​Our mission is to make the world a better place by alleviating human suffering and promoting humanitarian values.

We understand responsibility for the world as the possibility for each PAH employee and volunteer to actually participate in the aid process and influence it. The work of any of us contributes to saving people’s lives. This obliges us to develop ourselves and to raise the quality of our aid.

Polish Humanitarian Action (PAH) is a non-governmental organisation founded in 1992 in Poland. We are active at local and national level, but also provide humanitarian assistance worldwide.

Our mission is to make the world a better place through alleviation of human suffering and promotion of humanitarian values. PAH fulfils its mission by empowering communities in crises to regain responsibility for their own future and become self-reliant. PAH shapes humanitarian attitudes among the public and creates a modern culture of mutual help. PAH combines effectiveness with the respect for human dignity.

The most important strategic objective of PAH is to ensure dignity and basic services, as well with human rights in areas affected by conflict, natural disasters and poverty. The main filars of our work is to provide the following:
        1. access to water and sanitation
        2. access to education
        3. access to food and food security
        4. possibility to live in decent conditions, to independence and self-determination
        5. protection of life and health during natural disasters and armed conflicts

​This is where we work:

Our main activities are providing humanitarian aid and development assistance, as well as educating society. In our work, we are guided by the following principles: humanitarianism (openness towards and respect for people of different races, nationalities and religions, as well as sensitivity to human suffering), impartiality (we provide help according to needs, regardless of conflict sides), neutrality (we do not take a stand in religious or political disputes), independence (our help is independent of state) as well as the following values: solidarity, justice, human dignity, equality, peace, freedom, tolerance and pluralism.

We work with communities suffering from natural disasters, armed conflicts, persecution and long-lasting poverty in order to ensure their rights to life and health, water and adequate sanitary conditions, food, education, proper living conditions. We help communities with special focus on the most vulnerable groups, including children, women, the disabled, refugees, repatriates and IDPs, securing life and health during natural disasters and armed conflicts.

By delivering humanitarian aid, we have built the strength of PAH and developed our own methods of providing aid which are consistent with the principles and ethics of our organisation. PAH participates actively in the development of the third sector towards its integration, professionalisation and implementation of advocacy activities in the field of development cooperation and humanitarian aid.

​Here you can see our 2013 Report:

Polish Humanitarian ACTION was founded in 1994, but we started our mission of making the world a better place already in 1992, as the Polish branch of the EquiLibre Foundation. It was when Janina Ochojska started ORGANIZING convoys with donations for the besieged Sarajevo. It was the first initiative of this kind, which provided opportunity for the Polish society to rpovide aid to people suffering from war and insecurity.

When we say “Polish Humanitarian Action”, we think “Janka”

Janka is the founder and president of PAH. She is an extremely modest woman, an undisputed authority in the field of humanitarian aid. She has always been an active community worker – as a student she participated in the activities of the Jesuit University Chaplaincy, and from 1976 she was an oppositionist and an activist of the trade union NSZZ Solidarność in Toruń. Her aim in life she discovered in France, where she had an operation in 1984. It is there that she first encountered the idea of a humanitarian organisation – EquiLibre, where she worked as a volunteer. She coordinated the French medical and food aid for Polish hospitals and she organised support convoys to Bosnia.
She felt a desire to bring humanitarian activity to her home country and inspire the Polish people to care for those in need. Janka was the initiator of the first humanitarian aid convoy to Sarajevo. She organised the first Polish aid mission in Kosovo, then in Chechnya, Iraq, Iran, Lebanon, Sri Lanka, Afghanistan, Sudan, Darfur and the Palestinian National Authority. Since the establishment of the Foundation, she has been developing and promoting PAH, ceaselessly acting in the field.
​Read more about Janka...

Twenty two years ago, on the 26th of December 1992, the first convoy, organized by Polish Humanitarian Action left Poland and headed for Sarajevo. This convoy initiated a series of more than twenty transports with aid not only for the inhabitants of Sarajevo, but also for Bosnia and Herzegovina and other countries of former Yugoslavia which suffered because of the war. Read more...

PAH’s activity served as a mobilising factor for people from different social backgrounds, who were determined to help and to show their solidarity with people in need. Thanks to their commitment, we were able to organise a series of spontaneous aid campaigns. We concentrated mainly on immediate aid, by sending to areas afflicted by conflicts and natural disasters convoys with donations to satisfy the basic needs – food, medicine, rehabilitation equipment and other necessities indispensable to survive.

Since then we have encountered crisis situations of various kinds and have employed various methods of providing assistance. The experience has helped us greatly expand and specialize our relief efforts. PAH's mission is to make the world a better place by relieving suffering and promoting humanitarian values. We help people in crisis situations return to self-reliance and assume responsibility for their own future as soon as possible. We work efficiently while respecting human dignity and thinking about the long-term prospects for a sustainable development in regions affected by war, natural disasters or poverty. We also engage in consciousness-raising efforts in Poland, trying to foster humanitarian attitudes and deepen public understanding of the relations between the Global South and the Global North. We shape a modern culture of aid and teach people about it.

For the last twenty years we have brought help to people in 44 countries all over the world, we have provided access to water for over 500,000 people and the access to adequate sanitation for one and a half million people. We have created the opportunity to gain education for more than 25 000 students, funded over 10,000,000 meals for malnourished children in Poland and around the world, provided humanitarian aid worth PLN 263,000,000 (88mln USD), we have brought help to 17,000 refugees living in Poland and to 2,000 returnees.

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PAH has been present in Somalia since 2011. With WASH and Nutrition programs PAH supported more than 70 000 people from the most vulnerable communities in different regions in Somalia. Our primary focus was to provide safe drinking water through drilling new boreholes, constructing water distribution systems, and constructing rain water reservoirs.

In our work we also focus on other WASH components, that is improvement of sanitary conditions and raising awareness on hygiene and sanitation, to make our WASH interventions fully comprehensive. All interventions include operation and maintenance trainings for future mechanics, provision of spare parts as well as distribution of hygiene materials. PAH aim is to ensure sustainability and effectiveness of interventions.

PAH has been gradually expanding activities in Somalia with a priority given to the most vulnerable beneficiaries and locations - especially to far, rural, prone to drought pastoral areas, then IDP camps and settlements. In 2011, PAH has opened PAH Country Office in Garowe, Puntland and in May 2012 field office in Mogadishu.

From 2011 we have implemented various projects in different areas in Puntland. We conducted WASH for schools programme is to support schools with access to water and sanitation by constructing school berkads, establishing school gardens and improving existing sanitation facilities. The project was implemented in cooperation with Puntland Ministry of Education and WFP. In 2012 and 2013 (for 15 months) we were also providing Emergency Nutrition in Mogadishu. Our projects are funded from PAH's own resources which consist of individual donations, public collections and donations from the private sector.

In 2013 PAH became ECHO partner in Somalia. Our emergency WASH response for IDPs is implemented in Puntland – Garowe and in Mogadishu.

With this intervention wesupport 20 000 internally displaced persons (IDPs) people in camps in Jowle and Mogadishu (km.7-13). In most of the activities PAH engages local community through cash for work programs. In 2014/2015 PAH includes livelihoods component in the WASH intervention in Jowle IDP camp, which includes vocational trainings, establishment of public/private partnership in latrine dislodging, support in establishing waste management system. In Mogadishu focus of the activities will remain on emergency WASH response in k7-13 or other new areas where IDPs will be relocated or arriving.

Beside ECHO program, we implement minor projects, funded by private donors and PAH contribution. In 2014/2015 we will rehabilitate shallow wells and a borehole in Mogadishu, in areas with huge influx of IDPs.

​Background of the project

The ongoing conflicts, repeated droughts and the persisting lack of humanitarian access to the southern regions of Somalia create a regular influx of IDPs to Mogadishu. The continuous arrival of new IDPs and the remaining poor health and nutrition status of many IDPs already living in Mogadishu not yet targeted by the nutrition programmes create a continuous need for providing health and nutrition services.

Between April and June 2012 showed that IDPs in Mogadishu were in critical nutrition phase. In addition, outbreaks of infectious diseases such as cholera, and diarrhea have resulted in the deterioration of the precarious malnutrition levels. According to FSNAU, 2.12 million people are projected to be food insecure from August to December 2012. It can be expected that those people might seek refuge in Mogadishu. Also the nutrition cluster assumes that a significant improvement of the humanitarian situation is unlikely to happen in the coming three years.

PAH intervention targeted 2 areas: Bondhere district and Halw-Wadag District in Mogadishu, which were among the most chaotic and suffering places where vulnerable communities have come across. This was the front line of the TFG army fighting Al Shabab, and every day there were new fights. The area has been in the news before it has not been liberated because of the co-current fights. Consequently, the nutrition cluster had put it into its agenda of consideration.

The projects was successfully implemented as responses to Nutrition emergencies and there are important lessons that make them rationale alternatives to the current unavailability of basic Nutrition services in these areas. First, based on monthly basis, households almost entirely received Nutrition services to manage the basic health and nutrition at household level.

The initiative was to link the health service promotion and beneficiaries increasing their chances for survival and increasing awareness for replication in current programming along the tenets of the MDGs which among others aim at cutting on child and mother mortality. Additionally, the initiative has led to better sanitation and hygiene management within the IDP camps which have become dumping grounds as result of the massive and consecutive awareness raised during the project implementation.

In relation to the continuously high level of malnourishment in the region, especially in the case of children, pregnant women and breastfeeding mothers, Polish Humanitarian Action decided to continue to support both outpatient clinics in therapeutic supplementary feeding for for 15 months.

Implemented project activities were as follows:

· two sessions of SOYDA health and nutrition staff training
· two cycles of trainings for mothers, community health workers and other community groups for  the promotion of breast feeding for the new sites\
· screening of all children under five years and consequently register and admit those meeting the admission criteria of SAM and MAM without medical complications
· provision of the appropriate RUTF (ready to use therapeutic foods) to the admitted severely malnourished children without medical complications
· provision of Vitamin A and iron and other micronutrient supplementation, appropriate IYCF services, deworming of malnourished
· immunizations and prevention of common illness including malaria and providing treatment services at the SOYDA health and nutrition centres
· hygiene promotion, sanitation and hygiene education and promotion of appropriate infant and young child feeding and caring practices

During the nutrition program in Mogadishu we helped more than 33 870 people, most of them were children and women. 

The project was funded by PAH (259 900 USD) and implemented in partnership with SOYDA (Somali Young Doctors Association).

​Since October 2012 PAH has been helping to build a rainwater intakes and reservoirs, the so-called berkad, in order to streamline the functioning of the schools and make them independent from expensive deliveries of water with the use of cisterns.

With the aim of improving access to water for the school students in Puntland, PAH and WFP agreed to continue a partnership under the project “Water for Schools”, first established to implement a pilot project of constructing one underground water storage reservoir in Jalam school in Puntland. The selection of the schools was discussed with and approved by the Ministry of Education (MoE) and the school’s Community Education Committee (CEC).

The main purpose of the project is to assist schools targeted by WFP’s School Feeding Programme with a stable and free access to water to support their cooking activities. Preparation of daily school meals, consisting of products provided and delivered by WFP, can be a great challenge in schools with no water reservoirs. Since water is necessary for any cooking activities, construction of berkads can be seen as an appropriate solution. The availability of water will also improve the sanitation conditions in the schools since water could be used to wash hands before consumption of the food.

In order to lower the costs of water delivery to the school and to ensure appropriate water resources throughout the year, we want to build a berkad, i.e. a traditional rainwater reservoir, with the assistance of the local population. The berkad is constructed in such a way as to collect the largest possible volumes of water from the higher areas but also from the school roof.

The amount of water in the constructed berkads should enable schools to establish vegetable and fruit gardens. As already mentioned, WFP provides the selected schools with the basic food supplies. Yet students’ diet is still very limited. That is why cultivation of vegetables (such as tomatoes, onions, or peppers) could serve as a great method of enriching daily eating habits of school children. Establishment of school gardens could also serve as a great way to promote knowledge of farming and encourage local community to introduce such practices around their own houses.

School in Ceel Buh

Ceel Buh, located around 170km north-east from Garowe, is a small town inhabited by poor vulnerable community. The school was constructed in 2002. There are 306 students enrolled comprising of 161 boys and 145 girls, there are 6 teachers.

There are two small ground water tanks located next to the school, built by Mercy Corps and UNICEF. They are not used as they have been badly constructed and the structures have cracks. The water poured inside the tanks leaks into the ground. The school community repeatedly tried to repair the tanks with the use of cement, but it has not brought any positive results. Consequently, all water is brought and kept in jerry cans.

School in Hagi Aden

The school in Dangoranyo district was founded in 2002 and there are 420 students (222 boys and 198 girls). The school itself is a building consisting of one office and 9 classrooms.

School in Ham hamaa

School was built by means of community contribution and has not enough space to accommodate 6 grades (upper and lower primary level) in 3 classrooms so some of the class take part outdoor. There are 5 teachers. There are 150 students – only 45 out of 150 are girls. The school has recently been enrolled into WFP’s projects aiming at increased school enrolment rate among girls by proving food incentives.

School in Haji Kheir

Currently, 265 pupils attend the school: 150 boys and 115 girls aged from 6 to 18. Since 2011 the school has been covered with the supplementary feeding programme of the World Food Programme (WFP). WFP provides pupils with products for preparing daily meals, such as breakfast and lunch. However, their diet is limited to basic products, such as rice, porridge, corn flour and palm oil.

School in Jamal

The school in Jalam exists thanks to the support of the local community and international aid. The students’ parents pay only a part of the schooling costs and the meals are provided by the World Food Programme (WFP).

Local population was engaged in the construction of the berkad and the constructors were remunerated with the use of food-for-work method. In this case, the food was provided by PAH’s partner i.e. the World Food Programme (WFP).

Project Background

The central problem in Nugal region is that most pastoralists moved with their herds to the few grazing areas that received some rains. These locations are generally far from water sources (including Springs, Boreholes, Berkeds and Ballis). Once water was exhausted, they moved to nearby water sources, causing overgrazing, exploitation of resources, and exposing livestock to contact with strange animals. Any subsequent loss of human and livestock lives from this extended situation means that pastoralists will continue to suffer poor food security as well as reduced income for essentials such as food and health care. Surviving livestock will have little nutritional or sellable value in terms of meat available and lack of milk production forcing them to adopt some extreme measures such as distress coping mechanisms -- namely reducing meals, selling household items, migrating to cities in search of labor, dividing family members, and sending children to relatives, reverting the pastoralists into a vicious circle. Traditionally nomadic families move the large stock to distant grazing areas in the dry seasons.

Situation in Nugal

In Nugal Districts, the most reliable water sources are springs, deep boreholes and shallow wells, which feature prominently in areas with relatively high water table. Most of these permanent water sources are located in towns. The outlying villages have a scarce number of permanent water sources in comparison to the domestic and livestock water demand for the area. Springs act as important sources of water for these areas. However, springs are mostly inaccessible by both people and their animals and population depends solely on trucked water.

We have built a water transportation and distribution system from the nearby sources which were hard to reach. The village is located in the Eyl District in Somalia. In the past, villagers and dwellers used the source which is located in a deep canyon. Women and children walked the steep path every day in order to collect water. However, due to the steepness of the path only small volumes of water could be transported at one go. Thanks to our project water can now be accessed in the village. PAH has built a water tower, water intake points for people, watering troughs for animals and a generator room. It has also fitted the system with the necessary equipment and trained a group of beneficiaries to become operators and mechanics. Moreover, training sessions on hygiene were conducted.

Provision of permanent and semi-permanent water sources through construction of springs, drilling of boreholes and construction of Berkeds has encouraged settlements in Nugal region. The increased demand for commercial activities (trade, small scale enterprise), availability of some basic social services (water, health) and enhanced peace and stability has also encouraged people to settle in some of these centers.

The worst problem presently faced by most of the communities in Eyl and Dangoroyo districts of Nugal Region are lack of safe drinking water and poor sanitation and hygiene conditions caused by: (a) failure of Deyr 2011 seasonal rains, and (b) lack of water sources nearby grazing areas. The effects are:
- high prevalence of water borne diseases and high morbidity rates among the most vulnerable members of the community, such children, women, and the elderly due to unclean and shortage of water plus poor hygiene condition
- poor hygiene and sanitation practices
- displacement of large number of pastoral community
- significant reduction of frankincense production which badly impacted the income of households as well as the macro-economic situation of the region
- high cost of water trucking, however, the situation requires an urgent intervention before it turns to be humanitarian disaster.

PAH activities in Ceel Madoobe:

• Rehabilitation and upgrading of existing water spring in Ceel Madoobe, and providing water distribution system: ground water storage at the spring, elevated water tank, two water kiosks, two animal troughs, twin generator room, three VIP latrines
• Water Supply System Construction includes: water recovery test, spring intake construction, laying distribution pipes, construction of two water kiosks, two troughs (one for camels and one for goats/sheep), twin generator room and a water tank.
• Water recovery test: Water recovery test confirms the capacity of the point to recovery an amount of water after water in withdrawn at a certain time
• Capacity building. Training of village water committees on water management, cost recovery and Operation and Management of water systems and Training on Hygiene and Sanitation.

Aim of the project was to provide access to water through rehabilitated water source systems to 14,790 people and more than 40,000 livestock. Project was funded by PAH.

Project was implemented in partnership with Muslim Aid.

Most of us take easy access to drinking water for granted. Each day, we use huge amounts of water when we cook, wash ourselves, our clothes or dishes. Meanwhile, one eighth of the Earth’s population suffers from thirst and diseases caused by drinking contaminated water.

The public opinion does not realise this, because lack of drinking water does not kill in such a spectacular way as floods, earthquakes and wars. Its victims pass away silently; they are mostly infants and children living in agricultural areas or big-city slums. They die from diseases such as cholera, typhoid fever, polio and diarrhea, which kills 2.2 million children per year.

Lack of water paralyses the development of individuals and entire communities. It is one of the main reasons why millions of children do not go to school. They cannot afford to learn; they have to help their mothers to get the water for their households. The European needs a couple of seconds to turn the tap on, but in some places on Earth, getting water consumes 25% of people’s time. This has a huge impact on local economy: the United Nations Development Programme estimates that each dollar invested in the improvement of water and sanitary conditions would bring 8 dollars of additional profit in return.

Seemingly, the issue of access to water concerns mostly Asia and Africa, because this is where most people suffering from thirst, undernourishment and related diseases live. However, such an interpretation is superficial. The world we live in is a dense, interrelated network, a “global village”, in which economies of specific states are no longer independent and in which social and ecological problems have a truly planetary aspect. It is the global processes that cause the advancing water crisis. Climate changes, natural disasters, poverty, armed conflicts, growing population and urbanisation have all contributed to the current situation.

What is worse, the situation is constantly deteriorating. Droughts and floods caused by global warming are more and more frequent, and hence they cut off more and more communities from clean water. Climate changes are caused by CO2 emissions and pollution. Almost half of the world’s biggest rivers are gravely contaminated or are in danger of drying out. Still, every day 2 million tons of sewage is drained into the world’s waters.

Most of global clean water resources are consumed by agriculture. Unfortunately, the irrigation systems used in developing countries are of low quality, so a significant amount of water is wasted. Moreover, as a result of wasteful economy, forest areas, which constitute a natural factor in preserving the good quality and safe amount of global water resources, are shrinking.

The drinking water crisis is also aggravated because of the growing population. Since 1950s, as a result of demographic explosion, the population of our planet has tripled. Currently, there is over 6 billion people in the world, and in 25 years this number will grown to 8 million. While the demographic situation of more developed countries is stabilising, less advanced regions note a significant increase in the number of inhabitants, especially in big cities. The development of infrastructure in fast-urbanising areas is too slow to satisfy the population’s need for industrial and drinking water. In countries suffering from shortages, water is often treated as an object of profiteering. In some cities, prices of water established by private suppliers are over a hundred times higher than the official prices. In Delhi (India), this price is even 489 times higher.

Access to drinking water is a necessary condition for the societies to develop and fight poverty. Without satisfying this condition it is impossible to improve education and health care. This is why lack of drinking water can be seen as a factor that widens the gap between the rich and developing countries.

Lack of access to water can become a problem of each inhabitant of our planet. Consciously or not, we all contribute to the decrease in drinking water supply. Only by combining efforts of societies, governments and institutions can we prevent the crisis from worsening. The global community is now aware of the situation and made it one of the Millennium Development Goals to reduce the number of people with no access to drinking water by half until 2015. Unfortunately we already know that in some regions of the world, such as Sub-Saharan Africa, these goals cannot be attained.

Somalia has one of the highest maternal mortality rates in the world. This has been estimated to be 1044/1000000 life birth. Most deliveries occur at home with the assistance of traditional birth attendants. Consequently there is a delay in referring to the hospital in case of emergencies.

Health services in Puntland have never met the needs of the region’s population and were in a precarious condition even before the collapse of the former Somali government. The civil upheavals and influx of the internally displaced people from other parts of the country worsened the situations.

Women at IDP Camp in Garowe, Puntland, have experienced complications during pregnancy. Many pregnant women die as a result of inaccessibility of RH and basic health services which are not available in IDPs settlements. This situation increased number of pregnant women who remain at to be highest risk of prenatal, postnatal and postpartum stage

Project Background

With the aim of improving WASH Projects for the health facilities inside the IDPs in Garowe, The African Network for the Prevention and Protection against Child Abuse and Neglect (ANPPCAN) Garowe field office together with PAH agreed to construct sinks (hand washing facilities) in the maternity center and connect Maternity Park (garden) with water pipes.

The maternity home do not have water connection (hand washing sinks) in spaces were medical assistance is delivered, which poses big challenge during child delivery and other medical activities i.e. maternity Lab, so this pushes the maternity center to keep clean and suitable for handling all the activities.

Additionally, maternity waiting center currently suffers poor conditions of hygiene standards and there is no separate hand washing stations inside the building unless inside the toilets. These facilities cannot be used during medical procedures, Other in the room in the center like lab room do not reach water system and that is also a challenge for improving a quality of tests.

Maternity waiting homes (MWH) are residential facilities, located near a qualified medical facility, where women defined as "high risk" can await their delivery and be transferred to a nearby medical facility shortly before delivery, or earlier should complications arise.

Many consider maternity waiting homes to be a key element of a strategy to "bridge the geographical gap" in obstetric care between rural areas, with poor access to equipped facilities, and urban areas where the services are available. As one component of a comprehensive package of essential obstetric services, maternity waiting homes may offer a low-cost way to bring women closer to needed obstetric care.

Maternity Waiting Homes in Jowle IDP supports mother with facilities to have normal deliveries and has established a system of referrals in case of complications during delivery to Garowe General Hospital. UNFPA developed a referral mechanism to handle complications arising from abnormal deliveries which are received in the MWHs. Garowe General Hospital was the referral Point for all cases which proved to be beyond the capacity of the MWHs Staff to handle, however, for the Introduction between ANPPCAN Team and Garowe Hospital Management was facilitated by UNFPA was mad a good referral pathway between ANPPCAN and Garowe General Hospital.

ANPPCAN Provides free transportation for pregnant mothers in the IDP vicinity when MWHs staff consider the case as “Severe and Un-manageable” at the MWH level. MWH has worked with community health promoters who were instrumental for sensitization and mobilization of the importance of the maternal health and made well aware the community of the existing services. They had close collaboration with IDP leaders, project beneficiaries and camp committees, since they had weekly health education sessions and constantly without any hesitation identifying women at risk the community level and managed to encourage these women to make use of the free of charge services available all the time.

The project was one of initiatives funded by PAH and implemented by The African Network for the Prevention and Protection against Child Abuse and Neglect (ANPPCAN). We are helping 60 women per month.

When emergencies strike, women become even stronger. In times of conflict, women may have to single- handedly ensure the safe flight of children, older relatives and the disabled across barren, unfamiliar territory, especially when men have been killed or are away fighting. In the aftermath of a natural disaster and in refugee settings women's usual roles often expand at the same time that even basic task, such as water collection, become more difficult to carry out. In all these situations, women must overcome immense obstacles to provide care and safety for others even as their own vulnerability to malnutrition, sexual violence and exploitations, sexually transmitted infections, unplanned pregnancy and unassisted childbirth may increase.

In times of crises, the particular strength and vulnerability of women are often overlooked in the rush to provide humanitarian assistance. Yet targeted support to women can be one of the best ways to ensure the health, security and well being of families and entire communities. This is why UNFPA, the United Nations Population Fund, works with partners to ensure that the specific needs of women are factored into planning of all humanitarian assistance. UNFPA also addresses urgent reproductive health needs that are sometimes forgotten.

Humanitarian response

Working with partners on the ground, UNFPA's humanitarian assistance is focused on the provision of reproductive health information and services. In this context, equipments and supplies were delivered to service delivery points and health care providers. Women at reproductive age received hygiene kits, and clean delivery kits were distributed to pregnant women and birth attendants to assist in clean deliveries. The package provided to health institutions and staff includes emergency obstetric care, sexual and gender- based violence medical treatment and management of sexually transmitted diseases.

Reproductive Health

Reproductive health encompasses key areas of UNFPA's vision: that every child is wanted, every birth is safe, every young person is free of HIV and every girl and woman is treated with dignity and respect. UNFPA's efforts focus on reducing the rate of maternal mortality in Somalia, which is among the highest in the world.

UNFPA supports the training of doctors, nurses and other health workers in life -saving emergency obstetric care. UNFPA responds to the priority needs of reproductive health information and services through qualified Somali partners inside the country to build the capacity of local institutions for long term sustainability.

Obstetric fistula

Obstetric fistula is a preventable injury of childbearing that leaves women with chronic incontinence and, in most cases, a stillborn baby. It is a hole in the birth canal caused by prolonged labour without prompt medical intervention. Reconstructive surgery can usually mend the injury with success rates of 90 % for uncomplicated cases, but most women cannot access or afford the medical treatment, estimated at 300 $.

HIV/AIDS

Conflict situations increase vulnerability to HIV. The emergence of the HIV pandemic requires vigorous and sustained campaigns on prevention and treatment. The social and economic disadvantages that woman and men face in many areas have made them especially vulnerable to these issues. UNFPA programmes include promotion of responsible sexual behavior, use of condoms for dual protection, and integration of HIV components in all reproductive and sexual health services.

Gender based violence

Access to health facilities in Somalia is limited. Sexual and gender based violence survivors suffer numerous downfall, among them weak clinical management and referral mechanisms, poor data collection and limited access to medical kits. As a continued sexual and gender based violence prevention and response initiative, UNFPA undertakes trainings on medical management of sexual and gender based violence survivors. The training aims to strengthen the capacity of health care providers in effectively managing cases of sexual gender based violence through medical and psychosocial support, HIV/AIDS prevention, administration of medical kits and referral mechanisms.

Female genital mutilation/cutting

Traditional practices meant to control women's sexuality often lead to great suffering. Among them is the practice of female genital mutilation/cutting, a major lifelong risk to women's health and a violation of basic human rights. This practice refers to the removal of all or part of the clitoris and other genitalia. It is based on the prevailing beliefs that female sexuality must be controlled, and the virginity of girls preserved until marriage. In Somalia, it is estimated that 98% of women have undergone female genital mutilation/cutting, with 78% having experienced an extreme form of it (infibulation). UNFPA works with boosting national capacity to develop and manage culturally sensitive programmes on preventing female genital mutilation/cutting. UNFPA supported training for key stakeholders such as religious leaders and traditional elders and development of media and culturally sensitive information materials.

Population and development

Development objectives, including early stabilization of population growth, can be achieved only by basing policies and programmes on the needs and choices of women and men. Efforts are aimed at enhancing the country's capacity to coordinate, plan, implement, monitor and evaluate population and development programmes, and to integrate population issues in development activities. UNFPA plays a key role in advancing the implementation of the International Conference on Population and Development agenda. UNFPA assistance in Somalia includes providing direct financial support in building the capacity of personnel and institutions in demography, population and development.

Youth

Since talking about sexual and reproductive health is still regarded as a taboo for the majority of the population, young people need increase access to participation and education in reproductive health, as they are vulnerable to sexually transmitted infections, especially HIV/AIDS. UNFPA is working to promote and protect the rights of young people. It envisions an environment in which both girls and boys have optimal opportunities to develop their full potential, to express themselves freely and have their views respected, and to live free of poverty, discrimination and violence. UNFPA have therefore established a National Youth Peer Education Network in Somaliland and Puntland in collaboration with the global Y-Peer Network.

Partnership

UNFPA would not be able to successfully carry out its work and impact the lives of those most in need without the partnerships it has with a broad range of governmental and non-governmental institutions dealing with population issues, sexual and reproductive health needs and rights, youth, gender and women's empowerment. The diversity of the humanitarian and development community proves to be an asset when all organizations build on their comparative advantages and undertake a result oriented approach. In this light, women's networks, youth organizations, national commissions, governmental institutions, the private sector and other United Nations agencies are all crucial partners in UNFPA's daily work.

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The leading causes of death and disability for Somali women of reproductive age are complication during pregnancy and childbirth, lack of access to skilled birth attendants, narrowly spaced births, and early adolescent marriages. In Somalia around 1,044 women per 100,000 women die during childbirth, placing Somali women among the most high-risk groups in the world, significantly higher than that of other Least Developed Countries (LDCs), either globally or in the Arab world.

Haemorrhaging, prolonged or obstructed labour and infections are the main causes of death. High rates of malnutr​ition, along with poor antenatal, delivery and postnatal care contribute to these high rates of mortality.

The child and maternal mortality rates for Somalia are amongst the highest in the world; one out of every ten Somali children dies before seeing their first birthday. While comprehensive information is not available, it is believed that leading causes of infant and child mortality are illnesses such as pneumonia (24 per cent), diarrhoea (19 per cent), and measles (12 per cent), as well as neonatal disorders (17 per cent).

One out of every 12 women dies due to pregnancy related causes. Access to maternal services is low with only 33% of births being attended by a skilled birth attendants. Modern contraceptive rate is around 1% only. The high fertility rate in Somalia puts the women at a high risk of mortality and morbidities around child birth especially with the low access to basic health services including family planning.

In order to ensure that women remain safe during childbearing years, it is vital that a competent health worker with midwifery skills be present at every birth. In Somalia, the majority of births (55.9 percent) take place with the help of Traditional Birth Attendants (TBAs), who often lack training on how to manage birth complications. Conversely, only 3.4 percent of deliveries are handled by medical doctors, 9.4 percent are assisted by family members, and 25.4 percent are aided by nurses and midwives

Since 1999, there has been minimal improvement in the number of births attended by skilled health personnel. Viewed by zone, since 1999, this indicator has increased in South Central and Somaliland but decreased in Puntland. It is important to note that Somaliland has achieved substantial progress on improving the number of births attended by skilled health personnel. This success is largely the result of government investment in health services and infrastructure.

Contraception prevalence also serves as a key indicator toward this MDG. The percentage of current contraception use among married women of reproductive age in Somalia is just under 15 percent. In addition, use of modern contraception methods is even much lower (1.2 percent). These low contraceptive prevalence rates result most likely from cultural and religious factors as well as low education and literacy rates among women, resulting in minimal knowledge about contraception methods.

Antenatal care coverage, an indicator of access to and use of health care during pregnancy, is very low in Somalia. In general, poor access to essential health care services during pregnancy results from several factors including insufficient human resources as well as inadequate and poorly equipped health facilities. Coverage is even lower in rural areas—less than half of that of urban areas—highlighting the significant rural-urban disparities in access to health care across Somalia. The Somaliland government, however, has placed strong emphasis on health policymaking, and thus this zone has had more successful performance in improving antenatal health care.

Here you can read ​The Countdown country profile for Somalia, which presents in one place the best and latest evidence to enable an assessment of progress in improving reproductive, maternal, newborn, and child health (RMNCH) and achieving MGD 4: Reduce child mortality an MGD 5: Improve maternal health.

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In 2013 PAH became ECHO partner in Somalia.

Our emergency WASH response for IDPs is implemented in Puntland – Garowe and in Mogadishu. With this intervention PAH supports 20 000 internally displaced persons (IDPs) people in camps in Jowle and Mogadishu (km.7-13). In most of the activities PAH engages local community through cash for work programs.

In 2014/2015 PAH is planning to include livelihoods component in the WASH intervention in Jowle, which includes vocational trainings, establishment of public/private partnership in latrine dislodging, support in establishing waste management system. In Mogadishu focus of the activities will remain on emergency WASH response in k7-13 or other new areas where IDPs will be relocated or arriving.

The main objective of our WASH programs is to ensure healthy and dignified living conditions for the IDP communities in Somalia – provide safe drinking water and proper sanitation facilities to internally displaced persons (IDPs) living in IDP camps.

Our ECHO Wash projects objectives and activities are:
·  Ensured access to safe water to IDP communities, through construction of shallow wells in Jowle IDP camp and rehabilitation of boreholes in Mogadishu and provision of necessary water system in both locations, along with operational and mechanics trainings.
·  Provision of safe sanitation facilities in IDP communities by rehabilitating existing latrines in Jowle and Mogadishu and constructing new latrines, also emergency latrines (Mogadishu).
·  Hygiene Promotion activities such as awareness campaigns and hygiene kits distributions, trainings on hygiene and sanitation promotion and community mobilization for Community Health Promoters’ and WASH Comittees.
·  Establishment of effective solid waste disposal management in IDP camp in Jowle, through construction of solid waste transit stations, awareness and cleanup campaigns, establishing system of latrines pit hole clearing.
·  Participation of the IDPs communities in Jowle and Mogadishu and supporting livelihoods by involving he most vulnerable people in cash for work program and establish of WASH committees in both locations.

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In 2011-2012 Somalia was affected by a devastating famine—caused by ongoing insecurity, an unrelenting drought, and restricted humanitarian assistance—which exacerbated the country’s ongoing displacement crisis.

As of September 2014, there were more than 1.2 million Somalis displaced internally and nearly one million refugees living in neighboring countries such as Kenya, Ethiopia, and Yemen. About 893,000 IDPs live in south-central Somalia (an estimated 369,000 IDPs in settlements in and around Mogadishu), 129,000 in Puntland and 84,000 in Somaliland – including those displaced in the regions of Sool and Sanaag. Based on interviews with UNHCR staff in Galkayo, Puntland, in June 2013, 70 – 80 per cent of IDP households in that region are headed by women. In 2013, UNICEF estimated that children make up nearly 60 per cent of the total IDP population (UNICEF, January 2013).

Hundreds of thousands of Somalia’s estimated 1.5 million internally displaced people (IDPs) have sought shelter in Mogadishu, but instead of finding safe refuge there, many of the displaced have encountered a hostile and abusive environment. OCHA states that more than 360,000 people displaced by conflict live in makeshift tents in crowded conditions in the capital, the biggest amount of the displaced people live the Afgooye Corridor, which lies to the north-west of the city.

All this sets a precarious stage for the situation of the internally displaced in the capital. The government announced in January that it is planning to relocate Mogadishu’s tens of thousands of internally displaced people to the outskirts of the city, a proposition that raises significant human rights concerns, in addition to complex logistical and development challenges. Human Rights Watch’s new report details the existing serious abuses against IDPs, including physical attacks, restrictions on movement and access to food and shelter, and clan-based discrimination against the displaced in Mogadishu.

Mogadishu is still the main destination point for the IDPs coming from affected by natural disaster and conflict areas but the current situation of IDPs in Mogadishu is not stabile, due to architectural changes, the new growing structure and the new actors willing to reconstruct the capital city of Somalia.

Many of the IDPs have been already relocated or evicted from the camps created last year in Mogadishu. Forced evictions have continued and gathered pace in recent months despite the authorities’ failure to find an alternative safe location. Some of the IDPs, who feel safe, are voluntary turning back to their place of origin but still major groups try to remain in the area of Banadir, in zona K and further in Km.7-13, where can seek for a protection and humanitarian service. It is not easy to predict, what will be the reaction of IDPs at the proposed location.

Living conditions in the Afgooye corridor are extremely difficult. People struggle for food and other basic necessities as the precarious security situation is preventing humanitarian agencies from accessing people in need. Some assistance is getting there through local partners, but the amounts are minuscule in comparison with the needs. Many people take risks and walk to Mogadishu and back every day in search of a daily living. Basic services such as health and education are scarce and rudimentary.

The most crucial area of the Afgooye Corridor is the area of km.7-13, which is constantly filled by the IDPs arriving from two opposite directions: from Afgooye Corridor and from inside of Mogadishu, manly from the IDP camps, whose dwellers have been evicted. The number of the population in the area of km.7-13 is estimated at 3,000 HHs. The population consist of the IDPs. PAH team met various people, those who've lived in the settlements since six and more months and new arrivals, who've settled down from one month or less (mainly from flew from camps in Mogadishu).

The common problems of IDPs living in the km.7-10 are lack of safe water (water is available but for payment) and limited access to food. The IDPs have very low income sources, limited to casual work in Mogadishu and charcoal, which constrain their possibility to survive in the area, where the basic products and service is payable. The lack of proper sanitation and hygiene has been seen by the PAH team in the area of km.9. - numbers and statistics of water sources and sanitation facilities are striking and requiring the action.

Jowle IDP camp

The 17 IDP settlements in Garowe, IDP camp hosts 2,143 households, mainly displaced from South Central Somalia. The IDPs settlements have been expanding over the last couple of years. However, the stabilizing security situation in South and South Central, due to the elected stable Central Government, has seen a limited influx of IDPs into Puntland. The inadequacy of ongoing intervention on displaced persons will further exacerbate the lives of the camp dwellers.

In general, IDPs in Garowe live in really bad conditions, with limited assistance from the Government. Living conditions of IDPs are severe and it a general lack of basic facilities and services such as security, sanitation, proper shelter, clean water, health care, education and low levels of nutrition. There are many challenges in terms of safety and protection.

Main challenges and WASH gaps identified by PAH in Jowle IDP camp (needs assessments from 2013) are as follows:

- 13 settlements have very poor and dilapidated water and hygiene facilities. There are 106 latrines out of which only 61 are being used currently by 10,536 people. It means that there is 1 latrine for about 172 people. Furthermore, the latrines are not demarcated on the basis of gender thereby posing further challenges to the women. The lack of latrines also forces open defecation; IDPs do not use soap neither any other hygienic products (due to economic reason). The hygiene awareness is very limited;

- water availability in the 13 settlements in Jowle camp is limited to seven shallow wells in working condition for the whole population. It means that there is one shallow well for 810 people. Given the small number of water sources many of the community members are forced to buy water from other sources by paying almost 3000 Somali Shillings (US$ 0.15) for five liters of water;

- lack of water impacts hygiene behaviors and health condition of the community and many people, interviewed by PAH, expressed that hand washing before eating and after defecation is not a common practice. Furthermore, women and children chose to stay without a proper bath/shower for many days;

- solid waste collection is extremely limited and almost does not exist, increasing health hazards for the community. Only few solid waste transit stations are located outside of Siliga settlement and they are not sufficient for the whole camp;

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For more information about our program for Somalia, please contact:

Nina Mocior, Head of Mission, tel.+252 907 392 139, nina.mocior@pah.org.pl

Washington Kote, PAH Representative in Nairobi,tel.+254 732 064 083, washington.kote@pah.org.pl

Our HQ contact data:
00-031 Warszawa
ul. Szpitalna 5 lok. 3
tel. (0 22) 828-88-82, 828-90-86
fax: 831-99-38
e-mail: pah@pah.org.pl
NIP: 525-14-41-253
REGON: 010849302

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