To ensure sustained and reliable health services in an extremely challenging environment, the World Health Organization (WHO) has used innovation and creativity to help the Federal and State ministries of health establish an operational medical supply chain for serving the most vulnerable and disadvantaged populations across the country.
WHO has managed to airlift, transport and stock over 1400 tonnes of medical commodities, worth around US$ 5 million during the past year to support essential health and nutrition care to the vulnerable population in the midst of extreme drought and food insecurity, which the country has been facing since November 2021. These supplies have been instrumental in providing basic health care and patient consultations to about 3.6 million people in the marginalized communities, protecting about 3.5 million children under 5 in access-constrained areas against various childhood diseases like polio, measles, cholera, malnutrition and helped administer various micronutrient supplements like vitamin A and deworming tablets to another one million children under 5.
To keep the medical stocks handy to meet the emergency needs of the country, especially in the face of an ongoing pandemic and drought, WHO is maintaining contingent stocks in 3 strategically located warehouses in Mogadishu (2553 cubic metres), Hargeisa (1540 cubic metres) and Garowe (536 cubic metres). To bring services closer to the people, WHO is in the process of opening 3 additional warehouses in the cities of Dollow, Kismaiyo, and Baidoa to better serve the states of Jubaland and South West–most affected by the drought, cholera outbreaks and internally displaced persons (IDPs). While WHO continues to strengthen the health systems and improve access to health care for the people caught in the cycle of conflict and climatic shock, such as the drought in hard-to-reach areas, the Organization is supporting the Government to establish a strong supply chain system, which will be pivotal for sustainable and equitable recovery of the health system from the convergence of crisis the country is facing. At the same time, a strong and operationally functioning supply chain system will contribute to building resilience for achieving universal health coverage. To this end, WHO continues to ensure improved access to health care for the vulnerable populations through delivery of medical supplies close to the communities using its humanitarian response imperatives. It also works towards building a system that supports availability and equitable delivery and distribution of medicine/product at the right time, minimizing inventory wastage, maximizing patient care and coordinating with other parts of the chain to ensure that health care providers and health care seekers get the medications and treatments they need and where they need them.
“Being a health professional and working in a resource-starved and geographically challenged health system in a conflict zone, WHO supplies are proving to be a lifeline for millions. Everyone wondered how a medical supply chain could work in Somalia, but I believe WHO has shown it to the world that if there is a resolve to serve humanity, obstacles can be turned into opportunities,” commented Dr Yusuf Omar Mohamed, Head of Pharmaceuticals & Supply Chain Section, Ministry of Health and Human Services, Federal Government of Somalia, while reflecting on WHO’s contribution is establishing the supply chain.
Medical supplies procured and delivered by WHO include kits for testing inter emergency health, trauma care, malaria, tuberculosis, HIV-AIDs, cholera and measles besides having medicines for treatment of all these diseases, as well as personal protective equipment (PPEs), long lasting insecticidal nets to control malaria, oxygen concentrators, solar panels, electricity generators, and ambulances among others public health, IT and office materials.
WHO has shown it to the world that if there is a resolve to serve humanity, obstacles can be turned into opportunities
Supply chain system
Due to security reasons and other operational challenges, WHO uses the seaports of both Somalia and neighbouring countries to import the majority of the required medical supplies. Procurement of medical supplies is triggered by programme staff via consultation with Health Cluster partners and the Federal and State ministries of health. The programme staff also develop a distribution plan to reach the health facilities at state, regional and district level to ensure procurements are accounted for and reach the target beneficiaries.
A transparent and layered procurement system then swings into action to seek the best and suitable supplies from across the global suppliers within established timelines. A regular procurement may take up to 3 months but in case of emergencies like the October 2022 twin-blasts in Mogadishu, WHO expedited the process and within a week after the blast airlifted trauma kits worth over US$ 1 million from the International Humanitarian City in Dubai.
Distribution network
When medical supplies arrive in the WHO main warehouse in Mogadishu, they are either distributed directly to the districts from Mogadishu as per the agreed distribution plan, or sent to the designated states for storage and dissemination to the health facilities. Currently, the warehouse in Garowe is serving Puntland State while Hargeisa is serving Somaliland and the rest of the states are served directly from the main WHO warehouse in Mogadishu.
Due to the security situation in the country, there is limited use of road transport, hence the majority of the medical supplies are moved by air from Mogadishu to the state warehouses where they are received by the state ministries of health for further distribution to the public health facilities.
“What satisfies us is the fact that people express gratitude to WHO for bringing these critical medical supplies. It indeed is a big motivational factor for us to brave all the odds and maintain a steady stream of life-saving supplies,” said Operations Support and Logistics Officer for WHO Somalia, Harrison Kiambuthi. “In the process of doing our work,” he added that, “We are also building local capacities in this comparatively new concept of medical supply chain management to ensure sustainability of our efforts besides continuing to bring digitization of the warehouse stocks and its air and road movement.”
WHO Somalia is grateful for the benevolence of donors like European Civil Protection and Humanitarian Aid Office (ECHO), World Bank and our trusted fund streams like Central Emergency Response Fund (CERF) and Contingency Fund for Emergency (CFE) for making this dream come true. These partners have helped WHO to ensure sustained provision of health services through 7 public health laboratories, 64 nutrition stabilization centres, 13 cholera treatment centres, 10 oral rehydration centres, 281 health facilities and numerous outreach teams including over 2000 community health workers.
