SOMALIA - HIV Humanitarian Overview: (1) Posted on September 23, 2010 at 00:01:36 AM by mb3
SOMALIA - HIV Humanitarian Overview:
Statistics
Total population (2007) 7,960,000
Urban population in % (2007) 36
Under 5 mortality M/F per 1000 births 135
Infant mortality 86
Life expectancy at birth males 45 years
Life expectancy at birth females 45 years
Refugees, origin Ethiopia Various 1,120 -120
IDPs 850,000
2006 Human Development Index Not ranked
Population undernourished 71% (OCHA CERF)
Maternal mortality per 100,000 live births 1044
Adult HIV Prevalence Rate (%): 0.5%
South Central. 0.6%
Puntland. 1%
Somaliland. 1.4%
No. of People living with HIIV: 24,000
Adults aged 15 and up living with HIV.24,000
Women aged 15 and up living with HIV.6,700
Children aged 0 to 14 living with HIV.890
Orphans aged 0 to 17 due to AIDS. 8,800
Percentage of pregnant women receiving treatment to reduce mother-to-child transmission.3.3%
Deaths due to AIDS.1,700
Humanitarian and HIV situation
The political outlook for Somalia remains uncertain. Somalia has had no effective central government since 1991, which has lead to a deterioration of infrastructure, disintegration of basic health and social services, widespread human rights abuses and some of the worst human development indicators in the world.
The outbreak of fighting in Mogadishu in early 2007, the worst since the civil war in the early 1990s, resulted in the deaths in hundreds of civilians and a sharp rise in human rights abuses. The African Union peace support mission for Somalia (AMISOM) is only partially deployed (1,700 out of the mandated 8,000 personnel). It has secured about 5 km radius of Mogadishu, including the airport. However further violence erupted in Puntland and Somaliland, with insecurity threatening to destabilize additional zones.
Affected populations:
Around 1.5 million people are in need of assistance and protection. A total of 450,000 people have been newly displaced as of November 2007 in addition to the 400,000 protracted internally displaced persons (IDPs).
IDPs comprise over 10% of the population, with a quarter of a million IDPs living in Mogadishu alone. They lack sufficient access to sustained assistance and protection. 1
Two-thirds of families who have fled during conflict have settled in the provinces of the Shabelles, immediately surrounding Mogadishu. Others have fled further north, including 2,600 people who have reached the town of Galkayo, 700 kms north in the region of Puntland. The town already hosts 11,000 people who fled Mogadishu between February and May. Recent arrivals, mostly women and children, reported robberies and rape by armed militiamen and thugs who set up roadblocks along the route. Galkayo has limited resources in terms of water, sanitation, education and health services. 2
Refugees:
464,253. 3 A further 25,000 Somali refugees have arrived in Kenya, and remain similarly isolated from health and education services.
Access to vulnerable populations is patchy and inconsistent due to conflict, lack of security guarantees, ongoing military air operations, and clan tension. The Government of Kenya’s closure of its border with Somalia on security grounds for several weeks from early January also hindered humanitarian access and delivery of assistance. Insecurity is often the main impediment to accessing healthcare.
Within South/Central checkpoints, unofficial roadblocks continue to obstruct movement of supplies and cause delivery delays. The logistics cluster has recorded 238 roadblocks/ checkpoints in South/ Central. Charges per truck have reportedly increased from USD 125 to USD 520. UN Agencies and NGOs still seek clarification from the TFG regarding tax exemption procedures. Overland transport of relief supplies is difficult due to robbery.
Protection:
During the conflict, in addition to indiscriminate shelling and attacks on the civilian population, abductions, rape, and unlawful killings have been reported by human rights organizations.
Food/nutritional status:
The entire country is chronically food insecure. Acute malnutrition rates continue to exceed the emergency threshold of 15% in many districts of South/Central. Following recent flooding, food security in riverine areas of the Juba and Shabelle Valleys deteriorated.
Health status:
Much of the population lacks access to basic healthcare and an acute shortage of trained medical personnel. Polio recurrence in 2005, with 215 confirmed cases as of November 2006 14 of 19 regions infected (WHO). Malaria, tuberculosis (TB), diarrhoeal diseases and other preventable diseases continue to kill thousands each year.
Water and sanitation systems damaged during the civil war have been somewhat rehabilitated by the international community in the past 10 years. However, extensive contamination of surface supplies remains a problem, with only 29% of the population having access to clean drinking water (UNFPA). Over half the population also lacks access to adequate sanitary facilities.
Natural hazards:
Flooding: The Deyr rains of October-December, while causing large-scale displacement (estimated at 255,000) and the destruction of homes and assets, resulted in exceptionally good crop production and continued pastoral recovery. The recently completed post-Deyr 2006/07 assessment by FAO/Food Security Analysis Unit showed many rural parts of Somalia – mainly in the north and central regions – are experiencing an improvement in livelihoods and food security. The March 2007 Climate Outlook Forum forecasts normal to above-normal rainfall in the Ethiopian highlands and coastal areas of the Juba Valley, which may result in renewed flooding in riverine areas not yet recovered from Deyr floods.
Drought:
Somalia is recovering from the worst drought in over a decade.
HIV epidemic
Somalia is approaching a generalized epidemic.Prevalence rates differ by area. According to UNAIDS most recent data, South Central Somalia has a prevalence rate of 0.5%, Puntland 1% and Somaliland 1.4%.The main drivers of the epidemic are sexual transmission and unsafe health care practices including blood supply.
Most at risk:
- Sex workers and their clients
- Mobile populations (truckers, returnees, nomadic population, which is 40% of Somalis
- Uniformed services
- Men who have sex with men
Most vulnerable 4
- Young persons
- Women (women are increasingly vulnerable, especially due to displacement and SGBV
- Orphans and vulnerable children
Response to HIV among populations of humanitarian concern
Somalis have one Strategic Framework and an Integrated Prevention, Treatment, Care and Support Plan in place in each zone. The three AIDS commissions work together and with international partners in Nairobi.
Building their capacity is a focus of the current program. There is one harmonized monitoring and evaluation framework with common reporting tools and a Country Response Information System database for all entities. AIDS has been mainstreamed in a Joint Needs Assessment, Reconstruction and Development Framework, Consolidated Appeals Process and a new UN Transition Plan for 2008 - 2009.
The overall objective of the Somali HIV Response in 2007 is to scale up integrated prevention, treatment and care services in line with Universal Access and Global Fund targets. 2007 focus:
Provide prevention services.
- Build the regional Partnership on HIV Vulnerability and Cross-border - Mobility in the Horn of Africa, focusing on populations of humanitarian concern
- Prevent new HIV infections and care and treatment for those already living with HIV (PLHIV).
- Reduce the vulnerability associated with family networks affected by HIV.
- Prioritise actions related to HIV prevention, care, treatment and mitigation within the context of humanitarian action.
Prevention:
Priority is to change KAPB (Knowledge, Attitudes, Perceptions and Behaviour). Surveys indicate a serious lack of understanding and awareness of basic information on HIV within Somali populations, including vulnerable populations (young people, uniformed services) at high risk of infection due to mobility and lack of services.
Health cluster includes integrated action on HIV, conducting education and awareness campaigns and integrating HIV and Sexually Transmitted Infections (STIs) services into health facilities.
Protection includes work on HIV as a key element in strengthening protection mechanisms for vulnerable populations, such as the displaced, and combating sexual and gender-based violence (SGBV) against women and girls.
Food security and livelihood includes HIV prevention, treatment, home-based care, and enhancement of food security for affected people, particularly, women-headed households in southern Somalia. The Food Aid response plan also includes HIV as a priority objective, with the aim of improving the health and nutritional status of at risk groups, including PLHIV.