When Fatima Abdi Ali, 32, experienced life‑threatening complications in her seventh pregnancy, she and her husband travelled more than 125 kilometres, crossing from Ethiopia to reach Mudug Regional Hospital in Galkayo North. It was the nearest facility equipped for such an emergency. On arrival, Médecins Sans Frontières/Doctors Without Borders (MSF) teams performed an urgent caesarean section, saving Fatima and her baby. “Not once did they ask us for money… They treated me with so much respect and dignity,” she says, cradling her newborn.
Mudug region has been battered by years of conflict and drought. Health services are limited; mothers and children often travel for hours on unsafe roads because nearby clinics cannot handle emergencies. Few women deliver with skilled health workers, and many do not complete recommended antenatal visits. Halima Abdi Adan walked for hours with her feverish two‑year‑old to reach the hospital, where MSF treated measles, pneumonia and acute malnutrition. “The people here saved his life,” she says.
Rising hunger and displacement are compounding these challenges. Somalia’s Post‑Gu analysis by authorities and United Nations agencies found that 3.4 million people- around 18 percent of the population- were facing crisis or worse levels of acute food insecurity between July and September 2025, and shows that 4.4 million people (23 percent) could face crisis or worse by the end of the year. About 1.85 million children under five are expected to suffer acute malnutrition between August 2025 and July 2026, including 421,000 likely to be severely malnourished. With funding shortfalls, food assistance is declining from around 1.3 million recipients to a planned 375,000 per month, leaving families hungrier and pushing more mothers and children to arrive at health facilities dangerously sick.
Amid these pressures, MSF supports the Ministry of Health in both Galkayo North and South to deliver free maternal and paediatric services. At Mudug Regional Hospital, teams run maternity, paediatric, neonatal unit, emergency and nutrition services and support a tuberculosis unit. Three mobile clinics take consultations, vaccination and nutrition screening to twenty‑three camps for displaced families. In the south, MSF supports Galkayo South Hospital and three clinics providing maternal health, neonatal unit, immunisation and emergency response.
Between January and June 2025, MSF assisted 3,076 births, up 3.6 percent from the same period in 2024. Antenatal consultations fell eight percent to 19,777, suggesting more women are missing preventive care and arriving later or in riskier condition. Malnutrition admissions rose by 49.6 percent, driven mainly by moderate acute malnutrition with complications requiring treatment; severe acute malnutrition admissions remained broadly in line with last year. Taken together, these trends show rising pressure on services even as other support shrinks.
“Mothers and children should not pay the price of remoteness and funding cuts,” says Mohammed, MSF’s Head of Programme in Somalia.
