In the Somali capital Mogadishu, more and more children are becoming victims of the fighting between pro-government forces and the Islamist militia al Shabab.
The World Health Organization (WHO) says the number of weapon-related casualties at the city’s three main hospitals reached a new peak last week. Of the nearly 1600 casualties, 46 percent were under age five.
Many ways to wound a body
“Beginning of May, we found the increase in the number of casualties under five and mortalities under five. The main types of injury are burns and shrapnel, blast injuries and bullets,” said Dr. Omar Saleh, a WHO trauma surgeon.
Many of the burns are third degree. Children suffer from disfiguring scars and infection over much of their bodies. One child had a bullet in his head.
“His body,” said Saleh, “is half paralyzed and he’s under five years old. It is a tragedy there.”
Injured children cannot be treated the same as injured adults.
Dr. Omar Saleh, WHO trauma surgeon, trained Somali health workers on caring for wounded children.
“That was the main reason actually why I went to Mogadishu,” he said, “Usually, children under five, they have special physiology and anatomy different than adults. And that’s why there should be a different approach.”
Saleh conducted training programs at two of the major hospitals in Mogadishu, which included preparing children for surgery, special surgical techniques, post operative follow-up care and maintenance.
Because a child’s body is not fully developed, care must be taken when administering drugs. “The doses should be calculated carefully, otherwise they will die from the treatment itself,” he said.
Worst cases
“Usually, those third degree burns are a big challenge. They need a lot of transfusions. They need antibiotics. They’re liable to infection, the wound infects, and then septicemia and they die from infection,” he said.
Some children have lost an arm or a leg.
“Imagine a child under five years old who loses his hand or his leg. How is he going to live afterwards?”
None of the children are expected to be transported to other countries for special care or reconstructive surgery. Saleh said the children’s families are too poor to pay for that. However, his training classes for Somali health workers did include skin grafts, cosmetic and reconstructive surgery.
Why so many kids?
There’s a simple reason why so many children are being wounded now in the Somali capital.
“People live in Bakara market. The fighting now in Mogadishu is in Bakara market… one of the cheapest areas in Mogadishu. So imagine the IDPs [internally displaced persons] after the drought…. They come back to Mogadishu to Bakara market and they take their chances just to be able to live there. If some family was killed or something, the next day you’ll find another family staying there,” said Saleh.
The trauma surgeon said international help is needed to fund Somalia’s battered health care system. He said about $60 million has been requested, but so far, only about $16 million has been given by donors.
“This fighting in Mogadishu is far from over. It’s going to continue for some time and we need the international community to pay attention to what’s happening to do something,” he said.
The WHO said that since the beginning of 2011 about 4,000 people injured in the Somali conflict have been admitted to the capital’s three main hospitals.