The ICRC remains extremely concerned about the humanitarian situation of the Somali population. Throughout 2007, Somalia has suffered a series of shockwaves caused by the conflict and by natural disasters. The situation is particularly desperate in Mogadishu, which has been repeatedly battered.

"Our priority has been to provide assistance to those caught up in the conflict, particularly the displaced, and to ensure that basic health services continue," said Pascal Hundt, head of the ICRC's Somalia delegation. "The ICRC has repeatedly reminded all parties to the conflict of their obligation to comply with international humanitarian law, in particular to take constant care in the conduct of military operations to safeguard the lives and dignity of the civilian population and to protect medical facilities and staff."

Medical assistance

The ICRC supports the two surgical referral hospitals in Mogadishu, namely Medina and Keysaney. Since August, an ICRC-backed team of surgeons from the Qatar Red Crescent Society has been working at Keysaney Hospital, which is managed by the Somali Red Crescent Society.

In 2007, the two hospitals treated more than 4,000 people who had been wounded in the conflict – twice the number of war-wounded admitted to the two hospitals in 2006. One third of these were women and children under 15 years of age.

The number of surgical operations performed in the two hospitals in 2007 came to 8,500, an increase of 62 per cent compared with the previous year. Roughly half of these cases concerned people wounded in the fighting," explained Dr Pierre Gratzl, the ICRC's medical coordinator for Somalia. "This illustrates the twofold impact of the conflict – the increase in the number of wounded is compounded by the severe compression of medical services available to the population. Mogadishu used to have about a dozen hospitals; now there are only three or four left, including the two referral hospitals we are supporting."

The ICRC helps cover operational costs at the two hospitals as well as providing medical supplies, training and even surgical staff. Its surgical team also helps out at other hospitals in conflict-prone regions of the country which have also received ICRC medical supplies.

In addition, the ICRC supports 24 medical clinics operated by the Somali Red Crescent, providing medicines and other medical supplies, salaries, training and assistance with infrastructure. In 2007 these clinics, many of which are located in remote areas of southern and central Somalia, gave 147,000 consultations, mostly to women and children.

This year the ICRC delivered over 206 tonnes of medical supplies to hospitals and other health facilities in Somalia, a 50 per cent increase over 2006. The supplies included surgical materials, kits for treating the war-wounded and medicines.

Food, water and other essential assistance for the displaced

In addition to medical services, the ICRC has also provided direct assistance for the repeated waves of people forced to flee their homes because of the fighting. During the year, over 800,000 people received essential household items in southern and central Somalia, in the areas around Mogadishu and in the northern Sool region. Over 230,000 people forced to flee Mogadishu also received three-month food rations. In the first quarter of the year alone, 21 million litres of water were distributed to displaced people throughout the country.

Given the scope of the humanitarian needs in Somalia, the ICRC's primary focus has been on emergency assistance. But the organization also helps people mitigate the effects of the conflict and natural disasters through a variety of water and sanitation projects and livelihood-support programmes.

In the first part of 2007, the ICRC provided more than 71,000 farming families with seed. Later in the year, during the second rainy season, another 26,750 families received seed along with two months of food rations. In addition, 14 rainwater catchments were rehabilitated through cash-for-work-programmes that provided much-needed income for over 6,000 families.

Another 10,000 families in riverfront areas received treated mosquito nets. Some 280,000 sandbags were distributed to 45 villages to reinforce riverbanks before the flood season and 15 river dikes were also shored up. When cholera threatened the central region, 1.3 million litres of chlorinated water were distributed to local residents.

A total of 10 boreholes, 52 wells, 24 rainwater catchment systems and two water-treatment plants were constructed or rehabilitated during the year. An estimated 450,000 people benefited from ICRC water and sanitation projects during the first 10 months of 2007.


Restoring family links

Another important aspect of the ICRC's work is to restore and maintain contacts between family members separated by conflict. Together with the Somali Red Crescent, the ICRC collected close to 6,000 Red Cross messages and distributed more than 10,000 messages, many from outside the country. Over 1,000 tracing files were opened on behalf of people searching for family members and over 100 ICRC travel documents were issued.

The ICRC is deeply concerned about the deteriorating humanitarian situation in Somalia. "Alternating floods and drought remain an ongoing threat, together with the protracted conflict," said Pascal Hundt. "We have no idea when those who have fled Mogadishu and other places will be able to return home. This is putting an enormous strain on them and on the communities that have taken them in."

"The Somali people have shown incredible resilience in the face of this succession of tragedies," said Mr Hundt. "The ICRC is committed to remaining as close to them as possible in 2008 and helping them to cope with the effects of the conflict and natural disasters."