UNITED NATIONS NATIONS UNIES
WORLD H E A L T H O R G A N I Z A T I O N
ORGANISATION MONDIALE DE LA
SANTE
REGIONAL OFFICE FOR THE EASTERN MEDITERRANEAN
RFX;IONkL CCDMTTTEE FOR THE EASTERN MEDITmNEAN S i x t h Session
W T H EDUCLTION I N SOMfiW
Submitted bv t h e I t a l i a n Trust Administration of Samalia
The a r e a of Somalia is approximately 500,000 square kilometres; n a t u r a l resources a r e few and over half t h e population, which amounts t o 1,300,000 inhabitants, i s nomadic. Apart from a limited number of town dwellers, t h e g r e a t e r p a r t of t h e population l i v e s by a g r i c u l t u r e along t h e r i v e r s and by s h e e p r e a r i n g in t h e d r y areas. They lead a primitive l i f e , which is now being changed t o some e x t e n t by the work of t h e I t a l i a n Trust Ldministration in t h e s o c i a l f i e l d , and through t h e health and educational services. Both a r e under t h e c o n t r o l of the Department of S o c i a l Development, which can thus c l o s e l y coordinate and i n t e g r a t e t h e two services.
The usefulness of t h i s i n t e g r a t i o n may be observed i n t h e f i e l d of h e a l t h education i n which t h e schools as well a s t h e health organization p a r t i c i p a t e .
The h e a l t h education programme f o r t h e Somalia population i s not ambitious;
it i s a simple one i n view of t h e anvironmental conditions, t h e countryts resources and, above a l l , of the psychology of the i n h a b i t a n t s which does n o t r e a d i l y lend i t s e l f , a s t h e many i n t e r n a t i o n a l experts who worked i n Somalia noticed, t o major experiments, imposed d u t i e s and sudden and r a d i c a l
innovations.
The Somalis a r c by nature proud and i n d i v i d u a l i s t i c ; they c l i n g t o t h e i r t r a d i t i o n s and t h e i r habits. Thus, i f i t i s not t o f a i l , every innovation must be accompanied by p . t i e n t p r s u c s i o n , p r a c t i c a l small s c a l e demonstrations and welfare and h e a l t h a c t i v i t i e s , t o g a i n t h e confidence and support of t h e population, Above 911 t h e r e should be no hurry. On t h a t basis, t h e I t a l i a n Trust Ldministration of Somalia proposes t o c a r r y out a programme of slow b u t
o f f e c t i v e and l a s t i n g penetration, through a s o r i e s of converging a c t i v i t i e s with t h e s o l e o b j e c t of making t h e population h e a l t h conscious, t o teach e l e m e n t a v standards o r hygiene and prophylaxis, t o help it give up
t r a d i t i o n a l customs which c o n f l i c t with h e a l t h p r i n c i p l e s and t o spread t h e simple r u l e s of prevention which may l i m i t t h e spread of t h e most dangerous o r t h e most common disaascs.
In p a r t i c u l a r , h e a l t h education now aims a t improving n u t r i t i o n , p r o t e c t i n g t h e health of mothers and children, l i m i t i n g t h e spread of malaria, tuberculosis, s y p h i l i s , trachoma, and c r e a t i n g t h e psychological conditions f o r an improvement of t h e environment, through b e t t e r houses, t h e p r o t e c t i o n of water s u p p l i e s and sewage d i s p o s a l and through i n s e c t control, house and personal hygieno.
Naturally, t h e i n h a b i t a n t s of t h e urban contres and t h e v i l l a g e s a r e more e a s i l y reached in carrying out t h i s programne, and t h e sedentary r u r a l populations a r e more d i f f i c u l t t o con+.aot; it is oven moro d i f f i c u l t t o reach t h e nomads who l i v e in the woods, forever iq search of pasture and water f o r t h e i r c a t t l e .
The r e s u l t s of t h i s h e a l t h education, as i s t h e case with a l l s o c i a l programmes, were f i r s t very limited and hardly noticeable; but it may now be s t a t e d t h a t a few signs of progress begin t o manifest themselves and t h a t t h e i n i t i a l phase which w i l l lcad t o successive and qcicker dcvelopmcnts has been completed; while it has not boon possible yot t o e x c i t e t h e i n t e r e s t of the cornunity and t o e n l i s t i t s cooperation, t h e i n t e r e s t of some groups of t h e population i n h e a l t h and hygiene problems has been aroused and some improvement of t k o h e a l t h of c e r t a i n individuals o r of c e r t a i n f a m i l i e s has been noticed.
To a t t a i n such r e s u l t s t h e r e i s n e i t h e r appropriate personnel nor organization t o d e a l exclusively with h e a l t h education; t h i s would involve too g r e a t expenses and would not f i t with t h e physical environment of Somalia whose population is l i m i t e d and scattored.
The health education of t'ne public i s entrusted in t h e f i r s t instance t o schools where personal hygione, rudimentary knowledge of t h e main d i s e a s e s o f t h e area, t h e human body and i t s diseases and disease provontion a r e taught.
This s y l l a b u s i s taught i n primary, a d u l t and secondary schools, and, a s t h e n m b e r of s t u d e n t s i s approxiruately 22,OCO and as thore a r c overy p a r
&5,000 now students, it is bclievod t h a t a g r e a t number of young people l e a r n t h e eloments of hoalth evory year.
I.n important c o n t r i b u t i o n t o tho hoalth education of t h e population is made by hospitals, i n f i r m a r i t s and mobile u n i t s ; a l l t h e h e a l t h personnel,
including t h e medical and t h e a u x i l i a r y s t a f f , have p r e c i s e i n s t r u c t i o n s not only t o t r e a t p a t i e n t s
'b
t a l s o t o explain t o them, when it is p o s s i b l e o r advisable, t h e causes of t h e i r diseases and t h e way t o prevent them in f u t u r e . In addftion, t h e rnedical s t a f f and t h e Somali a u x i l i a r y s t a f f of senior rank ( s o c i a l a s s i s t a n t s , s a n i t a r j a s s i s t a n t s and midwives) c a r r y out a elowly p e n e t r a t i n g hoalth propaganda i n the hoalth c l i n i c s and in the houses; and simple l e c t u r e s and meetings on h e a l t h s u b j e c t s a r e o f t e n organized i n a l l the p a r t s of t h e country. I n t h i s respect, it should be remembered t h a t t h e a u x i l i a r y h e a l t h s t a f f i s i n s t r u c t e d i n t h i s propaganda work i n the course of i t s t r a i n i n g .F o r i n s t a n c a , a l l midwives a r c providod with midwifery kits and when t h e y v i s i t homes in v i l l a g e s , t h e y i n s t r u c t young mothers i n s t e p s t o be taken t o have a normal pregnancy and a normal delivery. They teach how t o d e l i v e r healthy babies and how t o lceop tilorn healthy i n t h c f i r s t years of l i f e . O f course, r e g i o n a l and d i s t r i c t 3iodical o f f i c e r s supemiso, guide and follow the work of t h e i r s t a f f i n t h a t f i e l d and contribute t o it personally.
Anothor c o n t r i b u t i o n t o t h e health education of t h e p u b l i c is made by t h e p r e s s and t h e b r o a d c a s t k g service. S o m a l i a ' s d a i l y papor o f t e n contains onsy a r t i c l e s on healt'n subjects; l o a f l o t s have been p r i n t e d and distribu%ed t o e x p l a i n t o the population t h e o r i g i n and t h e causes of c e r t a i n p r i n c i p a l diseases.
Radio programmes include t a l k s on health problems i n the Somali language and t h e s t a t i o n s in t h e nain d i s t r i c t s of tho T e r r i t o r y broadcast on t h e need t o improve enviroanental s a n i t a t i o n . L comedy in t h e Somali language showing
ih
a funny way t h e c o n t r a s t betweon t h e a t t i t u d e of t h e old shepherd who c l i n g s t o h a m f u l t r a d i t i o n a l h e a l t h h a b i t s and t h a t of t h e young progressive Somali who puts h i s t r u s t i n t h e doctor and appreciates t h e b e n o f i t s of nedicine and hygiene has been most scccessful.A p r o j e c t is now being planned t o i z ~ t a g r a t e t h e i n s t r u c t i o n of t h e a u x i l j a r y health parsonnel with a period of p r a c t i c a l t r a i n i n g i n a small v i l l a g e , t o c a r r y out h e a l t h education, t o c r e a t e an i n t e r e s t in communal h e a l t h problems, t o c r e a t ~ i n f a c t i n a few small c e n t r e s h e a l t h
on-an i n d i v i d u a l and
a
community basis. Those p r a c t i c a l exercises w i l l bo c a r r i e d out by s o c i a l a s s i s t a n t s , s a n i t a r y a s s i s t a n t s and midwives who w i l l have t o be,Qterestod i n houso s a n i t a t i o n , personal hygiene, prevention of diseases, mother and c h i l d welfare and t h e protection of food. It is probable t h a t UNICEF and-mO,
whose roprosentatives v i s i t e d Somalia recently, w i l l p a r t i c i p a t e i n t h i s project.i n o t h o r c o n t r i b u t i o n t o h e a l t h education i s made by mass canpaigns, p a r t i c u l a r l y t h e malaria c o n t r o l campaign which i s now being conducted i n a g r e a t p a r t of the T e r r i t o r y . The s t a f f of t h e malaria c o n t r o l campaign does not confine i t s work t o t h e DDT spraying of dwellings and t o t h e entomological study of t h e v e c t o r s but it a l s o helps t h e protected population and c a r r i e s out a h e a l t h campaign which w i l l be gradually extended i n t h e near f u t u r e when t h e planned oampaigns f o r t h e c o n t r o l of s y p h i l i s and t u b e r c u l o s i s a r e implemented;
in tho f i o l d of t u b e r c u l o s i s i r p o r t a n t r e s u l t s have been r e g i s t e r e d with regard t o t h e e a r l y diagnosis and i s o l a t i o n of p a t i e n t s and following tho intense propaganda oarried out s i n c e 1952 f o r t h e c o n t r d l of tuberculosis, t h e number of p a t i e n t s attending TS c l i n i c s and the Mogadiscio TB h o s p i t a l has almost
S t a r t i n g on a s n a l l scale, mass h e a l t h education has been gradually developed and i n t e n s i f i e d . The importance of t h i s educational e f f o r t is not underestimated and t h e programnos f o r t h e near f u t u r e a r e promising, although they a r c not backed by l a r g e funds and an appropriate organization.
Results i n t h i s f i e l d a r e not measured i n t c r n s of years 'mt in terms of decades and one should not bewer-optimistic about f u r t h e r progress in t h e near future.
