The situation was terrifying. My daughter was so small, and she was very weak. Watery stool after watery stool, and she couldn't keep anything down. She wouldn't even take breast milk. Her eyes looked sunken, and she just lay there so weak. I was so scared I was going to lose her.
The nightmare began in a camp in Bossaso, Bari region of Somalia. Eight-month-old Rahma*'s tiny body writhed in pain as relentless waves of diarrhea and vomiting drained her of life. Her mother, Farhiya*, watched in terror—her baby's sunken eyes and limp body a haunting sight. In a place where medical help is scarce and survival is uncertain, every minute counted. If they couldn’t reach help in time, she feared the worst: losing her baby. A desperate rush to Bossaso General Hospital would determine Rahma’s fate. Farhiya*and her baby arrived at the hospital on October 10th, 2024, and were immediately admitted to the Cholera Treatment Center (CTC). Doctors diagnosed Rahma* with severe dehydration due to massive vomiting and diarrhea. She received intravenous fluids, antibiotics, and oral rehydration salts with zinc, and was carefully monitored. Expressed breast milk administered through a nasogastric tube, provided crucial nutrition. After five days of intense treatment, Rahma* recovered.
During this time, Farhiya*, Rahma*'s mother received counselling on childcare, including feeding, hygiene, maintaining warmth, and recognizing danger signs. Once Rahma regained her weight, they were discharged and linked to a free health center or general hospital for continued care.
Farhiya*, Rahma*'s Mother's Story:
"My name is Farhia, and I'm originally from the Somali Region of Ethiopia. We fled our home because of the prolonged drought and the conflict. I live with my family in Bossaso in two small makeshift shelters constructed of sticks, cartons, and clothes, paying $10 a month in land rent.
We are a family of 12 [currently two children live with family members] living in two makeshift rooms in a camp in Bossaso. My husband is currently unemployed, and I do manual labor such as washing clothes and garbage collection to support us. I am a mother of nine children (three boys and six girls), and most of them are out of school due to a lack of fees. Only two children attend school, one living with their father and the other with a cousin, who can afford their school fees. The rest of my kids help me with daily household tasks.
Sometimes, I earn about $1 a day from cleaning houses and washing clothes, which is all I can provide since my husband is unemployed. One morning, my daughter fell ill, passing watery stool and vomiting.
The situation was terrifying. My daughter was so small, and she was very weak. Watery stool after watery stool, and she couldn't keep anything down. She wouldn't even take breast milk. Her eyes looked sunken, and she just lay there so weak. I was so scared I was going to lose her.
I immediately rushed her to Bossaso General Hospital, where she was diagnosed with cholera and admitted to the CTC. After receiving specialized care and treatment, Rahma baby survived, and all my worries have rapidly diminished.
I now understand the importance of visiting health facilities whenever there is a case of diarrhea or cholera. I will encourage other mothers to seek examination and care for their children. Finally, I want to express my gratitude to those who supported me, including Save the Children and the Minister of Health."
Background / Project information
Through the French Government-funded Integrated WASH and Health Response, Save the Children equipped health centers, trained staff, and provided life-saving medical supplies—ensuring children like Rahma received immediate, free, and high-quality care. The aim of the project is to improve access to safe water, appropriate sanitation and hygiene services, and clinical case management for AWD-affected community members in Bari region. This initiative is critical in addressing Acute Watery Diarrhea (AWD) cases, waste management, and promoting safe hygiene practices among vulnerable populations in the Gardo and Bossaso districts of the Bari region.
Bari region faces a high risk of AWD outbreaks due to inadequate water, sanitation, and hygiene (WASH) infrastructure, compounded by environmental health risks. Poor access to clean water and sanitation facilities significantly increases the likelihood of waterborne diseases, contributing to high morbidity and mortality rates, particularly among children and individuals with disabilities. The response will focus on reaching 21,035 individuals in Gardo and Bossaso, with a special emphasis on including an estimated 15% of people with disabilities. Ensuring that marginalized groups have access to critical services is essential for promoting equity and inclusion in health and WASH initiatives.
The project is implemented in Bossaso and Gardo in the Bari region to reduce the risk of diarrheal diseases. It focuses particularly on preventing Acute Watery Diarrhea at the community and facility levels. Save the Children International, in collaboration with the Ministry of Health, plans to conduct monthly awareness campaigns using community health worker (CHW) platforms.
In Bossaso (Bari), which hosts 22 IDP sites with 19,431 households (116,740 individuals) and 15,602 refugees, 10 health facilities are experiencing significant service disruptions. This is occurring amid a concerning rise in disease outbreaks in Puntland, including 2,414 suspected cases of AWD/cholera, with 76 deaths (CFR 3%). Specifically, Bossaso has reported 744 suspected cases and 22 fatalities. Additionally, there are 488 suspected diphtheria cases, resulting in 66 deaths (CFR 14%). Rahma's story is occurring within a larger humanitarian crisis in Bossaso, where a large population of IDPs and refugees are struggling with limited resources and healthcare access. The 10 health facilities in the area are facing significant disruptions, hindering their ability to respond effectively to the alarming surge in disease outbreaks. These outbreaks, coupled with the strain on healthcare facilities, create a dire situation for vulnerable populations like Rahma's community, exacerbating their struggles and increasing their risk of health complications.
The humanitarian situation for internally displaced persons (IDPs) in Bossaso is rapidly deteriorating, with vulnerable communities facing Acute Watery Diarrhea (AWD), cholera, and severe malnutrition, risking countless lives. Current efforts funded by the French Embassy are insufficient to alleviate their suffering, and without immediate access to lifesaving health and WASH (Water, Sanitation, and Hygiene) services, the crisis will worsen. We urgently call on donors to act now and provide essential support to protect this population and avert a humanitarian disaster; your generous contributions are vital for making a meaningful difference in the lives of those affected.
