Health care workers in Somalia suffer from high rates of anxiety, depression and stress because of their work with COVID-19 cases, a new study finds.

The study was presented at a health research conference in the Somali town of Garowe last week. Initial findings recorded a high prevalence of anxiety in the workforce at 69.3%, 46.5% for depression and 15.2% for stress.

The study used the Depression, Anxiety and Stress Scales (DASS), widely used in scientific circles to measure the three emotional states. Researchers interviewed 186 health care workers in three hospitals in Mogadishu between May and August 2021.

Dr. Abdirazak Yusuf Ahmed, the study’s lead author and director of the De Martino Hospital, the main COVID-19 medical facility in Mogadishu, said several factors played a role in the prevalence of these traumatic experiences in the health care workforce.

“The first one is that this disease is associated with deaths,” Ahmed said. “They (workers) were afraid they could take the virus to their homes and pass on to their loved ones.”

He also mentioned low motivation among the COVID-19 workers.

Doctors working in Somalia are not surprised that the multiplier effects from COVID-19 contributed to the workers’ ill health.

Since March 16, 2020, when the first case was detected, Somalia has recorded 1,340 COVID-19 deaths and 26,203 positive cases, at a fatality rate of 5.1%. But independent studies and press reports argued that COVID-19 deaths in Somalia have been enormously undercounted. Somalia has administered more than 1.6 million COVID-19 vaccine doses so far, with only 5.6% of the population fully vaccinated.

The discovery of personal health challenges among frontline workers comes at a time when the country lacks enough health care workforce to provide services.

Last week’s conference, which was attended by federal and regional health officials, local doctors and international health workers, including representatives from the World Health Organization, recognized the severity of the lack of enough health care workers.

A statement issued at the end of the conference stated that the low workforce density in the country stands at 5.4 doctors, nurses, and midwives per 10,000 population. WHO recommends a ratio of 44.5 per 10,000.

The statement further said that according to WHO’s health workforce guidelines, there is a gap of 55,000 skilled health professionals in the country.

It said the gap affects all components of the health system, ranging from service delivery, health workforce, health information systems, access to essential medicines, financing and leadership, policy and governance.

This shortage is attributed to the migration of health workers from Somalia because of war and crisis, according to Dr. Mamunur Rahman Malik, WHO’s Somalia representative.

“This shortage means that the country doesn’t have adequate health workers who are required to run and manage primary health centers or hospitals,” he said. “So, services are below optimal or of poor quality as the services are provided by lay health workers.”

Good news for child mortality

The conference predicted progress in reducing child mortality and maternal mortality in Somalia in coming years.

With investment and implementation of basic health services, the maternal mortality ratio is expected to decline to 332 deaths per 100,000 live births by the year 2030, signifying a 50% reduction from the present level, the statement said.

Similarly, the mortality rates for neonatal, infant and children younger than 5 are expected to decline from 122, 77 and 38 per 1,000 live births in 2020 to 63, 42 and 20 deaths per 1,000 live births, respectively, by the year 2030.

Child mortality in Somalia is believed to be the highest in the world, according to a report published by Amnesty International in August 2021, with an estimated 15% of people having access to medical care in rural areas.

This report originated in VOA Somali service’s “Investigative Dossier” program.
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