Why should you be worried about ICU beds in Somalia?

May 6, 2020·39 min·3 clips

In Somalia, people face a brutal choice: stay home and die of hunger, or go outside and die of COVID-19.

Host Belabes Benkreda opens by framing COVID-19 as the most globalized crisis in history, yet one receiving predominantly domestic media coverage. He argues that events in countries like Somalia and Syria will produce consequences felt globally within months. The episode's first guest, Benjamin Mason Meyer, is an associate professor of global health policy at the University of North Carolina at Chapel Hill and author of the forthcoming Oxford University Press book Foundations of Global Health and Human Rights. Meyer traces the human rights-based approach to global health back to the World Health Organization's founding principle that the highest attainable standard of health is a fundamental right. He explains that the International Health Regulations, last revised in 2005 after SARS, were designed to create a harmonized global surveillance system with both minimum public health requirements and maximum limits on rights restrictions. Meyer argues that China's delayed reporting hampered WHO's early response, and that the WHO director general spent a month convening an expert committee before declaring a public health emergency of international concern. He contends that travel bans adopted by governments including the United States violated international law on three grounds: they lacked scientific basis, were more invasive than alternatives, and violated human rights. Rather than containing the virus, he says, these bans created chaotic airport conditions that facilitated spread and blocked necessary medical personnel from traveling. Meyer warns that governments worldwide are using states of emergency as pretexts for human rights abuses and consolidation of power rather than implementing evidence-based public health measures. He closes by arguing that neglecting global solidarity weakens every nation, and that unchecked viral spread in fragile health systems risks producing mutations that could return to wealthier countries. The second guest, Dr. Deko Mohamed, is an OBGYN, founder of the Hargala Institute, and a veteran of Doctors Without Borders and a 90,000-person refugee camp outside Mogadishu. She describes Somalia as the least prepared country in the world for COVID-19 according to the Informed Global Risk Index, with only 19 ICU beds for 15 million people. Dr. Mohamed recounts the shock that swept through Somalia's health community when the country's first COVID death occurred and two Ministry of Health employees tested positive, potentially exposing all health personnel who had been in contact with them. She explains that social distancing is structurally impossible in a country where ten family members may share a two-by-two meter shelter in an internally displaced persons camp. Somalia's government allocated only five million dollars to its COVID response, enough to partially equip half of one hospital without ventilators. Al-Shabaab's territorial control further limits the government's ability to reach parts of the country, leaving civil society to fill the gap. Dr. Mohamed describes social media misinformation — including claims that heat would kill the virus — as damaging to public health efforts, and says religious leaders have been telling people to trust in God rather than practice basic hygiene. Despite her decades of experience through civil war, Ebola, and cholera outbreaks, Dr. Mohamed says COVID-19 is the most frightened she has ever been, describing sleepless nights and a sense of screaming internally as she watches the scale of the threat go unrecognized. She closes with a message that COVID-19 has placed all of humanity in one box, and that wealthy nations should recognize that Somalis face a choice between starvation at home and infection outside.

As heard by us

A sober case for why Somalia's health capacity is a global issue.

The Big Picture uses Somalia to frame a wider point about how COVID-19 exposes shared vulnerability. Belabes Benkreda and global health policy expert Benjamin Mason Meyer move from strained health systems to the case for international cooperation, bringing in the World Health…

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Why you'd press play

If Somalia's COVID-19 fight sounds distant, this makes it feel uncomfortably, and politically, close.

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