When Aid Shrinks, the Walk Gets Longer: Inside Garasbaley Health Center, Mogadishu

For some families, even that journey is out of reach. Transport costs are simply too high, leaving mothers and children without essential maternal and child healthcare. The World Health Organization (WHO) warns that more than 600 health facilities across Somalia could shut down. For women already walking for hours, every closure means a longer journey, and for some, no care at all.

We spoke with two mothers who made the journey to Garasbaley Health Center, a facility supported by SOS Children's Villages, to seek care. Their stories reveal what happens when essential health services become fewer, farther away, and harder to reach.

“We walked together in a group of mothers to reach here.”

Fardowsa holds her 11-month-old daughter as a health worker prepares her for routine vaccination at the SOS-supported Garasbaley Health Centre in Mogadishu.

Fardowsa, 31, a mother of 3, lives in Elasha Biyaha in the Afgooye District. Her 11-month-old daughter was due for routine baby vaccinations. Unable to afford the transport fare, she joined other mothers on a nearly 5-kilometer walk to reach Garasbaley Health Centre.

"Before, there were several small health facilities around us," said Fardowsa. "They have been closed for more than a year now. I could not afford the transportation to get here, so I joined other women and walked together to reach here."

A haven for families with nowhere else to go

About 10 kilometers west of Mogadishu's city center, Garasbaley district is home to hundreds of informal settlements that shelter displaced families and people affected by forced evictions in central Mogadishu. As a major destination for internally displaced people (IDPs), the area keeps absorbing vulnerable families into ever-growing, sprawling IDP camps. It is a refuge with few basic services, where families struggle to access clean water, shelter, education, and healthcare.

Dr. Muna Issack, the Garasbaley Health Center In-Charge, checks a newborn delivered minutes earlier at the SOS-supported Garasbaley Health Center in Mogadishu.

The number of people seeking treatment has grown substantially, from about 200 a day before to more than 300 in recent months. Between April and August this year, the facility recorded about 41,000 patient visits, for services ranging from maternal and child healthcare to nutrition and psychosocial counseling.

"Over the past three months, we have seen people displaced by conflict, including those from Basra in the Lower Shabelle Region and those affected by the recent conflict in Baidoa City, seeking assistance here," said Dr. Muna Issack, the Health Facility In-Charge. "That means we stay late to attend to each of these mothers and children."

“I left home early in the morning so I could make it here in good time.”

Omar Samow, a public health nurse, checks a child's eyes for signs of malnutrition at the SOS-supported Garasbaley Health Center in Mogadishu.

Fadumo Iftin, 27, a mother of four, lives in the Talowadaag IDP Camp on the farthest periphery of Garasbaley District. Her husband is elderly, so she had no one to help her carry her 2-year-old son. She walked to the facility, slowly, snaking through several informal settlements before she finally reached the center.

"My son was unwell for three weeks. There is no health center around us. I tried several traditional healers, but it didn’t work,” said Fadumo. “Last night, he was in pain, so we didn’t sleep.”

"I didn't have the fare, so I walked early in the morning to make it here on time. A neighbor had told me about the facility. It took us two hours to get here," she said. "I'm grateful for the assistance I received."

 A lifeline that needs to stay open

For Fardowsa, Fadumo and thousands of mothers like them, Garasbaley Health Center is not just the nearest centre but the only one within reach. Every step they take, with a child in their arms and no fare in their pockets, shows what is at stake as funding shrinks and services disappear.

Behind the numbers (6.5 million Somalis facing food insecurity and 2 million children at risk of malnutrition) are mothers walking for hours so their children can be seen.

Through the CaafimaadPlus Consortium and with support from the UK Government through the British Embassy in Mogadishu, Garasbaley Health Center is helping to save lives and bring essential services closer to communities. But health centers like Garasbaley cannot keep their doors open, or their staff working late, without continued support. When aid shrinks, the walk gets longer, but with support it does not have to end at a closed door.