Blog written by Mohamed Ismail, Program Director – CHASP Program, Save the Children Somalia

“A beacon of hope as Save the Children support 77 health facilities across Somalia which now provides free essential maternal, newborn, and child health services to the community as mothers call for operation theatre”

Herale, Somalia - Nestled 100 kilometers from Adado town in Somalia, beyond the barren rocks and plains lies the small town of Herale with a small resilient pastoralist community of about 1000 households that face challenges that most of us can scarcely imagine. Children of Herale are born in a town where they have limited or no access to essential healthcare, nutrition, and vaccinations.

 The children of Herale have grown up without vaccinations. Maternal and child health has also largely been an unknown concept until recently when Save the Children, in partnership with the government of Somalia initiated a beacon of hope under ‘The Community Health and Social Accountability Program’ (CHASP) with an aim of providing Essential Package of Health Services (EPHS), including basic maternal and child health services in Adado and 12 other districts across the country, with generous funding from Swedish International Development Cooperation Agency (SIDA) and Swiss Agency for Development and Cooperation (SDC). 

 CHASP brought a lifeline to communities in dire need through the operationalization of 77 health facilities across Somalia including the Herale Health Centre which now provides maternal, newborn, and child health services to the community. Children and mothers can now access basic health services at Herale Health Center operationalized and supported by CHASP. However, like any other program, CHASP is not without a challenge. It lacked Comprehensive Emergency Obstetric and Newborn Care (CMONC) services at the Herale Health Centre to manage complications in labor as the facility did not have an operation theatre. Without an operation theatre, mothers in labor and with complications had to be referred to other facilities in Adado town which is 95 km away with nearly impassible terrain over a rocky and rough road. From Herale, it takes about four hours to get there in Adado. Tragically two mothers lost their newborn babies this year on the way while being referred for birth complications to Adado Hospital and some mothers never took the journey due to economic constraints.

 Through the leadership of the Community Health Committees (CHCs) trained by the program, the Herale community decided to do something about this tragedy. They rallied their local resources, mobilized funds from the diaspora community, and constructed and operationalized an operation theatre within the Herale Health Center. Abdimalik, the Hirale CHC chairman looked proud of the progress and said “We are grateful to Save the Children, we now have seen how important healthcare is and we want to do all we can to maintain it”. It is a remarkable display of determination and ownership of their newfound healthcare resource.

A Hero Emerges

During my visit to the newly inaugurated theatre in Herale, I had the privilege of meeting Dr. Hafsa Ali, a real champion for children. Dr. Ali, a recent graduate of Bachelor of Medicine and Surgery from Kampala University in Uganda, returned home to volunteer at Herale Health Centre as the only doctor in the health facility. “My community has invested in me, and I feel it is time I give back.” Her dedication and selflessness in volunteering to operate the theatre exemplify the spirit of service that underscores the Herale community's journey towards giving children a healthy start in life.

Here we also met Sahra Ahmed, a 30-year-old mother of six, resting after a successful C-section. Her journey to motherhood has been difficult, marked by the loss of three children due to childbirth complications. Nearing her due date, she travelled to Herale Medical Center, refusing to surrender to the ambiguities of home birth, and in Herale, Sahra found not just medical expertise, but a sense of welcome and care. The doctors, understanding her past traumas, opted for a C-section, ensuring a safe delivery.

Herale is a testament to the often-underestimated contribution of locally-led responses and the transformative power of community-driven initiatives. With the Herale Health Centre now equipped with a functional EPHS including a functioning operation theatre and Dr. Hafsa Ali's unwavering commitment, the town is no longer isolated from critical healthcare services. It's a reminder that beyond the barren rocks and plains of Adado, an oasis of hope has emerged, and it is a beacon for the future of sustainable health care in Somalia.

 As the SIDA and SDC support is coming to an end in the next few months, the Herale community is worried about losing their newfound healthcare resource and that their gains may be reversed. A joint government and partner support for a transition will put Herale and many other communities under the CHASP program in a better position for access to more sustainable and resilient lifesaving health initiatives.