Kismayo: A mother in southern Somalia carried her three year old daughter for three days to reach a hospital nearly 90 kilometres away, highlighting the difficulties families face in obtaining treatment for severely malnourished children as humanitarian assistance declines.
Halima Abdullahi Ibrahim took her daughter, Asho Hassan Abdi, to Kismayo Referral Hospital, where the child was diagnosed with oedema, a swelling condition associated with severe acute malnutrition. Their journey illustrates the challenges faced by families who live far from health facilities and struggle to access essential medical care.
The case comes as Somalia faces a worsening food security emergency, with millions of children at risk of malnutrition and humanitarian agencies warning that funding shortages are reducing access to treatment. The threat of flooding during the October to December rainy season could further complicate efforts to reach vulnerable communities.
An assessment released by the Integrated Food Security Phase Classification on September 23 estimated that 1.92 million children aged between six months and 59 months were suffering or were expected to suffer from acute malnutrition and require treatment between July 2026 and June 2027. Of these, an estimated 433,000 children are expected to experience severe acute malnutrition.
The assessment also projected that 5.4 million people would face crisis level food insecurity or worse between October and December 2026. This includes approximately 1.5 million people expected to face emergency level hunger or worse.
These figures describe projected levels of need rather than the number of people already receiving treatment or experiencing the most extreme conditions.
At Kismayo Referral Hospital, the pressure on health services is already evident. Jubbaland Health Minister Ismail Garas said the hospital admitted 152 children with severe acute malnutrition in August, and four of them died.
The figures illustrate the risks facing severely malnourished children, whose weakened bodies are more vulnerable to serious complications, particularly when they also suffer from infectious diseases.
Humanitarian agencies have warned that funding shortages are making it harder to respond to growing needs. UNICEF reported on August 21 that 205 health and nutrition facilities had closed. It also reported that admissions to stabilisation centres treating children with severe malnutrition and medical complications increased by 32 per cent during the first half of 2026 compared with the same period last year.
The World Food Programme has separately warned that reduced resources are limiting nutrition assistance. Its emergency information indicates that more than 230 nutrition centres have closed and around 1.1 million children and mothers are no longer receiving nutrition assistance. These figures come from separate agency reports and should not be combined into a single total.
The World Food Programme has said it needs US$162 million to sustain life saving assistance through March 2027. Without additional resources, vulnerable families could face further difficulties obtaining food and medical treatment.
Displacement has added to the hardship. Many families have lost their livelihoods and are struggling to find adequate food, clean water and healthcare. At the Luglow settlement outside Kismayo, displaced people face difficult living conditions.
Ali Adan Ali, Jubbaland's commissioner for refugees and internally displaced people, said many displaced families had not received humanitarian assistance since 2023 because of funding shortages.
Repeated poor rainy seasons and drought have damaged livelihoods across Somalia, particularly among communities that depend on farming and livestock. Conflict and insecurity have also disrupted livelihoods and complicated the delivery of humanitarian assistance.
Malnutrition becomes more dangerous when children also suffer from diseases such as measles. UNICEF has warned that the combination of inadequate nutrition, disease and limited healthcare places vulnerable children at greater risk.
The October to December rainy season presents another serious concern. Forecasts linked to the El Niño weather pattern indicate the possibility of unusually heavy rainfall in parts of Somalia during this period.
The Food and Agriculture Organization has warned of a high risk of flooding in central and southern Somalia. Floodwaters could damage crops, kill livestock, displace families and cut off roads used by humanitarian workers to deliver food and medical supplies.
The Somali Disaster Management Agency has been coordinating with United Nations humanitarian officials to strengthen preparations for possible flooding. However, the extent of the coming rains and their impact on vulnerable communities remain uncertain.
The September assessment also identified a risk of famine among internally displaced people in Baidoa, in southwestern Somalia, under a worst case scenario. The assessment was based on data collected in April, and a follow up assessment was planned for October to gather updated evidence. This does not mean that famine has been officially declared.
Despite the growing challenges, community health workers continue to screen children and connect families with nutrition services. Such efforts can help identify malnutrition earlier and improve access to treatment, particularly in areas where hospitals are difficult to reach. However, the availability of these services remains a concern as facilities close and humanitarian resources decline.
For families such as Halima Abdullahi Ibrahim's, the distance to healthcare and the availability of assistance remain critical concerns.
With millions of children projected to need treatment over the coming year, humanitarian agencies face increasing pressure to restore nutrition services, secure funding and prepare for possible flooding. Timely assistance will be essential to prevent further deterioration in the health and living conditions of Somalia's most vulnerable children.