Somalia is facing a crisis of disastrous malnutrition, exacerbated by prolonged drought, ongoing conflict, economic instability and a vulnerable healthcare system. The Baidoa and Mudagh regions, where Medecin is frontières (MSF) operate, are examples of crisis deployed nationwide, with thousands of children at risk of severe malnutrition and its life-threatening consequences.
Chronic funding shortages have crippled humanitarian efforts and forced critical nutrition programs to be reduced or closed. The looming threat of the 2025 La Niña-led drought could push already vulnerable communities to the brink. MSF is urgently urging donors and humanitarian organisations to take immediate action to prevent widespread suffering, as the outcomes can be devastating.
Father’s final hope to save his child
Kalimow Mohamed Nur had no choice but to gamble desperately. The twin sons were weak from hunger, their small bodies were frail from repeated attacks of vomiting and diarrhea, and he borrowed enough money for a day’s journey – the amount that he would take several months to earn – and then went on a tough trip to Baidoa. The roads were long and the heat was unforgiving, but the promise of free medical care at Bay Regional Hospital was his last hope.
“I got a loan of about $130 and had to travel to 300 kilometres of Baidoua to find free medical care,” says Karimou, whose twin sons were treated for severe acute malnutrition at MSF Support Bay Regional Hospital. “They were so small, we could barely afford to buy enough food. They kept getting sick.”
Kalimow’s story, marked by poverty, distance and absence of local services, echoes the harsh reality that prevents countless families from accessing care. In Somalia, life-saving treatment has turned into a privilege that only a few people can access.
Malnutrition, a year-round crisis in some Somalia
In Baidoa and Mudug, malnutrition has become a sustained, year-round crisis, not a seasonal challenge. “We see high malnutrition rates as well as normal, lean season,” says Jarmilla Kliescikova, MSF medical coordinator in Somalia. “This is a chronic crisis that calls for sustained intervention.”
In 2024, the MSF team treated 18,066 severely malnourished children throughout the Somalia project, a significant increase from the previous year. At Mudug, admission to outpatient nutrition programs has skyrocketed by 250% due to both rising needs and expanded outreach efforts. Baidoa also highlighted the increasing number of enrollments throughout 2024, increasing despair among families seeking care.
However, these efforts hardly damage the surface. According to the United Nations Humanitarian Cooperation Agency (UNOCHA), an estimated 1.7 million children faced acute malnutrition in 2024, including 430,000 people suffering from severe acute malnutrition. While MSF interventions are important, they represent only about 1% of the malnourished population, highlighting the overwhelming vast scale of the crisis and the pressing need for wider support.
Conflict and climate change are promoting massive displacement and forcing people into areas with already scarce resources. The repeated droughts devastated agriculture, leaving families who were unable to maintain the ones that were once dependent on farming and livestock. At displacement sites, the prevalence of severe and moderate malnutrition is surprisingly high, but excessively extended health centers have a difficult time dealing with it.
Funding gaps force critical programs to shrink
In addition to the crisis, the lack of funds has devastated the humanitarian response. According to UNOCHA, in 2022, only 56% of Somalia’s humanitarian fundraising needs were met. For example, Bidoa has reduced several nutritional programs since 2023, reducing essential services such as treatment feeding centres.
“The closure of these programs left a devastating gap,” says Mohammed Ali Omer, head of MSF programmes in Somalia. “Children who desperately need life-saving medical foods are turning their backs. And only a few communities will benefit from vaccinations, becoming vulnerable to diseases that are vulnerable to preventable diseases. This is not just a crisis, it’s a catastrophe that unfolds in real time.”
An even greater threat looms on the horizon as Somalia suffers from the ongoing dry spell: the La Niña-led drought expected in 2025. La Niña is a climate phenomenon that cools sea surface temperatures and disrupts global weather patterns, often leading to reduced rainfall in East Africa. As water sources have been depleted and food production has been crippled by previous droughts, the effects could force more families from catastrophic homes and further increase malnutrition rates. As droughts become more frequent and more severe, the window of recovery shrinks, but rising food prices push survival even further out of reach for the most vulnerable.
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The looming crisis that can still be prevented
Without immediate and sustained support, thousands of children face not only starvation, but also weakening immunity, increasing vulnerability to disease, and irreversible developmental harm. Healthcare systems already struggling under unrelenting demand risk total collapse as outbreaks and complications rise. MSF is urgently urging donors and governments to act now ahead of the 2025 drought strike. We need to expand nutritional therapy, expand food distribution, strengthen medical services and save lives while we still have time.
“Humanitarian assistance in Somalia is already dangerously low, and now reports of further funding cuts, including cuts in US aid, will make the situation worse and put more lives at risk,” Omer said. “Reducing nutrition programs is at the worst possible time. Malnutrition rates are rising, evacuation is rising, and the need for assistance is greater than ever,” he says. “It’s not irresponsible to reduce the support we have now. It’s fatal. It’s time to act. For the Baidoah and Mudagh children, every moment is important to give them the opportunity to survive.”
