Wounded treated in hospital and people on the run following fighting in Galgaduud Region, Somalia

A new surge in fighting in the Galgaduud region of central Somalia has led to many casualties and forced thousands to flee.

Following heavy fighting between two groups last Sunday, the Somali medical teams of the humanitarian organisation Médecins Sans Frontières (MSF) have treated 46 casualties at Istarlin hospital in Guri El. This brings the total of wounded treated there since fighting broke out in the area more than two weeks ago to 86.

Between 45,000 to 60,000 people are reported to have fled the town of Guri El and the regional capital Dhusa Mareb to seek refuge in rural areas, but are virtually cut off from much needed assistance.

"The situation has worsened by the day in this area of Galgaduud," explains Tom Quinn, who coordinates MSF programmes in Somalia. "Guri El has become a ghost town, as has Dhusa Mareb. We have gone from about 200 children a week to almost no children in our consultation wards, which is extremely  worrying knowing how high the needs are. Tens of thousands of women, children and elderly have run away, and are now facing difficulties in accessing food, water and medical care."

Initial reports are alarming. MSF staff have been told that families camp during the day under the shade of a tree, and sleep out in the open at night. The impact of the ongoing conflict on an area where food is already scarce could lead to a disastrous situation, particularly when combined with a lack of water and medical care. In more stable times, the MSF-supported Istarlin hospital treats between 80 and 100 severely malnourished children every month.

"Reaching the people who fled the violence and being able to deliver aid is crucial, but it has become increasingly difficult in Galgaduud region," says Quinn. "Both transport by air and road has been restricted due to the dangerous situation in the area, which has rendered supply of medical items and relief materials more difficult."

After days of negotiations, MSF is starting water trucking to both the displaced people from Guri El and Dhusa Mareb. However, providing hands-on medical care to those who fled to the bush is proving difficult against the background of a constantly changing conflict.

Overcoming the difficulties in providing humanitarian relief is a priority for MSF in Galgaduud region, but also throughout the many regions of Somalia where needs remain unacceptably high. While international attention largely focuses on the problems of piracy in Somalia's high seas, the suffering of millions of Somalis goes ignored.

MSF runs medical programmes in nine regions of Southern and Central Somalia.

The organisation has worked in Guri El (Istarlin) hospital in Galgaduud region since 2006.

In 2008, an average of 3,700 people a month received consultations and free medication in the hospital's outpatient department and an average of 330 people were hospitalised every month. MSF also runs two health posts in the area: one in Dhusa Mareb, the capital of Galgaduud, and one in Hinder, which opened in January 2008.  Last year, an average of 1,600 consultations were provided in these two health posts each month.