for Caritas organisation Trócaire in Somalia. “I have treated cholera before, but I have never seen anything like this in terms of volume of sick people and lack of facilities.”

Abdi Tari Ali has been in the Gedo region of Somalia. He manages the Trócaire Somalia Programme, but his background as doctor meant he scrubbed up to help overwhelmed staff. “There is no question of normal working hours. Staff are working 24 hour shifts to save lives”.

New arrivals at a camp on the outskirts of Mogadishu, Somalia, line up for water at a water distribution. These people have been uprooted by the famine in Somalia and wait to receive aid from CRS NGO partners. Photo by Mohamed Sheikh Nor for CRS

New arrivals at a camp on the outskirts of Mogadishu, Somalia, line up for water at a water distribution. These people have been uprooted by the famine in Somalia and wait to receive aid from CRS NGO partners. Photo by Mohamed Sheikh Nor for CRS

Trócaire has a 25 year presence in the Gedo region, providing health, nutrition and education. The Caritas member organisation for Ireland supports 3 hospitals, 10 primary health units and 4 health centres.

“We have two challenges: cholera and hunger,” said Ali. “If the long rains don’t come in April, it will be a catastrophe”.

A famine in 2011 left over a quarter of a million people dead. The current drought, one of the worst in living memory, is far more severe and protracted than one in 2011. Crops have been destroyed. Many villages have been left without water. “They are pastoralists. Their animals have died. They have been wiped out,” said Ali.

“People are walking 90km here because there is water for their cattle or they want to get to Ethiopia,” said Ali. “However the border has been sealed so they are stuck in IDP camps where conditions are very bad. We have seen 40,000 cases of sick children: malnourished, with diarrhoea, or respiratory infections because they are sleeping without proper shelter.”

The feeding programme for children has increased from 9000 to 12,000 and Trócaire has scaled up in 13 more villages. “We’re completely overstretched,” he said. “Children are the worst affected by the lack of food.  You see straight away from their puffy faces, thin hair and swollen feet and bellies that they are malnourished. If you press down on the skin, you leave a dent. There is no elasticity left.

“We don’t do blanket feeding, instead focusing on the most vulnerable with wet feeding and food baskets. Yet the needs are blanket. We do quick tests for malnutrition for the children as they arrive and put them straight into the feeding programme.”

As well as nutritional support in clinical care locations, Trócaire will increase  school feedings. In 2011, increased school dropouts correlated with high levels of famine, and food interventions at school level are critical for food security and to keep children in school.

Cholera cases are soaring. Conditions in the IDP camps are unhygienic, there is a lack of clean water and people are weak from hunger. One case can infect a whole camp or village quickly. Trócaire has established two cholera treatment centres, where people receive treatment such as rehydration and antibiotics.

“Cholera is easy to treat, but they need to reach us. People are being carried on stretchers or camels 20km. You don’t know how many have died on the way,” he said. “If the patient doesn’t get assistance in 6 hours, you lose them – 100 percent. Children die even quicker. ”

The 30 beds are not enough for the hundreds of cases.  Medicine is used up as soon as it arrives. “The lucky ones have a bed, but many more are outside,” said Abdi Tari Ali. “We are in urgent need.”

Caritas organisation, Catholic Relief Services, is also providing food aid for those displaced. CRS provides cash, transferred via mobile phone, allowing people in rural areas affected by drought to buy food and water.

“We have been able to mobilise at-hand resources quickly, but the situation will require a sustained response for which we greatly appreciate your efforts,” says Lane Bunkers, CRS country representative for Kenya and Somalia.

Women and children uprooted by the drought in Somalia built makeshift houses on the outskirts of Baidoa

Women and children uprooted by the drought in Somalia built makeshift houses on the outskirts of Baidoa and will receive aid from CRS NGO partners. Photo by Mohamed Sheikh Nor/CRS

CRS’ emergency response focuses on the rural areas in south central Somalia and near the Kenyan border to help keep farmers—many whose livestock are dead or dying—from giving up everything and migrating to overcrowded, strained temporary camps for displaced people.

Activities include installing water points and repairing boreholes and shallow wells; training communities to maintain local water systems; improving the health of livestock through water supply, food and disease prevention; and supporting hygiene promotion activities.

“We knew in December that we were facing a major crisis, but the international community is slow to act. Famine with a massive loss of lives could be avoided with  blanket cash transfers. There is food in the markets, people just need the resources to buy it.  We also need to open the borders to Ethiopia and stop forced repatriation of refugees from Kenya,” said Ali.

The Caritas confederation will be looking to scale up its response to the food crisis and cholera outbreak with an international appeal supporting both CRS and Trócaire.