"I haven't seen our home region for over nine months"

As more than 2,000 Somalis cross the borders of their country into Kenya and Ethiopia every day in search of assistance, in Somalia itself unprecedented numbers of people are on the move in a desperate search for food and medical help. MSF teams in Somalia are dealing with fast-rising numbers of displaced families who have travelled long distances to reach MSF’s hospitals and therapeutic feeding centres.

Luul Sankus, a mother of two, walked with her husband and children for more than 160 kms to the village of Hurufle in the Juba Valley.

“I haven’t seen our home region for over nine months now. We are farmers and, when the rains failed, there was nothing left for us where we come from. My husband and two of our children walked all the way to Hurufle, where we are now living as displaced people. When we came to Hurufle, our son fell ill; there was no treatment, no shelter and no food. I was advised that I should take him to the MSF hospital in Marere. That’s why I am here.”

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What characterises this crisis is that people are now leaving their villages and the rural areas en masse because crops have failed and livestock are dying.

“Displacement is nothing new to Somalis,” says MSF operations manager Joe Belliveau (pictured opposite). “For the past few years, hundreds of thousands have fled the violence in Mogadishu and elsewhere. What is new is that people are now fleeing the rural areas simply because they have no more food to eat.”

Camps for the displaced are appearing inside Somalia wherever people feel they have a better chance of getting help. In the village of Jilib, in Lower Juba Valley, for example, around 5,000 people have spontaneously settled in a makeshift camp in the hope of receiving support from the local community, the authorities and MSF.

MSF is currently running nine medical-nutritional programmes in South Central Somalia, most of which are in territory controlled by Al Shabab. Along with MSF’s three large health programmes in refugee camps over the border in Kenya and Ethiopia, the nine programmes in South Central Somalia conduct thousands of medical consultations daily and currently treat over 10,000 severely malnourished children.

“In several parts of Somalia, this is the worst situation we’ve seen in the past decade,” said Belliveau. “Normal coping mechanisms are exhausted and many people have reached their limits. MSF is prepared to do more, but to do so we need certain restrictions to be lifted. If MSF is allowed to send in international technical experts to work alongside our more than 1,000 Somali staff, and if we are permitted to send in supply flights with therapeutic feeding and other medicines, then we can scale up further.”

But with continued restrictions on international staff and flights, there are limits to what MSF is able to do.