Somalia: The impact of poor sanitation and improper waste disposal on the health of minority IDPs in Baidoa

Baidoa is the capital of the Bay region of Somalia, situated approximately 250 kilometres west of Mogadishu. It is an ethnically diverse town with local residents originating from other parts of Somalia. Baidoa’s population is estimated to be over one million. It hosts a large number of internally displaced persons (IDPs), many of whom identify with minority communities who have moved from their areas of origin due to drought, famine and poor security.  

The size of Baidoa’s IDP population is increasing rapidly. According to a 2020 report by the Research and Evidence Facility: ‘Although UNDP [the UN Development Programme] estimated the population of Baidoa at 370,000 in 2005, the population has since then more than doubled. Currently, the IDP population alone is estimated at 360,000, settled in 485 sites in and around the city.’ In July 2022, the Camp Coordination and Camp Management (CCCM) Cluster verified 498 IDP sites in Baidoa, hosting 89,476 households or 596,931 individuals. An October 2022 report by Médecins Sans Frontières suggested that, ‘Between January and August 2022, more than 200,000 people arrived in Baidoa. This is in addition to the approximately 600,000 people living in the city. After the capital Mogadishu, Baidoa now hosts the second-largest number of displaced people in Somalia’. 

Most of the families or households living in the IDP camps in Baidoa have long been faced with inadequate sanitation services. As a result, many of them, especially women, children, persons with disabilities and elderly people who identify as belonging to an ethnic, religious or linguistic minority, are particularly vulnerable. These people are not protected from hunger and live under very poor sanitation and hygiene conditions, which has led to repeated outbreaks of water-borne diseases in the IDP community.

The enduring problem of poor sanitation is a root cause of diseases such as diarrhoea and cholera. Poor sanitation and lack of water are forcing residents in Baidoa’s IDP camps to clean themselves with mud containing faeces or urine. Open defecation is a common practice in the IDP camps. Access to proper latrines is non-existent; where improper ones exist, they are very limited in number and serve about five times more than the standard number of 20 individuals per toilet. Most of the makeshift huts accommodating IDPs are 50 metres away from the toilets, with the sickening odour of the toilets a daily reality. Where available, these facilities are used by men, women and children who sometimes spend a long time waiting to use the facilities, which often persuades individuals needing to relieve themselves urgently to seek a close-by area they can use.

This challenging situation makes minorities in these IDP camps more vulnerable to water-borne diseases caused by the lack of clean latrines. The camps do not have accessible water for either drinking or sanitation, thus increasing the risk of vulnerability to communicable diseases such as cholera. Women usually have to trek long distances to access any type of water, fetching water in jerrycans of about 20 litres for a household of about six persons or more. Water scarcity is exacerbated by the fact that the water accessed by minority IDPs comes from the Isha Baidoa, a heavily polluted rivulet that runs through the nearby city. River pollution is one of the major causes of death for IDPs when it comes to poor sanitation and cholera outbreaks in Baidoa.  

Research carried out by the University of Southern Somalia revealed the various factors that can be attributed to the outbreak of the cholera epidemic affecting Baidoa. ‘Poor sanitation’ was blamed unanimously at 100 per cent for the outbreak of cholera in the IDP camps.  

This analysis is consistent with the real-life story of HI, an internally displaced woman who lives in one of the camps. The threat of cholera is especially acute for the minority communities living in the south of Baidoa, particularly members of the Eylo ethnic group, such as HI. HI has seven children. Two of her children have physical disabilities, affecting their legs and backs, which means they cannot walk.  

HI explains that her family was displaced in 2011 from an area near Bur Hakaba district, due to the drought that hit south-western Somalia. Since then, she has been living in Bur Heledi camp. She says: ‘We do not have clean water, so there is no health in this camp.’ She points out that the sources of water are open wells that are not treated; their cleanliness is very poor and so the water can make people sick, yet ‘better alternatives are not available’. The other source of water is the Abow Asharow water stream, which is about 1 kilometre from the camp.

Another female minority IDP, AHD, states that the lack of hygiene makes them ‘seriously vulnerable to diarrhoeal diseases’. She adds: ‘Some of our relatives were victims of cholera several times. There is nothing we can do about it. No help to improve our situation.’ Cholera strikes the IDPs recurrently, especially during periods of water scarcity or in the rainy season. Heavy rains often lead to unsanitary conditions in the area due to the lack of toilets and children who defecate outside in the neighbourhood. A single outbreak may result in the deaths of many children and adults. HI tells how cholera affected her family in 2017, when one of her children died. A second child was saved after he was taken to one of the nearby hospitals.  

Another IDP, an elderly male from an ethnic minority community, laments the condition of camps accommodating minorities: ‘Poor hygiene and sanitation are more likely aggravated by the lack of care because people live in huts that cannot protect themselves from rain and dust. Our existence does not matter to anyone except Allah!’ He adds: ‘Children, women and the elderly can die from malaria, which is the most recurrent disease in our camp.’

In conclusion, the challenges faced by minority IDP families in accessing basic sanitation are vast. These include lack of education and lack of awareness of the importance of sanitation and hygiene. These life-threatening issues are augmented by low coverage of services, with poor sanitation quality and a lack of security and justice. Malnutrition and disease are among the common challenges in the minority IDP camps, affecting mainly pregnant women, children and the elderly. Failing to address these challenges may lead to a catastrophic humanitarian crisis in Somalia that could wipe out large numbers of minority IDPs.

Photo: Fadumo walks to fetch water at Camp Tawakal Two Diinsoor in Baidoa, Somalia. Credit: Mohamud Utaama.