MOGADISHU, Somalia (AP) – To save his severely malnourished 3-year-old son, farmer Yusuf Bulle traveled from a remote region in southern Somalia to the capital, Mogadishu, where he found hope at a rare health unit. After 15 days at Banadir Hospital, his child was deemed out of danger. “Where I come from, there is no hospital,” Bulle said, highlighting the desperate situation many face in accessing health care.
Somalia, one of the poorest countries globally, is undergoing a health care crisis aggravated by recent cuts to U.S. Agency for International Development (USAID) funding. The Trump administration's decision to dismantle USAID has disheartened many Somalis, who feel they cannot rely on their own government, which is primarily focused on combatting the al-Qaida-linked militant group al-Shabab.
According to Somalia's deputy health minister, Mohamed Hassan Bulaale, the reduction in U.S. aid has resulted in over 6,000 health workers losing their jobs, with up to 2,000 health facilities negatively impacted. This blow comes at a time when the Center for Global Development has indicated that Somalia is among countries most vulnerable to reductions in donor assistance.
While there has been a slight decline in bombings and gunfire from militants against health centers, attributed to President Hassan Sheikh Mohamud’s intensified campaign against al-Shabab, local leaders argue that the focus on militaristic efforts has come at a significant cost to health care and other essential public services. Many regions outside Mogadishu lack functioning public hospitals, forcing residents to travel through dangerous areas to access medical care.
This year, Somalia's Ministry of Health received $91 million from a national budget exceeding $1 billion, though much of this funding is dependent on external support. This amount is a welcome increase from last year’s $52 million, but mainly sourced from donor contributions, indicating a precarious reliance on outside assistance. Despite foreign backing, as seen with the recent cuts, such support can be inconsistent and unpredictable.
Hospitals in Mogadishu, including Banadir Hospital and De Martino Hospital, are primarily supported by international NGOs and humanitarian organizations. Dr. Mohamed Haashi, who oversees the malnutrition unit at Banadir, indicated that this department relies solely on donor funding from Concern Worldwide. Following the USAID cuts, the unit lost 37 employees but still manages to operate with the help of 13 remaining staff funded by outside resources.
At De Martino Hospital, Dr. Abdirahim Omar Amin expressed concerns over uncertainty after contracts with humanitarian partners expire in 2025. With a considerable influx of children suffering from preventable diseases such as diphtheria, attributed to parents’ fears of militant attacks on vaccination campaigns, the hospital is operating under precarious financial conditions reliant on donor support. Amin pointed out that while the hospital provides free services largely due to aid, the Ministry of Health, which is meant to support these facilities, should step up its contribution.
Bulaale, the deputy health minister, mentioned that the government is collaborating with partners to develop a contingency plan following the loss of USAID funding but did not elaborate on the details. This situation is indicative of Somalia's broader struggles: many public health facilities, devastated during years of civil war, are only beginning to function again, and the federal government grapples with asserting control amid ongoing security threats.
As the Somali federal government focuses on restoring security with the aid of African Union forces, U.S. military strikes, and various international partners, including Turkey, which supports a hospital in Mogadishu, the pressing health care crisis remains unaddressed. Mahad Wasuge from the Somali Public Agenda think tank noted that even newly functioning public hospitals still rely heavily on donor funding and lack a direct government financial plan that would enable them to provide comprehensive health care.
Both Banadir and De Martino hospitals serve as critical referral centers for the most vulnerable populations in need of medical attention. A pregnant woman who recently visited De Martino expressed her reliance on the hospital for free medication, emphasizing the dire need for accessible health care services. Meanwhile, political representatives like Mohamed Adam Dini criticize the government’s focus on combatting chaos rather than addressing widespread health concerns, citing a lack of a national health care strategy.
