Amran Osman, a 35-year-old married woman, resides with her extended family in an Internally Displaced Peoples (IDP) camp in Korsan, located in Wadajir district, Somalia. In 2011, due to the conflict between government forces/ AMISON and the AS Militia, Amran and her family were forced to leave their home in Huriwa district, situated on the south-eastern periphery of Mogadishu. The ongoing conflict in Huriwa, now between Al-Shabaab and the AMISON troops/Somali national forces, has compelled Amran and her family to continue living in Korsan camp.
Under the strategy of “Leave No One Behind” the IPPF-led WISH2ACTION programme seeks to scale up integrated sexual and reproductive health services to key populations including the poor, youth under 20, people with disabilities, and those in humanitarian settings. The programme is implemented in Somalia by the International Rescue Committee.
Established in 2011, THE Korsan camp provides temporary shelter, food, water and other basic needs to people who are displaced by conflict. The Korsan Health Centre, managed by International Rescue Committee (IRC), a partner in the IPPF-led WISH2ACTION programme, provides health services to the residents.
To make a living, Amran sells local food at a checkpoint near the Mogadishu airport. She is the mother to nine surviving children, but tragically lost one after childbirth. Amran has experienced multiple challenges during her pregnancies, including severe hyperemesis gravidarum (severe nausea and vomiting, often resulting in dehydration and hospitalisation) and anaemia which she has been hospitalised for. Additionally, her pregnancies were closely spaced with intervals of approximately 6-8 weeks between births and subsequent pregnancies. Short birth intervals are associated with an increased risk of maternal complications and child health concerns.[i] Both Amran and children have struggled on and off with illness.
Community health workers from the WISH2ACTION programme conducted mobilisation and sensitisation sessions to raise awareness on sexual and reproductive health (SRH) and services in the Korsan IDP camp, including her village. They delivered key messages including the importance of healthy birth spacing and informed the residents of the availability of free contraceptive services at the Korsan Health Centre.
After careful consideration, Amran decided to seek additional information and receive a contraceptive method at the WISH2ACTION supported Korsan health facility. Following a counselling session, Amran selected a long-term contraceptive method to delay any future pregnancies. She received a 5-year implant.
Later, Amran confided in her mother about the contraception she had received. Unfortunately, her mother disapproved and shared this information with the wider family, including her husband, who criticised and rejected Amran. As a result, she chose to remove the implant. In their community, the belief prevails that contraceptives permanently prevent conception, and having many children, especially male ones, is considered a source of strength. However, determined not to get pregnant, Amran secretly began taking oral contraceptive pills but failed to adhere to the prescribed regime, and she became pregnant.
Amran experienced a challenging pregnancy and ultimately underwent a C-section, but tragically her child did not survive the delivery. Upon seeing her poor and deteriorating condition, her family finally understood the gravity of her situation and agreed that Amran should use a long-term contraceptive to prevent future pregnancies. Facility staff provided comprehensive counselling to her family, addressing their concerns, and emphasising the importance of birth spacing. Consequently, Amran received a 5-year implant 18 days after the C-section. She is recovering well and is grateful to the Korsan Health Staff and the WISH2ACTION programme.
As we mark World Refugee Day today, we celebrate the strength and courage of refugees, while recognising and addressing the challenges faced by forcibly displaced people like Amran. These include limited access to SRHR services, barriers to contraception, sexual and gender-based violence (SGBV), stigma and discrimination, poor hygiene, and sanitation facilities to name a few. It is imperative that all stakeholders: governments, donors, development organisations and programmes like WISH2ACTION recommit to improving the lives of refugees and defending their rights so that they can live full dignified lives.