Somalia’s healthcare system has been weakened by three decades of instability and civil war, the limited capacity of the state, and poverty-related deprivation. Indeed, out of the country’s 15 million people, it is estimated that close to 70% are living below the poverty line with 2.6 million have been internally displaced (The World Bank, 2020). Moreover, health care in Somalia is mainly delivered through an uncoordinated and poorly regulated network that involves the private sector and humanitarians drawn from different aid agencies. However, not only is the health care system in the country ill-equipped to take care of the country’s health needs, but it is also bogged by economics, culture, ethics, and religion.
The poor economic state of Somalia has had devastating effects on its health care system over the years. Recently, the economic situation of the country has been worsened by the Covid-19 pandemic, extreme flooding and droughts in some parts of the country, and locust infestation. All these factors have conspired to contract all the sectors of the country’s economy. Both the federal and state governments have witnessed a drastic decline in revenue due to reduced livestock exports, remittances, and trade taxes. As a consequence, the government’s capacity to provide such vital services as health care has been severely hampered (The World Bank, 2020). Additionally, a bad economy has left catastrophic impacts on poor populations who no longer consider health care as a priority.
Somalia has a deeply religious and traditional society, which is mainly dominated by the Islamic culture. Health care interventions are affected by Islamic traditions and deep cultural orientations. For instance, circumcision of girls is a common practice in Somalia despite the sustained global efforts to stop it. According to the Islamic doctrines, a girl or a woman is not allowed to expose her nudity to a male figure with who she has no direct blood or marital relations with (Gele, 2020). The few doctors working in the country and drawn from international aid organizations have found this to be challenging in their delivery of health care to girls who are victims of genital mutilations, for instance.
The culture and religious aspects of the country’s health care system are closely intertwined with the issues of ethics and morality. The circumcision of girls in Somalia is the reality of living that seems to be acceptable to anyone. On the other hand, it is ethically inappropriate for a medical practitioner to disown a people’s culture under the pretext that the culture is inferior. It is ethically impermissible for a doctor to appoint himself as a guardian of moral cultures of his patients (Eklöf et al., 2019). This implies that the doctor must abide by the existing culture of circumcision, which is detrimental to health care provision.
Healthcare System: Somalia vs. the United States
The most prevalent infectious diseases in Somalia are diarrheal related illnesses, cavities, malaria, parasitic infections, measles, anemia, and eosinophilia. On the other hand, in the United States mental health problems, diabetes, high blood pressure, cancer, and obesity are the most worrisome health care problems. This implies that there are different health care interventions between these two countries. Other parameters that define health disparities between these two countries include life expectancy, GDP per Capita, unemployment rate, percentage of children in school, literacy rate, female genital mutilation, and infant mortality rate. The life expectancy in Somalia is 55 years against the United States’ 79.3 years (The World Bank, 2020). This implies that the US has more advanced health care systems than Somalia. The infant mortality rate in Somalia is 95 per 1,000 births against the US’ 5.8 per 1,000 births (The World Bank, 2020). Therefore, it is apparent that Somalia lags way behind in health care delivery due to a myriad of issues highlighted above.
Eklöf, N., Hupli, M., & Leino-Kilpi, H. (2019). Factors related to privacy of Somali refugees in health care. Nursing Ethics. Web.
Gele, A. (2020). Challenges facing the health system in Somalia and implications for achieving the SDGs. European Journal of Public Health, 30(5). Web.
The World Bank. (2020). Somalia scales up social protection measures as Covid-19 constrains economic growth. Web.