Doctor Salah: We are following up on the casualty data since almost a year and a half ago, particularly in Mogadishu. At the beginning of May, we found an increase in the number of casualties under five and mortalities under five. The main type of injuries is burn, shrapnel blast injuries, and bullets. What I’ve seen there is multiple children under five years old with third degree burns, ugly scars, infections all over their body. Some of them have a bullet in his head and his body is half paralyzed—and he is under five years old. It is a tragedy.
DeCapua: Doctor, how do you treat these kids?
Doctor Salah: That was the main reason actually why I went to Mogadishu. When we found a high number of casualties, usually children under five, they have special physiology and anatomy that is different than adults; and that’s why there should be a different approach. So that’s why I’ve run the trainings, to explain to the health workers in the two main hospitals in Mogadishu how to preoperatively prepare the case, operatively, the operative techniques, postoperative follow-up and maintenance until the patient is discharged from the hospital. Usually children cannot tolerate high levels of anesthesia because the kidneys, the liver is immature, they cannot tolerate overdose of drugs. In fact for each child, the doses should be calculated carefully, otherwise the child will die from the treatment itself. Usually those third degree burns are a big challenge: they need a lot of transfusions, they need antibiotics, they are liable to infection. The wound infects and then septicemia and they die from infection. Some of them, they lost their arms. Imagine a child under five years old loses his hand or his leg, how is he going to live afterwards?
DeCapua: Doctor, will these children be taken out of Somalia to be brought to other countries possibly, for skin transplants or reconstructive surgery?
Doctor: Unfortunately, no. But what I have done there that I was training the others to do, not transplants, but skin grafting and some cosmetic and reconstructive surgery in Somalia.
DeCapua: So Doctor, why do you think there are so many children who have become casualties?
Doctor: Most people live in Bakara Market, the fighting right now in Mogadishu is in Bakara Market. Bakara Market is one of the cheapest areas in Mogadishu. So imagine the IDPs after the drought, they went outside and then they cannot afford to live in a tent, for example, somewhere. So they come back to Mogadishu, to Bakara Market, and they take their chances, just to be able to live there. If a family was killed or something, the next day you will find another family staying there. They came from a poor background, therefore their family cannot support them to go abroad—to be treated abroad.
DeCapua: Doctor, are you calling on the international community for more help in this matter?
Doctor: Very much, very much. Help is needed, health is seriously underfunded. We explained that we needed maybe 58 million and what we got was like 9 million or something. This fight in Mogadishu is far from over, it’s going to continue for some time and we need the international community to pay attention to what’s happening and to do something