Building health systems from scratch in Somalia

Photo: Kate Holt/IRIN

The health system needs a shot in the arm (file photo)

MOGADISHU, 26 April 2013 (IRIN) - Lul Mohamed, director of the paediatric ward at Banadir Hospital in the Somali capital, Mogadishu, treated five children after two bomb attacks killed 30 people on 14 April. "And they were shooting last night. One died, a bullet in his liver," she said of an eight-year-old boy.

Yet these are conditions of relative peace in Mogadishu. While the conflict is not over, insecurity has diminished since the withdrawal of insurgent group Al-Shabab in 2011. This relative security is allowing Mohamed to focus on preventative healthcare, a luxury she did not have two years ago.

In March 2013, she admitted 26 cases with measles, 19 with tuberculosis, 14 with tetanus and nine with meningitis. She is frustrated because all of these diseases are immunizable. Six of the children admitted that month died.

Mohamed hopes this year to immunize 1,000 children per month in the hospital's tiny but brightly painted vaccination room. Two volunteers sit at a desk, another monitors those coming in and out. They say they became volunteers when donors pulled out and staff were let go. By 1pm that day, they had vaccinated 28 children.

"A huge improvement in a short time - if peace holds," Mohamed said.

Vaccination

Coinciding with World Immunization Week, the Somali government announced on 24 April its intention to vaccinate all children under the age of one with a new five-in-one vaccine, known as a pentavalent vaccine, funded by the GAVI Alliance, with the UN Children's Fund (UNICEF) and the UN World Health Organization (WHO) as implementing partners.

"Children in Somalia are dying of diseases that are prevented in the rest of the world," said Maryam Qasim, the Minister of Development and Social Affairs, speaking at the vaccine’s launch. "Introducing this vaccine is a milestone in history."

President of Somalia Hassan Sheikh Mohamud also presided over the launch, showing unprecedented support for improving child and maternal health in Somalia, two of the eight UN Millennium Development Goals. He also announced that his government would consider co-financing the vaccination programme, as other countries do, in the future.

Currently, fewer than half of children in Somalia have received the mandatory diphtheria, tetanus and pertussis (DTP) vaccine, a rate that Anne Zeindl-Cronin, senior programme manager at the GAVI Alliance, describes as "incredibly low". Only 7 percent of children in Puntland and 11 percent of children in Somaliland receive the required three doses by their first birthday, according to a joint UNICEF and government survey.

 The pentavalent will protect immunized children against these three diseases, as well as heptatitis B and Haemophilius influenzae type b.

Health system strengthening

"Coming from such a low base, if we have system strengthening, we should see a huge improvement in a short time - if peace holds," Zeindl-Cronin said.

Eighteen months passed between country's decision to use the pentavalent and implementation of the programme, and Zeindl-Cronin recognizes that difficult tasks still lie ahead for GAVI's implementing partners. "It's easy to come here and put [the vaccines] in [a] fridge. It's getting them into the children that's the challenge."

There is not a great deal of infrastructure to rely on. Somalia has suffered close to 25 years of civil war. Its health system is fragmented, supported by an unregulated pharmaceutical industry and dominated by private practitioners who offer help only to those who can afford it. Private doctors in Somalia are earning up to US$10,000 per month.

A legal framework for healthcare is absent, and the federal state, which includes the semi-autonomous regions Somaliland and Puntland, raises questions about how any system might be structured.

"Normally, there is one food and drug administration. But where? Is it in Mogadishu? Or in each of the zones [south-central Somalia, Somaliland and Puntland]?" said Marthe Everard, WHO's representative for Somalia.

In addition to the systemic and infrastructural challenges of delivering healthcare in Somalia, large areas of the country are still controlled by Al-Shabab; others are inaccessible due to armed groups that have filled the vacuum left by Al-Shabab. Omar Saleh of WHO estimates that 30-40 percent of southern Somalia is accessible to external healthcare providers at any one time.

Risk persists

In his speech at the pentavalent launch, President Mohamud condemned Al-Shabab for blocking access: "In the certain areas they control, there have been no vaccinations at all in the past few years. Al-Shabab needs to understand that they are not only killing people through explosions, but every child that misses vaccinations they have practically killed."

The pentavalent vaccine launch is being accompanied by an awareness-raising campaign. Sikander Khan, UNICEF Somalia Representative, hopes that, once demand is created, the vaccine will reach women even in areas that Al-Shabab controls. "There is no parent in the world who doesn't care about the well-being of their child," he said.

Farhiyo Mohamed, who has six children, brought her youngest to an outpatient clinic in Benadir, Mogadishu, to receive the pentavalent at no cost. The mother says she visited the clinic when Al-Shabab was still in the city, but that it was dangerous to do so. "Al-Shabab would question you when you came back. Today, we are happy," she said.

While prospects are improving, inequitable access remains a major challenge. Paediatrician Mohamed, at Benadir Hospital, calls for a three-pronged commitment, not only from the government, but also the community and health workers. She says motivating and engaging private and public sector workers is critical to improving the reach of healthcare, and the reach of vaccines in particular.

A unified approach to climate change and hunger

Photo: IRIN

Mothers and infants' lack of access to quality food can permanently damage the growth of the next generation

JOHANNESBURG, 24 April 2013 (IRIN) - Studies out of Ethiopia, India, Kenya and Niger show that children born during natural hazards, like droughts or floods, are more likely to be malnourished. Yet as the climate changes, it is poor countries - already struggling with hunger and food insecurity - that are increasingly likely to face these natural hazards.

A recent conference considered this issue from the perspective of “climate justice” - an approach to climate change focusing on the rights of vulnerable people who are the least responsible for causing climate change but among the most affected.

The Hunger-Nutrition-Climate Justice (HNCJ) conference, held in Dublin, Ireland, was organized by Irish Aid, the Mary Robinson Foundation, CGIAR and the World Food Programme (WFP). Among the topics explored were “joined-up approaches” - also known as the “nexus” approach.

The nexus approach seeks to find solutions based on the interconnections between various sectors or disciplines. For instance, addressing interconnected malnutrition and climate change problems would involve working across health, agriculture, environment, water and land management sectors.

“No one level, sector or stakeholder group alone can identify and implement sustainable solutions to complex societal challenges such as hunger and climate change,” said one of the papers at the conference.

IRIN spoke to experts about how joined-up approaches and "climate justice" can help improve nutrition for the most vulnerable and shape sustainable development efforts in the future.

Joined-up approaches

Experts say the nexus approach is a way to advance the social, environmental and economic aspects of sustainable development simultaneously.

Oscar Ekdahl, WFP policy officer, says using joined-up approaches to address hunger, nutrition and climate justice should come naturally.

“People’s needs, as well as opportunities, are by nature multi-sectoral,” he said. “More often than not, multiple sectors or service providers - for example ministries of agriculture, social planning, and environment - are required to effectively address issues such as hunger and undernutrition.”

Building resilience among vulnerable populations - entailing support from both humanitarian and development actors - can also help address nutrition and climate change problems simultaneously, says José Luis Vivero Pol, an anti-hunger activist with Université Catholique de Louvain. “Well-nourished people and children will better cope with climate change vagaries (either floods or droughts) than malnourished children,” he explained via email.

FAO’s Richard China said the future of the nexus approach will be determined by how countries choose to allocate resources to the Sustainable Development Goals (SDGs) - a set of goals the UN is formulating to guide development after the Millennium Development Goals (MDGs) end in 2015.

One of the criticisms levelled against the MDGs is that they have encouraged countries to ensure funds flow through sectors, or to adopt strategies with narrow sector-based approaches. Experts hope the SDGs will instead promote inter-related interventions by the various sectors.

"The money you own cannot exclusively determine the food you get, as food is a basic human need"

China says the UN Secretary-General's Zero Hunger Challenge, which aims to end hunger “in our lifetime”, underlines this inter-related approach. Achieving the goals - “100 percent access to adequate food; zero stunted children less than two [years old]; all food systems are sustainable; 100 percent increase in smallholder productivity and income; and zero loss and waste of food” - will require interventions across multiple sectors, including agriculture, health, nutrition and climatology.

Overcoming status quo

IRIN has explored the nexus between hunger, nutrition and health and the connections between water, energy and food, and has found that rigidly organized governments are often the biggest deterrents to accepting joined-up approaches.

Lawrence Haddad, director of the Institute for Development Studies, says people already live in a joined-up world, and that “it is governments, donors and researchers who have the luxury of fragmenting” the world into sectors.

To address this, he suggests introducing more problem-based training at the university level, which would encourage officials to think across sectors. He also recommends funding projects that link sectors, and ensuring government ministries are organized around problems rather than sectors.

“None of these are easy, as they all will require disruption of the status quo and all the vested interests aligned with them,” he said.

Even so, WFP’s Ekdahl says governments have begun “to budget time and finance required for this type of collaboration, but more is required.”

Climate justice

Climate change disproportionately threatens the food supplies of the most vulnerable, an issue campaigners for climate justice at the UN talks on climate change have been raising.

Many advocates see a rights-based approach as essential to both sustainable development and climate justice. The UN, for instance, has been pushing countries to enact laws recognizing the right to affordable food, which would compel governments to act in times of food insecurity.

In a joint paper for the HNCJ conference, UN Special Rapporteur on the right to food Olivier De Schutter, former president of Ireland Mary Robinson, and Tara Shine, the head of research and development at the Mary Robinson Foundation, say ensuring the rights to food, life, health, water and housing must be the foundation of any approach to sustainable development.

But some are sceptical that this can be achieved.

Pol, the anti-hunger activist, says climate justice is a “fancy word” and will only mean something if it "is implemented through binding legal frameworks and mounting public budgets”, with more restraints on the privatization of natural resources and common goods.

He adds that appealing for climate justice seems meaningless when countries have failed to implement the Kyoto Protocol, which aims to reduce greenhouse gas emissions and mitigate climate change.

“The money you own cannot exclusively determine the food you get, as food is a basic human need,” Pol continued. “If we keep on thinking along those lines, within 50 years we'll have to pay for breathing...another human need."

He advocates the polycentric approach developed by Nobel laureate Elinor Ostrom. This approach encourages natural resource management at multiple levels, including within communities. Individuals, communities, local governments and local NGOs should decide to take steps to address climate change rather than waiting for a global agreement between governments, according to Ostrom.

Getting it in writing

Haddad points to another inequality inherent in the relationship between malnutrition and climate change: "There is another type of injustice that affects everyone in the world - the injustice being the legacy that this generation is leaving the next one - wherever they live. This has some parallels with nutrition, because nutrition is also about what we as adults can do to prevent stunting in the first 1,000 days after conception - a legacy that plays out throughout the child's life... So there is a kindred spirit between the two issues of climate change and undernutrition... I think we could find ways to exploit it - perhaps in the context of the rising interest in resilience."

WFP’s Ekdahl says that there is recognition of the importance of nutrition and food security among officials negotiating a UN treaty to prevent further global warming and to protect people from the effects of climate change.

"However, there is less progress in terms of getting specific nutrition language into the actual text" of the treaty, he said.

Sidaan Cigaal U Aqaanay? Qoraa Aadam Musse Jibril

Qoraa Aadan Muse Jibriil

Hordhac: Waxay aqoonyahanada xagga maskaxda Qofka Aadamaha ku xeesha dheeri yidhaahaan: Qof kasta oo inaga mid ah waxaa ku jirta Maskax muggeedu u dhimo ama ka waynhahay Qaarrad dhan, sida Africa ama America oo kale. Laakiin Maskaxda Aadamuhu way ka nuxr wayntaha marka dhinaca hal-abuurka laga eego.
 

Inta badana Aadamuhu kama wada faaiideysto mana wada isticmaalo mugga iyo nuxurka maskaxdiisa Eebe ku mannaystay. Mugg-waynaanta maskaxdu  waa waxa Aadamuhu kaga duwan yahay noolaha kale.

Waxaa kale oo la yidaahaa qof kasta oo inaga mid ahi waa faylasuuf dhab ah (Philosopher). Waxaa kale oo la yidhaahaa: Qof kastaa waa daahirad sideeda u taagan (phenomenon) oo qoto dheerideeda aan la koobi karan.  

Haddaba, waxaa hubaal ah in qof kasta oo aad istidhaahdo waataqaan  inta aad ka taqaanaa tahay hal dhibic oo badweyn ka mid ah.

Midda kalena, waa arrin aad u adag in qofka aad wax ka sheegayso aad dhexdhexaad ka noqotid, adiga oo aan u jixinjxin dhinaca dareenkaaga caadifiyadeed, una janjeedhsan dhinacyad jiclaanshaha ama necbaansha midkoodna.

Waxa sidassi yeeli kara oo keli ah qofka u go’ay oo u ban-baxy ciliml-baadhista, iyo curinta fekerka iyo oqoonta.

Cigaal Kuma Ayuu Ahaa?

 Waa su’aal jawaabteeda aad la isuku khilaafi karo, mana mooggani arrinkaas, hase yeeshee  haddaan u badheedo in aan isku qaado gidaarka intaa qarada iyo dhumucda le’eg, ha ila yaabina haddii aan u xagliyo dhinaca caadifada, oo ka yara durko dhabaha cilmi-baadhista iyo dhex dexaadnimada.

 Runtii, anigu si toosa oo qof ahaaneed Cigaal umaan baran, ula mana shaqayn, asaga oo qof caadi ahna ma arkin, waxaan ku garaasaday asaga oo madax ah oo S.N.L. u madax ah.

Da’daydii waqtigaas waxaanu ku graadsanay xamaasaddii waddaniga ahayd iyo yuhuuntii xarakadii uu asagu hogganka u ahaa. Waxa asaga noola mid ahaa raggii kale ee xarakada waddaniga huggaaminayey, sida Maykal Maryamo, Axmed Xassan, xaaji Cumar Askar, Xaaji Xassan Geele, Sayd Axmed Shiikh Musse, iyo kuwo badan oo kale oo da’dii asaga ka dambaysey.

Laakiin, madaama uu asagu ka dhalin yaraa da’dii hore, ayaa asaga, Axmed Ismaciil cabdi Dukhsi, Ibrahim Cali Ducaale, Maxamuud Saalax nuur ( Fagadhe), Cali maygaag Samater, Axmed Yusuf Ducaale, Axmed Saciid Naaleeye Jaamac Saalax Axmed, iyo kuwo kale oo badani waxay noo ahaayeen diiradda qaan-gaadhnimada ee aanu ku hirano, dhinaca kalena anigu  ma ahayn raggi  xurgufaha tartanka siyaasadeed dhexmaray waqtigii dhisma dawladeedka Somaliland, manta ruuxeedana ma ahi dadka tartanka siyaasadu ka dhexeeyo, mana ahi nin damac siyaasadeed leh. Waxaan ahay ,sida dad badani la socdaan nin damac aqoonyahan leh, meel ay ila gaadhoba. Waxaa run ah in asaga iyo niman kale oo saaxiibo ahi igu kellifeen  in aan saaxadda siyaadda si toosa uga muuqday mar dambe, kamase xumi hadda, waanse ka werwersanahay sida aan labada isugu wadi karo. Waana sababtii aan uga baxay markii uu geeriyooday Cigaal.    

Midda kalena, ninku ma ahayn shakhsi caadi ah, ma ahayn siyaasi keliya ah, mana ahayn nin ku kooban geyigeena Somaliland ama Somaliyeede, runtiina wuxuu ahaa nin intaba ka badan kana balladhan marka, laga eego xagga adduun aragiisa iyo yuhuuntiisa intaba. Raiisal Wasaaraha Itoobya, Malas Sinaawi, ayaa mar si aan u salaano Dr.Cabdilmajiid Huseen noogu geeyey, anaga oo koox aqoonyahano sheeganayey oo Somali ah, wuxuu nagu yidhi: ‘Cigaal waa nin xeeldheere iyo khabiir ruug-cadda siyaasadeed ah, haddi uu hadda Somaliland dhisayana lama sharaysan karo, waa nin akhri yaqaan taariikhdu saday u socoto, waana in aan dhamaanteen wax ka barano inta uu nool yahay’. Waxaan huba in qaar naga mid ahi ay ka nexeen ama aanay jeclaysanin hadalka Malas sinaawi Cigaal ku amaanay.

Waana arrimahaas oo dhan dartood kuwa laga yaabo in aan dhexdhexaad uga noqon karin ka hadalka cigaal. Waa arrin aan sahlanayn, marka qofku garan karo mus’uuliyadda iyo amaanada qoraalka.

Cigaal, alla ha u naxriitee, wuxuu lahaa mug aad u wayn iyo nuxur aad sarreeya marka laga eego wacyigiisa iyo dareenkiisa adduun-araga ah, wuxuuna lahaa dhinacyo aad u badan, waxaana ka mid ahaa asaga oo ahaa nin dawlo (states man), nin fekera ama (thinker), suugaan yahan ama abwaan, nin cilmaani ah (secular) oo cilmiga si weyn u aaminsan, lakiin wuxuu isla markii ahaa nin diini ah oo diinta Islaamka aad u aaminsan aadna u yaqaan, asaga oo aan filayo in uu xataa Quraanka oo dhan korka ka xafidsanaa.

                           Cigaal Ma Mutacalim-buu  Ahaa Mise Aqoon-yahan?

 Ma jiraan u malaynayaa qof keligii intaas oo dhinac oo uu lahaa ka yiqiin, waxna ka odhan karay. Maxaa yeelay xataa qofkii damcaa inuu wax ka yidaahdo dhinac ka mid ah dhinacyadaas wuxuu u baanaanayaa cilmi-baadhis dhab ah oo uu ugu kuur kalo.

Dhinaca furaha u ah in qofku intaas oo sifooyn ah oo Cigaal lahaa yeesho waxay ku xidhan tahay sua’aashan jawaabteeda, ma mutacalim keliya buu ahaa mise indheer-garad iyo aqoonyahan?

Dhab ahaantii, waa sidaan u arko anigu’e, Cigaal wuxuu ahaa Indheer-garad sidiisa u taagan ama ‘Intellectual’.

Si aan taas u sugo, waxaan aan isku deyayaa in aan kala xadeeyo aoqoon yahanimada iyo indheer-garadnimada.

Ninkii Talyaaniga ahaa ee la odhan jirey Antonio Gramge ayaa arrinka aqoonyahanka iyo Indheer-garadka (Intelligentsia and Intellectuals), si qoto dheer leh u kala qeexay. Intelligentsia-da  ama aqoonyahanka wuxuu ku sheegay dadka waxbartay oo dhan, heer kasta ha ka gaadheene, laakiin aan awoodda u lahayn in ay curiyaan aqoonta nafteeda. Wuxuuna ku tilmaamay in ay yihiin kuwo iygu quuta oo ka faaydeysta aqoonta laakiin aan hal-abuuri Karin aqoonta. Indheer-garadkase wuxuu ku sheegay aqoonyahanka qaybteeda xulka ah ee curisa fekerka iyo aqoonta.      

Bal aan haddaba isku dayo in aan wax ka idhaaho dhinaciisii ugu nuxurka weynaa, ee cigaal lahaa, ee aan dadka intiisa badani dhaadi Karin.

Waxaan muddo dame fahmay dhiniciisa ah Indheer-garad iyo curiye figradeed  aan sina loo yaraysan Karin, taas waxaan kula sharatami karaa diyaarna u ahay qof kasta oo daneeya aqoonata lehna dareen iyo wacyga Indheer-garadka.

Si aynu arrinkan isula eegno bal aan idin xasuusiyo warqadii uu ka akhriyey madashii shirweynhii kowaad ee dib-udhiska Somaliland ( First Conference on Reconstruction Strategies &Challenges Beyond Rehabilitation, Hargeisa, October 20-24,1998)  laguna qabtay Hoolka shirarka ee Aqalka Wakiilada. Khodbadii uu ka jeediyey halkaas waxay dhalisay haddad xasuusataan muran badan iyo doodo ka yimid  dhinacyo kala ujeeddo ah.

Cigaal wuxuu warqadiisaas ku yidhi : “Waxaanu nahay qabaa’il kala madax bannaan oo ay tahay in ay dawlad wada dhistaan’.Marka aad arrinkan si cilima ah oo siyaasad maalmeedka aan ku dheehnayn u eegto waa biyo kama dhibcaan inay ka turjumaya xaqiiqada ka jirta geyigeena iyo guud ahaanba Africa.

Hab dhaqan-dhqaale oo soo jireen ah kuna salaysan Qabaa’il iyo hab dawladeedkii gumaysigii reer galbeedku keenay,. Iyo baahi loo qabo  qaabka dawladnimada shisheeyuhu keenay iyo waayo-aragtideedii laga dhaxlay in lagu dhaqmo lana adkeeyo haddi la rabo in casrigan manta jira la higsado si horuumar loo gaadho.

Weedhan aan soo xiganayaa runtii ma aha weedh keliya oo si toosa loo turjumi karo. Waa waxa loo yaqaan mafhuum ama  aragti guud oo cilmi ahaaneed (scientific Concept). Waana mid ka turjumaysa xaqiiqo la taaban karayo oo laba dhinac ah, waa mide waxa ay sheegeysaa waxa ay bulshadeenu ka koobantahay iyo in ay tahay qabaail ee aanay jirin waxa loo yaqaano dabaqaad ijtimaaci ahi ama ‘Social classes’. Midda kalena ay meesha ka maqantahay waxii saldhiga u noqon lahaa dawladnimada oo ahaa dhaqaale-biir (Capital accumulation)  iyo waayo-aragtida iyo dhaqanka kala danbaynta iyo u hoggaansanaanta jaranjarada maamulka dawladimo.

 Sida darteedna ay adagtahay sida dawld looga dhiso bulsho ka kooban ama ku dhisan qaab dhaqan-dhaqaale oo qabiilnimo ku dhisan.

Runtiina arrinkani ma ah mid ugub ah oo aan hore looga hadlin, waa arrin ay culimo badani hore uga hadashay. Maxaa yeelay waa xaalad guud ahaanba manta Africa ka taagan, haba ugu darrato xaaladda Somalida’e.

Hadda, waxaa aniga weyli dhawaaqeedu ii sii baxayaa ‘kala madax bannaan’

Haddaba, weli ma ka fekertey sida qabaailkeenu u kala madax bannaan yihiin, iyo sida kala madax-banaanidaasu carqalad ugu tahay dismaha dawladnimada.

Xalka loo baahan hayay waa kan Madaweyne Cigaal inoo horseeday, oo ah in la isku dhafo labada nidaam, kan dhaqanka iyo kan dhimoqoraadiyada xisbyada badan. Taas bay Somaliland ku soo biirisay 

qaabka dhisma dawladeeka Africa, waana meeshay ay ku jirto indheer-garadnimadii Cigaal.

Aadan Muuse Jibriil

adamjibril@hotmail.com  

260,000 people died in Somalia famine: report

In this Aug. 15, 2011 file photo, children from southern Somalia hold their pots as they line up to receive cooked food in Mogadishu, Somalia. Officials in East Africa say a report to be released this week by two U.S. government-funded famine and food agencies gives the highest death toll yet from Somalia's 2011 famine.

Officials in East Africa say a report to be released this week estimates that 260,000 people died in Somalia’s 2011 famine, more than double previous estimates.

The report by two US Government-funded famine and food agencies gives the highest toll from Somalia’s 2011 famine. One previous estimate said between 50,000 and 100,000 people died.

A Western official briefed on the report told The Associated Press that it says 260,000 people died, and that half the victims were five years of age and under.

Two other international officials briefed on the report confirmed that the toll’s report was in the quarter-million range. All three insisted they not be identified because they were not authorised to share the report’s contents before it is officially released.

When it comes to Somalia's displaced, don't mistake ambition for achievement

As the number of internally displaced people in the world reaches record levels, Somalia's situation highlights why creative solutions are needed to assist returnees

Compounding the challenge of returning refugees are the many thousands of internally displaced people living in Mogadishu. Photograph: John Moore/Getty Images

Somalia's new government is beginning to build confidence in its ability to progress the country's recovery.

The UK opened its new embassy – a collection of shipping containers painted white – in Mogadishu last week, and other European countries are following suit. Somalia's progress raises an immediate question: is it now time for hundreds of thousands of refugees and displaced people living in the region to return?

Though there are many reasons to be optimistic about Somalia's future, it is important not to mistake ambition for achievement, particularly when it comes to thinking about large-scale repatriation.

Kenya hosts the world's largest refugee camp complex, Dadaab, and views refugees both as a drain on resources and a security threat. It has made no secret of wanting to send refugees back to Somalia as soon as possible. Last December, Kenya tried to force all Somali refugees living in its cities to relocate to the camps; the move was temporarily blocked by the High Court in Nairobi, pending an investigation.

The Dadaab camps are hardly welcoming; women are particularly vulnerable to rape, and theft, killings and forced recruitment of young men are also frequent. The dangers in Dadaab and Kenya's hostile attitude are prompting some refugees there to take their chances and return to Somalia despite the real risks that entails.

Though weakened, al Shabaab rebels remain active in many of the rural areas of Somalia to which refugees may return, and regularly carry out attacks, including in cities nominally under the control of the government and African Union troops. Somalia's new government is working to establish security and services in areas under its control, but these goals are not yet reached.

Large numbers of returnees face not only retribution for having fled the country and a hard time re-establishing themselves in areas where government and international aid has limited reach, they may also have a destabilising effect on the government just as it starts to get on its feet.

Solutions for Somali refugees will come through picking apart the idea that they are an undifferentiated mass, all with similar problems. Understanding who they are, why they fled and what they have to return to may lead to creative solutions involving resettlement in third countries, repatriation for some and continued hosting under more lenient conditions for others.

Although it might seem that Somalia has experienced constant war and famine since the collapse of the state in 1991, there have been ebbs and flows of displacement. From the late 1990s to mid-2000s, the country was relatively calm; there were no major flows of displacement. From 2006 to 2012, violence escalated and with it the numbers of people fleeing increased; these flows peaked in 2011, when famine gripped much of south-central Somalia.

Estimates suggest that of the more than half a million people now living in Dadaab, more than 10,000 are third-generation refugees; they and their parents were born in the camps. So what does "return" mean to a person who has never lived in Somalia? For their grandparents, who have spent the past 20 years living in the camp, the challenges of return will be enormous. Most have lost any property they once had; they will need assistance to access land, help finding a place to live and the means to earn a living.
People who fled more recently may find returning easier if they have maintained ties to their home areas. But they may still need to develop alternative livelihoods, especially if they no longer have land. They may also need to be able to come and go for a time, working to establish themselves but keeping a foothold in the refugee camps in case security deteriorates and until it is safe to bring their families.

Many of those displaced in 2011 were agriculturalists from minority clans who had been living in normally fertile areas. But the dynamics of conflict have involved shifting power relations and the takeover of some clan territories by more powerful clans. Due to continued lack of access to most of the famine belt, it is difficult to know what conditions await them. Some may be able to return to their farms; others may need to be settled in new areas.

Compounding the challenge of returning refugees are the many thousands of internally displaced persons living in Mogadishu. The capital is effectively a huge camp for displaced people, who face insecurity, lack of clean water, absence of sanitation facilities and inadequate food. Strategies to assist returnees that ignore those displaced inside Somalia are unlikely to work.

The new Somali government has more popular legitimacy than its predecessors. Though there are good reasons to be optimistic about Somalia's future, it is also important to recognise the challenges that currently make large-scale return impractical. Creative solutions are needed, but only once basic security can be ensured.

Julian Assange: "We thank the Icelandic people"

Julian Assange WikiLeaks founder

Wikileaks Press Release -- Milestone Supreme Court Decision for WikiLeaks Case in Iceland -- Today's [April 24th] decision marked the most important victory to date against the unlawful and arbitrary economic blockade erected by US companies against WikiLeaks.

Iceland's Supreme Court upheld the decision that Valitor (formerly VISA Iceland and current Visa subcontractor) had unlawfully terminated its contract with WikiLeaks donations processor DataCell. This strong judgement is an important milestone for WikiLeaks' legal battle to end the economic blockade that has besieged the organisation since early December 2010. Despite the effects of the blockade having crippled WikiLeaks resources, the organisation is fighting the blockade on many fronts. It is a battle that concerns free speech and the future of the free press; it concerns fundamental civil rights; and it is a struggle for the rights of individuals to vote with their wallet and donate to the cause they believe in.

If the gateway to WikiLeaks donations is not re-opened within 15 days Visa's Valitor will be fined 800,000 ISK ($6,830) per day.

WikiLeaks publisher, Julian Assange, said:

"This is a victory for free speech. This is a victory against the rise of economic censorship to crack down against journalists and publishers"

"We thank the Icelandic people for showing that they will not be bullied by powerful Washington backed financial services companies like Visa. And we send out a warning to the other companies involved in this blockade: you're next."

"We hope that the that the European Commission also acknowledges that the economic blockade against WikiLeaks is an unlawful and arbitrary censorship mechanism that threatens freedom of the press across Europe. If it fails to do so, the Commission must be regarded as failing to live up to the founding European principles of economic and political freedom."

Today's [April 24th] verdict strengthens other fronts in this battle. There is an active legal action in Denmark against a Danish sub-contractor for VISA, equivalent to Valitor. The decision will also buttress the pre-litigation work already under way in various jurisdictions against the international card companies and financial services companies - VISA and MasterCard, Western Union, PayPal and Bank of America, and other payment facilitators that teamed with these giants to form a concerted, and equally unlawful economic blockade against the organisation.

In November the European Parliament passed a resolution which included a clause drafted specifically in relation to the economic blockade against Wikileaks. The resolution called on the European Commission to draft regulations that will prevent online payment facilitators from arbitrarily denying services to companies or organisations, such as WikiLeaks.

WikiLeaks has also launched a formal complaint to the European Commission on the basis that VISA and MasterCard, which together take up 95% of the European market, have unlawfully abused their dominant market position. The European Commission is still evaluating whether it will open a formal investigation but documents already submitted by the companies reveal that the credit card companies were in talks with powerful figures in the US Congress and Senate (Senator Lieberman and Congressman Peter T. King). http://wikileaks.org/European-Commission-enabling.html

Although it is still not possible to donate directly to WikiLeaks via credit card, freedom of press campaigners including Pentagon Papers whistleblower Daniel Elsberg, the actor John Cusack, and the Founder of the California-based Electronic Frontier Foundation (EFF) John Perry Barlow, have set up the Freedom of the Press Foundation to collect money for WikiLeaks. It allows donors to make anonymous, tax-deductable donations. http://t.co/qpW57qquOf