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Health conditions in Somalia are poor. Globally, the country has one of the highest rates of malnutrition, both in children and the general population. Infant mortality is high, at 126 per 1,000 live births, and life expectancy is low: only 47 years on average. Particularly during the dry season, the population is afflicted by outbreaks of cholera, a potentially fatal disease caused by unsafe water. Insect-borne diseases like malaria and Rift Valley Fever are also problematic. International Health agencies such as UNICEF and Doctors Without Borders have been working in Somalia for years to provide relief. One of the main public health concerns is access to clean drinking water. In the countryside, people can travel up to six hours a day to reach wells, which may be contaminated. Somalia’s health care system used to offer free Western-style treatment through hospitals and dispensaries, but both in the north and south, years of war have disrupted the hospital system, reducing facilities and limiting their resources. In the absence of other treatment, most Somalis rely on traditional healers. Sancoole practitioners perform operations such as bloodletting, scarification, cauterization and teeth-pulling. Cauterization is a common therapy for treating diseases such as hepatitis and parasites; the practice is based on the belief that disease and fire cannot coexist. Healers also use therapeutic massage and natural materials such as wood and plant extracts to treat fractures. A tonsillectomy can be performed by first sterilizing simple instruments in a fire.
A faallow healer practices a form of astrology, using dirt drawings, cards, coffee grinds and tossed shells to diagnose patients. Some diseases are believed to be caused by the evil eye or by spirits called jinn, or by the sufferer’s own sins. In these cases, a Somali might rely on an exorcist, who uses dance and animal sacrifices to drive out the supernatural invader.
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