Baardheere

However, other sources reported on violent incidents taking place in Kismayo town in 2020.²⁷⁸ The areas outside of the town are marked as being under mixed, unclear or local territorial control.²⁷⁹

According to observations by the consultants as well as by UN OCHA,²⁸⁰ the town has an airport which is open and functional. The location of the airport vis à vis the surveyed health facilities can be seen on the map below.

Map of location of Kismayo airport and surveyed health facilities Ma

Discrimination

The consultants did not take note of signs of clan based discrimination in the waiting areas of the surveyed health facilities. As mentioned in section 2.6.1 Discrimination based on clan affiliation the interviewed sources confirmed that the different regions of Somalia are relatively homogeneous in terms of clan and sub-clan presence; therefore people seeking help at the health facilities are likely to come from the same clan as the health workers employed there.

Women and children were the most frequent users of the observed health facilities.²⁸¹

managers as well as direct observations carried out by a consultancy company. Further information can be found in the section Methodology.

Map of Baardheere and researched health facilities

Map of Baardheere and the three health facilities surveyed: Hoosh Medical Centre, Bardhera General Hospital, and Kulmiya Hospital

10.3.1. Services offered by the surveyed health facilities

The surveyed hospitals and their offer of services are:²⁸²

 Bardhera General Hospital: this public hospital has departments which offer services within maternity health, nutrition, stabilisation for malnourished children and general outpatient

consultations. The staff consists of three doctors specialised in general medicine and qualified and auxiliary nurses. The hospital is supported by development partners including NGOs and IOM.

 Kulmiya Hospital: this private hospital/clinic offers general in- and outpatient services, in particular to pregnant women. It is run by one medical doctor, a general practitioner. Patients in need of specialised treatment are referred to hospitals in Mogadishu. The supply of medicines was, at the time of data collection, affected by the Covid-19 situation.

 Hoosh Medical Center: this private pharmacy is one of the most preferred health facilities in town due to the presence of qualified staff and the price of medicines. People from all clans are welcome in the facility. At the time of data collection, the supply of medicines was severely affected due to interruptions of supply due to the Covid-19 situation.

282 Tana, Sub-Study: Baardheere, p. 3

10.3.2. Consultation prices

Below is a table which presents findings from interviews with managers at two health facilities in Baardheere gathered by consultants and confirmed by visual inspection.²⁸³

Treatment prices are not fixed in South Central Somalia. In principle, there is no fee charged for a consultation at the public hospitals; private hospitals and practitioners are free to set their own prices.

The prices at the private facilities are high for the general population, especially those who have no employment or who work as day labourers, i.e. the income source of casual labour by earning daily wages from working in the informal sector such as construction, washing clothes, cleaning, cooking, porters, etc.²⁸⁴

N/A means that the specialisation was not available at the specific health facility at the time of the survey.

Consultation fees in USD²⁸⁵

Public Private

Bardhera General Hospital

Kulmiya Hospital

Registration fee²⁸⁶ Free 3

First visit/consultation with a doctor Free 4 - 5

Second visit Free Free if it is a follow-up visit

General practitioner Free 5

Cardiac tests (ECG) N/A N/A

Cardiologist N/A N/A

Cardiovascular surgeon N/A N/A

Endocrinologist/internal medicines doctors treating diabetes patients

N/A N/A

General surgeon N/A N/A

Gynaecologist Free N/A

HIV specialist N/A N/A

Laboratory tests²⁸⁷ Free 3 - 5

Neuro-surgeon N/A N/A

Oncologist N/A N/A

Paediatrician N/A N/A

Paediatric surgeon N/A N/A

Physical therapist N/A N/A

Psychiatrist N/A N/A

Thoracic surgeon N/A N/A

283For further details please see volume two of this report Health System Somalia: Consultation prices

284 Tana Sub-Study: Baardheere, p. 17

285Tana, Health System Somalia: Consultation and medication prices, Appendix F

286 Could be the fee for obtaining a patient booklet / card

287Please see Tana Sub-Study: Kismayo for details about available laboratory tests

The table indicates the presence of these particular medical specialists, but does not necessarily mean a disease cannot be treated, as it may be treated by a general doctor. For further details, please check for specific diagnosis in the price tables.

10.3.3. Access to health facilities

Security situation

Baardheere is under control of AMISOM/the Federal Government.²⁸⁸ According to observations on the ground by the consultants, the town is considered to be safe but safety outside of town is unpredictable as al-Shabaab has a presence within ten kilometres of the town.²⁸⁹ However, a source noted that violent incidents had taken place in the Geedo Region, including in Baardheere.²⁹⁰

According to observations by the consultants, the town has an airport which is open and functional.²⁹¹ The location of the airport vis-à-vis the surveyed health facilities can be seen on the map below.

Map of location of Baardheere airport and surveyed health facilities

Discrimination

The consultants did not notice signs of clan-based discrimination in the waiting areas of the surveyed health facilities.²⁹² As mentioned in section 2.6.1 Discrimination based on clan affiliation all interviewed sources confirmed that the different regions of Somalia are relatively homogeneous in terms of clan and sub-clan presence; therefore people seeking help at the health facilities are likely to come from the same clan as the health workers employed there.

288Political Geography Now, Control Map Somalia, May 2020, see map on p. 11 of this report

289Tana, Sub-Study: Bardheere, p. 4

290 ACCORD: Somalia, first quarter 2020: Update on incidents according to the Armed Conflict Location & Event Data Project (ACLED), 23 June 2020, url, p. 5

291Tana, Sub-Study: Bardheere, p. 4

292Tana, Sub-Study: Bardheere, pp. 4-5