Climate-induced humanitarian crisis, assessing the impact of recent floods and disease outbreaks in Somalia: short communication

Somalia, located in the Horn of Africa, is a nation with a predominantly arid climate. It has been increasingly experiencing the adverse effects of climate change, which poses significant threats to its environment, economy, and population. Somalia faces increasingly unpredictable rainfall patterns, particularly affecting its two main rainy seasons—the Gu and the Deyr. These changes in precipitation patterns have resulted in either delayed rains or significantly reduced rainfall. Such unpredictability directly impacts agricultural productivity and food security, as farming practices in Somalia are predominantly rain-fed. The irregular rains disrupt planting and harvesting cycles, leading to crop failures and a decrease in food availability.

Compounding these challenges are the extended periods of drought that Somalia has been experiencing with greater frequency. These prolonged droughts lead to catastrophic crop failures and loss of livestock, exacerbating food insecurity and malnutrition. The impact of these droughts is not only limited to the economic sphere but also extends to societal and health aspects, often resulting in internal displacement as communities move in search of water and grazing land.

Conversely, when rains occur, they are often intense and lead to severe flooding. Such extreme weather events, including flash floods and riverine floods, particularly along the Juba and Shabelle rivers, cause widespread displacement, infrastructure damage, and an increased risk of waterborne diseases. Annually, in Somalia, the occurrence of substantial rainfall leads to a notable upsurge in the prevalence of waterborne illnesses and viral outbreaks. The escalating frequency of climatic fluctuations, including floods and droughts, has resulted in adverse consequences for human health. These effects are manifest in the heightened incidence of various infectious diseases, encompassing gastroenteritis, viral hepatitis A, cholera, malaria, typhoid fever.

The recent heavy rains in Somalia have inflicted a toll on the population, affecting more than 2.4 million individuals, as reported by the authorities. Disturbingly, this has led to the displacement of over 1 million people and has tragically resulted in the loss of 110 lives across 36 districts¹.

Reports indicate that to the east of Jowhar town in Hirshabelle State, approximately twenty villages have been submerged due to flooding. In Mahaday town, which has endured inundation for a month, there has been significant damage, including the collapse of sanitation facilities and some residential structures. While water levels in the upper catchment area of the Juba River, particularly in Doolow and Luuq, have receded, certain downstream segments in Baardheere and Bu’alle continue to maintain high levels at or near their banks¹.

In the year 2023, a cumulative total of 15 554 suspected cases of cholera were documented, with 43 reported fatalities, resulting in a case fatality rate of 0.3%. Notably, within the past fortnight, there has been a notable surge in the incidence of new cholera cases, representing a substantial 44% increase across all districts. The districts of Belethawa, Afmadow, Dolow, and Daynile, all of which have been directly impacted by flooding, have reported the highest attack rates. Specifically, Belethawa recorded an attack rate of 3387 cases per 100 000 individuals, Afmadow reported 1036 cases per 100 000, Dolow registered 1437 cases per 100 000, and Daynile documented 1040 cases per 100 000². During the initial half of the year 2023, ~2.5 million cases of malaria were officially confirmed, and by November 2023, there were 1375 documented cases of measles².

The forced displacement of individuals from their residences inevitably has detrimental repercussions on their mental wellbeing. Consequences stemming from flooding include shortages of food, instances of starvation, malnutrition, and a scarcity of safe drinking water, all of which contribute to indirect health-related challenges. Moreover, children who are separated from their families are susceptible to becoming targets of illicit practices, including begging, child exploitation, and involvement in unlawful activities. Recently, Somalia experienced one of the most devastating flood events in its history, with more than 2.4 million individuals affected and an estimated 1 million people displaced as substantial portions of the nation were submerged. Since November 2023, the relentless and devastating flash floods have claimed the lives of over 100 individuals. These catastrophic events have resulted in the destruction of millions of residences, crops, roadways, and bridges, and have also severely impacted hundreds of healthcare centers³

At the onset of a flood, mosquito breeding tends to decrease. However, once the flood subsides, the stagnant water that remains creates an ideal environment for the breeding of malaria-transmitting mosquitoes. Typically, it takes ~6–7 weeks for a malaria outbreak to manifest under these conditions⁴. In 2022, a global total of 249 million malaria cases were reported and Somalia faced its own challenges. Within our borders, a total of 336 840 suspected cases of malaria underwent testing, uncovering 11 550 positive cases. This data underscores the significance of targeted interventions and continued efforts to combat malaria within our population. When compared to the figures from 2021 and 2020, there was a notable reduction in positive cases, with an 11% decline compared to the previous year and a significant 61% decrease in comparison to 2020. Furthermore, two malaria-related fatalities were reported in 2022. It is important to note that all these cases were managed and treated in accordance with the national treatment guidelines, utilizing artemisinin-based combination therapy⁵. During periods of flooding, there is a heightened risk of an increase in malaria cases, making it imperative to remain vigilant in malaria prevention and control efforts.

In addressing the humanitarian challenges arising from extreme climatic changes in the Somali context, it is imperative to raise public awareness and promote preventative measures. To achieve this, comprehensive awareness programs and campaigns should be launched, utilizing innovative communication channels like social media, messaging services, and caller tune services to reach a wider audience effectively.

These campaigns can focus on educating the public about the importance of environmental conservation, the risks of climate change, and practical steps for disease prevention. The government, in collaboration with NGOs and international health organizations, should implement mandatory preventive measures. These include water chlorination to ensure safe drinking water, widespread immunization campaigns against prevalent diseases, malaria prophylaxis, and guidelines for proper handling of deceased individuals to prevent the spread of infectious diseases. While the use of mosquito sprays is a vital component, it is clear that this alone may not be sufficient in the face of increasing mosquito populations due to climatic changes.

To enhance preparedness and response capabilities, it is crucial to strengthen surveillance systems. These systems should be equipped to detect the presence of mosquitoes and viruses in new areas, utilizing modern technology such as satellite imaging. This data-driven approach will allow for timely and targeted interventions. Furthermore, community engagement is key. Empowering local communities through education and resources will enable them to take an active role in preventive measures. This includes maintaining clean environments to reduce mosquito breeding sites, participating in health programs, and adhering to government guidelines. Implementing viable mosquito control strategies, such as the introduction of environmentally friendly biocontrol agents, and promoting disease prevention measures, are essential steps. Additionally, fostering international cooperation for resource sharing, expertise exchange, and joint research initiatives can greatly enhance the effectiveness of these measures. Overall, a multi-faceted approach involving governmental action, community participation, technological innovation, and international collaboration will be essential in mitigating the impact of climatic changes and protecting the health and wellbeing of the population in Somalia.

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Ethics approval was not required for this editorial.

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Sources of funding

The authors have no association with financial or nonfinancial organizations.

Author contribution

Manuscript was written by A.M.A. Review-editing was done by A.M.A. Referencing and formatting was done by F.I.N.

Conflicts of interest disclosure

The authors declare that they have no competing interests.

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Not applicable.

Guarantor

Asli Mohamed Abdullahi1.

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Not applicable.

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Not commissioned, externally peer-reviewed.