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PLOS BLOGS Speaking of Medicine and Health

Aid access to Somalia: there must be no hidden agenda to humanitarianism

In the past few days, al-Shabab, the armed faction that controls south and central Somalia, has lifted its ban on the delivery of food supplies and aid from other countries. First reported on Saturday 16th July, the ban was seemingly lifted ten days previously, and has resulted in giving the UN agencies such as UNICEF unhindered access to Somalia’s starving people. Speaking to the BBC, Rozanne Chorlton from UNICEF said that she hoped that this agreed access would encourage other agencies to deliver aid to the devastated areas of the country.

This welcome move will save the lives of many severely malnourished children, women and men. Because of the entrenched conflict scarring Somalia for many years, families affected by the severe famine have had to risk their lives travelling to camps in neighbouring countries  (Kenya and Ethiopia)  to access food aid and medical supplies. In addition to the risk of dying on the way, many families had to make the agonising decision to leave weaker children behind in order to give stronger siblings a better chance of making it to the camps. However, now that al-Shabab has allowed food and medical supplies into Somalia, starving people will hopefully not be forced to travel for days in search of food, and the shocking mortality rates due to malnutrition (reported by the ICRC to be one in every ten children in the famine affected areas of Somalia) will decrease.

But what if al-Shabab had not agreed to lift its ban on foreign aid? Would the world be content to continue to allow thousands of Somalis die or would the international community through the UN have the courage to act on its responsibility to protect and deploy a health protection force to Somalia to allow severely malnourished people to receive the treatment they need to save their lives—food? And Andrew Mitchell, the Secretary of State for the UK’s Department for International Development has said “We simply will not deal with al-Shabab and we will not allow our operations to be fettered by them.” So what willhappen if al-Shabab reverses its decision to allow safe access? Perhaps this is a question which the UN should urgently consider, and seriously discuss the resolution put forward by the International Health Protection Initiative which is supported by many individuals and medical organisations from around the world, including PLoS Medicine.

After all, Al-Shabab said that access of agencies to Somalia was conditional on outside aid groups having no “hidden agenda.” Given the recent shocking revelations about the alleged  US-led sham immunisation programme in Pakistan to fulfil military objectives,  the reputation of the entire humanitarian organisation is at risk with potentially catastrophic consequences.

As Dr. Unni Karunakara, MSF’s international president says: “Whether true or not, the mere suggestion that the provision of medical care was carried out under false pretences damages public perception of the true purpose of medical action.”

“With all populations in crisis, it is challenging enough for health agencies and humanitarian aid workers to gain access to, and the trust of, communities— especially populations already sceptical of the motives of any outside assistance.”

Guest post by Rhona MacDonald, freelance editor, Competing interest: Rhona MacDonald is the coordinator of IHPI.  PloS Medicine is a signatory to the IHPI resolution.


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