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In Baidoa, Somalis live at the epicenter of drought, hunger and conflict

Mariam Kasim sits with her grandson, who she says is suffering from measles and malnutrition, at a camp on the outskirts of Baidoa, Somalia, on Tuesday.
Luke Dray for NPR
Mariam Kasim sits with her grandson, who she says is suffering from measles and malnutrition, at a camp on the outskirts of Baidoa, Somalia, on Tuesday.

BAIDOA, Somalia — At a camp for displaced persons on the edge of Baidoa, in southwestern Somalia, Mariam Kasim says that she's very old — so old that it's impossible to really know her age. But she thinks she's 50.

Over those years, Somalia has suffered immensely from droughts and wars. But she says the suffering all around her in the Bakol camp in Baidoa is unlike anything she's seen in her lifetime.

"We have nothing," Kasim says of herself and the hundreds of thousands of other Somalis who are now living in makeshift camps surrounding Baidoa. She says most of the people here survive by begging. "We have no hope. No future."

Rains that have repeatedly failed, an Islamist insurgency and chronic poverty are all leading to what the United Nations and other aid agencies describe as a looming famine in Somalia. Millions of lives are at risk from food insecurity, with many in this part of Somalia dependent on aid. Given the scarcity of that aid, many, like Kasim and her family, are resorting to begging.

Makeshift shelters of sticks and scraps

Kasim is standing in front of the shelter she shares with her four grandchildren. Like the other shelters in this camp, hers is a dome of sticks wrapped in tarps, bits of cloth and grain bags.

Newly arrived displaced people build a shelter in a camp in Baidoa on Tuesday.
/ Luke Dray for NPR
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Luke Dray for NPR
Newly arrived displaced people build a shelter in a camp in Baidoa on Tuesday.

One of her teenage granddaughters sits in the powdery dirt at the entrance. Two younger grandchildren lean against Kasim's long black shawl. The children are thin. Their wispy hair is limp and faded to a dull orange from malnutrition.

Six months ago, after Somalia's fourth rainy season in a row failed, Kasim decided she had to get her grandchildren out of their village because there was no longer anything to eat.

"We were farmers and also keeping livestock," Kasim says. "But for the last three years, there was no rain, there was drought. So we couldn't grow our crops."

Officially, the last five rainy seasons, spanning the last 2 1/2 years, have been far below normal.

A woman walks to collect water from a water station at a camp for displaced people in Baidoa on Tuesday.
/ Luke Dray for NPR
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Luke Dray for NPR
A woman walks to collect water from a water station at a camp for displaced people in Baidoa on Tuesday.

Kasim lost all her livestock. She was forced to sell some to buy food and other animals died as her pastures withered in the drought.

When they had nothing left, Kasim packed up her grandchildren. Along with several neighbors, they set out on the nearly 170-mile trek to Baidoa.

"We walked and walked and walked," she says.

The journey took several weeks. They begged for food along the route. Her daughter — the mother of her grandchildren — had passed away several years earlier. So Kasim had to look after all of the children herself.

There were six of them. Two, she says, died during the grueling trip.

"We were having nothing to eat. So they died because of starvation," she says. They buried the children beside the road.

Women collect water at a displaced persons' camp in Baidoa.
/ Luke Dray for NPR
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Luke Dray for NPR
Women collect water at a displaced persons' camp in Baidoa.

Kasim and her neighbors were making this journey because they'd heard that international relief agencies were distributing food aid in Baidoa. Aid groups are working here, but when Kasim and the children arrived, she says, they found that the assistance wasn't enough. She and her kids now beg in town or collect firewood to sell in order to get food.

Somalia is teetering on the edge of a full-scale famine

There's growing concern that a mounting food crisis could lead to famine in Somalia. The food crisis isn't just affecting the south of the country, although aid agencies warn that Baidoa is one part of the country that could slip in to a full-scale famine in the coming months.

"Somalia has faced four consecutive failed rainy seasons. It's the worst drought we have seen in 40 years," says Elizabeth Omoke, an emergency specialist in UNICEF's Somalia office in Mogadishu. "The situation is bad."

Residents in many of the camps say they're not getting much food assistance, but Omoke insists aid agencies are working to get relief to Somalis who've been left with almost nothing by the drought.

"The humanitarian community is mounting a response, which is very much focused on the [internally displaced persons]," she says. "The response is heavily focused on Baidoa, as data shows that this is where the greatest needs are and where there's the greatest possibility of famine. The response in Baidoa has scaled up significantly since July. But depending on who you speak to, the services are not enough. The needs are there — and the needs are overwhelming."

"The needs are overwhelming," says Elizabeth Omoke, a UNICEF emergency specialist, standing on the rooftop of the UNICEF compound in Baidoa, Somalia, on Tuesday.
/ Luke Dray for NPR
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Luke Dray for NPR
"The needs are overwhelming," says Elizabeth Omoke, a UNICEF emergency specialist, standing on the rooftop of the UNICEF compound in Baidoa, Somalia, on Tuesday.

Baidoa is a city surrounded by Al-Shabab militants

Adding to the complexity of the food crisis in Somalia, the militant Islamist group Al-Shabab has banned international relief agencies or the government from distributing food aid in areas it controls. That includes much of the south.

All of the roads into Baidoa are controlled by Al-Shabab, forcing aid agencies to fly in most of their relief supplies. Humanitarian groups are even transporting armored cars in by plane because it is too dangerous to drive them to Baidoa from Mogadishu, the capital.

Meanwhile, the overwhelming needs Omoke mentions are increasing.

A mother waits in line for medical practitioners to weigh her child at an outpatient clinic monitoring malnutrition at a camp for displaced people in Baidoa on Wednesday.
/ Luke Dray for NPR
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Luke Dray for NPR
A mother waits in line for medical practitioners to weigh her child at an outpatient clinic monitoring malnutrition at a camp for displaced people in Baidoa on Wednesday.

At a bare-bones health clinic in a camp in Baidoa, Dr. Ali Nur Mohamed says the number of severely malnourished kids he's treating has jumped five-fold over the last six months.

"The situation is still critical," Nur says. He says more and more families are moving into the camps every day. And most of the kids arriving "are already malnourished," he says.

The clinic, run by the Deeg-roor Medical Organization aid group, is in a sheet-metal enclosure with a dirt floor. Mothers bring in children with bone-thin arms. Some of the kids struggle to hold their heads up.

Several malnourished children have died here recently, Nur says. Somalia has suffered two great famines in the past 30 years — in 1992 and 2011. The more recent famine killed nearly a quarter of a million people.

A child's upper-arm circumference is measured at a clinic in a camp for displaced people in Baidoa, Somalia. A measurement in the red indicates that the child has "severe acute malnutrition." Yellow means the child is at risk of acute malnutrition, and green indicates the child is well nourished.
/ Luke Dray for NPR
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Luke Dray for NPR
A child's upper-arm circumference is measured at a clinic in a camp for displaced people in Baidoa, Somalia. A measurement in the red indicates that the child has "severe acute malnutrition." Yellow means the child is at risk of acute malnutrition, and green indicates the child is well nourished.

While the current food crisis hasn't yet reached those proportions, the United Nations says more than 700 children died in nutrition centers in Somalia in the first eight months of this year.

Nur says pediatric malnutrition can be easily treated, particularly if it's caught early. Most malnourished kids rebound quickly, he says, if they're given fortified milk or high-calorie food supplements such as the aid staple Plumpy'Nut. Some just need some extra biscuits.

The problem, Nur says, is that so many of the residents of these sprawling camps around Baidoa have hardly any food at all.

Abdinasir Abdullahi contributed to this report.

Copyright 2022 NPR. To see more, visit https://www.npr.org.

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Jason Beaubien is NPR's Global Health and Development Correspondent on the Science Desk.