Somalia, one of the world’s poorest nations, faces a deepening health care crisis after the Trump administration suspended U.S. Agency for International Development (USAID) support earlier this year.
The loss of funding has hit communities already struggling with conflict, poverty, and fragile public services.
Doctors Without Borders (DWB) warned in August that widening funding gaps “undermine health care in Somalia.” They said the suspension forced the closure of 37 health and nutrition sites in and around Baidoa, roughly 250 kilometers from the capital, Mogadishu.
Although attacks by the al-Qaida-linked al-Shabab have decreased recently—credited by some to President Hassan Sheikh Mohamud’s “total war” strategy—Somali civic leaders argue that military gains have come at the expense of essential services.
“A significant amount of domestic revenue goes to the security sector,” said Mahad Wasuge, director of the Somali Public Agenda think tank. “Security remains the government’s first priority.”
READ ALSO: ECOWAS Suspends Guinea-Bissau Following Coup
Hospitals in Mogadishu rely heavily on foreign assistance. Banadir Hospital, built with Chinese support in 1977, and De Martino Hospital, established a century ago by Italian colonial authorities, remain the main centers for patients traveling from distant and insecure regions.
Even these hospitals depend on humanitarian groups. Banadir’s unit for severely malnourished children survives entirely on donor funding from Concern Worldwide. The organization also pays salaries for the 13 remaining staff members after 37 lost their jobs due to U.S. aid cuts.
At De Martino, nearly all laboratory equipment comes from donor contributions. Director Dr. Abdirahim Omar Amin fears the situation could worsen as contracts with humanitarian organizations expire next year.
“Now it looks like donors are fatigued,” Amin said. “Only two international NGOs work with the hospital—Population Services International and the International Rescue Committee.”
Most services at De Martino remain free thanks to these groups. However, patients with non-urgent conditions must cover some costs, which many cannot afford. Meanwhile, a diphtheria outbreak in rural areas adds further pressure.
A System Decades in Decline
Somalia’s public health crisis stems from decades of conflict and institutional collapse. After the fall of dictator Siad Barre in 1991, many facilities were destroyed or abandoned. De Martino Hospital once served as a shelter for displaced people fleeing clan-based warfare.
Today, the federal government struggles to extend authority beyond Mogadishu, even with African Union peacekeepers, U.S. airstrikes on al-Shabab, and foreign security partners.
Turkey finances a major hospital with intensive care capabilities in Mogadishu, but high-profile investments cannot fix systemic shortfalls.
“Even the few public hospitals that function properly depend heavily on donor money,” Wasuge said. “They don’t receive a direct government budget to provide better care.”
Mohamed Adam Dini, a parliament member from Puntland state, said the crisis reflects a deeper political failure.
“The health care situation is deteriorating, and we lack a national health plan because we don’t have a national political plan,” Dini said. “Unchecked disease outbreaks spread without a coordinated strategy.”
READ ALSO: Africa CDC Warns of Worst Cholera Outbreak in 25 Years
Despite the bleak outlook, many Somalis rely on Mogadishu’s functioning hospitals. Amina Abdulkadir Mohamed, a jobless mother, recently gave birth at De Martino because services were free.
With donor fatigue increasing and foreign funding uncertain, Somalia faces a dual challenge: securing its territory while protecting the health of millions dependent on a fragile system.
Esther Ososanya is an investigative journalist with Pinnacle Daily, reporting across health, business, environment, metro, Fct and crime. Known for her bold, empathetic storytelling, she uncovers hidden truths, challenges broken systems, and gives voice to overlooked Nigerians. Her work drives national conversations and demands accountability one powerful story at a time.
