Somalia's food insecurity is a complex crisis with roots in the country's turbulent past, ongoing droughts, and socio-political difficulties which have severely hampered agriculture and made it difficult for communities to access basic resources. (Carruth & Mendenhall, 2019). Addressing this issue requires implementing Action Area Three of the Ottawa Charter, which is about "strengthening community actions." The responsibility of a nurse working for the UN is to mobilise and involve community members in the fight against food insecurity. The essay will examine Somalia's food insecurity causes and effects on health. It also discusses how the community nurse can motivate and enlist stakeholders in the fight against food insecurity, ultimately fostering a long-term and neighbourhood-driven solution to this pressing problem.
Over time, Somalia's food insecurity has worsened, and it has a long-lasting effect on the population's health. Food insecurity in Somalia is made worse by its climatic conditions, particularly its vulnerability to droughts. With the possibility of a sixth failed rainy season in 2023, the nation is now experiencing an unprecedented fifth consecutive failure (Kimutai et al., 2023). Due to the droughts, water sources have been depleted, which has made it difficult to access clean drinking water and support agriculture. An already struggling population is under even more stress due to this vicious cycle of decreased food production and rising food prices.
Food insecurity in Somalia is heightened by climate-related shocks and poor land management, such as clearing trees for charcoal, a greater reliance on firewood, and unsustainable agricultural practices (Thalheimer et al., 2021). Access to basic resources is a significant concern in many areas of Somalia. Clean water, fertile land, and essential agricultural inputs remain elusive for numerous communities. This shortage is particularly pronounced in rural areas, where most of the population depends on agriculture for sustenance. Additionally, Somalia has grappled with devastating locust swarms that decimated crops, exacerbating food production difficulties for communities (Kassegn & Endris, 2021). The conflict in Ukraine has further exacerbated the food crisis within the country. With over 90 percent of Somalia's grain supply dependent on Ukraine and Russia, the onset of the war led to a significant shortfall in food provisions for Somalia (Dybala & Bezsmertna, 2022; IRC, 2022). An escalation in food price inflation or adverse economic events impacting livelihoods greatly exacerbate food insecurity. Notably, the existing income disparity, especially pronounced in rural areas with a Gini index of 37, implies that certain groups, like agropastoralists and nomads, are disproportionately affected due to their higher vulnerability to droughts, income shocks, and global fluctuations in food prices (World Bank, 2019).
The progress in establishing irrigation and drainage systems is notably deficient in Somalia, and there is a lack of a structured approach to water allocation and management. According to the World Bank's assessment, merely 31 percent of the rural populace have convenient access to a road that remains usable throughout the year within a 2-kilometre radius of their residence (SuM4All, 2017). This affects food movement from surplus to deficit regions, exacerbating localised food shortages. Corruption, weak governance structures, and the lack of effective institutions all contribute to the persistent nature of this challenge (Thalheimer et al., 2021). The absence of robust governance mechanisms hampers developing and implementing policies that could address the root causes of food insecurity . Poverty and unemployment are pervasive issues that further compound the food insecurity crisis in Somalia (Osman & Abebe, 2023). High levels of poverty and rampant unemployment leave a significant portion of the population struggling to access or afford an adequate and nutritious diet. This precarious economic situation further perpetuates the cycle, leaving communities caught in a cycle of deprivation. Access to education and healthcare remain elusive for many in Somalia, perpetuating the vicious cycle of poverty and food insecurity (Faleye et al., 2023). Gender disparities in agriculture hinder women's productivity, exacerbating Somalia's food insecurity, as they face limited access to crucial resources, technical training, and employment opportunities, compounded by low literacy and education levels (Dean et al., 2020).
Food insecurity has devastating health outcomes among Somali populations. Nearly half of Somalia's population under the age of five, or over 1.4 million children, are estimated by UNICEF to be at risk of acute malnutrition due to the ongoing drought (UNICEF, 2022). According to a UNICEF report from June, 386,000 kids between the ages of six and 59 months who had severe acute malnutrition required treatment (UNICEF, 2022). This puts a heavy toll on the health of its population, resulting in a host of detrimental outcomes that reverberate across generations. The insidious impact of malnutrition is most striking in the young, where it leads to stunted growth, a cruel manifestation of the body's struggle to thrive amidst scarcity. The toll it takes on children's physical development and long-term health prospects is profound, perpetuating a cycle of intergenerational deprivation (Siddiqui et al., 2020). Inadequate nutrition damages the body's natural defence mechanisms, weakening the immune system. Respiratory infections, diarrhoea, and other illnesses find fertile ground in bodies deprived of essential nutrients. Tragically, one of the most heartbreaking outcomes of food insecurity in Somalia is the elevated rates of child mortality (Turyare et al., 2021).
Maternal health also bears the brunt of this crisis. Pregnant and lactating women, already facing the immense physiological demands of motherhood, find themselves navigating treacherous terrain. Food insecurity heightens the risks of complications during pregnancy and childbirth, casting a dark shadow over what should be a time of hope and anticipation (Areba et al., 2022). More than 380,000 of Somalia's 2 million women of childbearing age need life-saving sexual and reproductive health (SRH) services and information, and more than 2 million women overall have been affected (UNFPA Somalia, 2022). Beyond the physical toll, the mental health effects of food insecurity are profound and far-reaching. The constant gnawing worry about where the next meal will come from takes a heavy toll on individuals and families, leading to increased stress, anxiety, and depression (Ae-Ngibise et al., 2021). Persistent food insecurity has severe implications for individuals' long-term health. Under such circumstances, people often turn to calorie-dense yet nutritionally poor diets out of necessity. This dietary pattern sets the stage for chronic health conditions like diabetes, heart disease, and hypertension to develop.
The third action area of the Ottawa Charter for Health Promotion, established by the World Health Organization in 1986, emphasises the enhancement of community initiatives and efforts in promoting health and well-being (WHO, 1986; Tarkang, 2020). This involves empowering communities to take an active role in addressing their own health needs and challenges. In the challenging context of Somalia, where food insecurity and malnutrition persist as pressing issues, the Ottawa Charter's Action Area Three, 'strengthening community actions,' becomes a critical framework for intervention. As a nurse working under the umbrella of the United Nations, my role is to provide direct healthcare and facilitate sustainable change in the community. Nurses can benefit from the Community Engagement and Accountability (CEA) Strategy and Action Plan in many ways. When vulnerable populations face serious health issues, it enables nurses to play a critical role in changing how healthcare is delivered (UN Somalia, 2022). Nurses can support more efficient and person-centred care by actively engaging with communities and ensuring their voices are heard. (Flaubert et al., 2021). In addition, nurses can utilise the CEA strategy's collaborative nature to collaborate closely with other healthcare organisations, and partners, ultimately improving their capacity to save and safeguard lives. This strategy supports empowering communities and promoting health and well-being, a cornerstone of nursing practice.
To do this, it would be necessary to identify key players in the community, such as elected officials, community-based organisations, women's groups, religious leaders, and other influential individuals. A collaborative environment where all voices are heard and valued requires the development of relationships with these stakeholders (Canfield et al., 2022). Participating in decision-making with stakeholders is essential to empowering them. This could be regular community gatherings, workshops, or focus groups. It is essential to involve stakeholders in the decision-making process. This entails making certain that the opinions of these community influencers and leaders are not only heard but also actively incorporated into the plans and programmes designed to increase food security. Nurses can benefit from their invaluable perspectives and local expertise by involving them in the planning and implementing of initiatives. These factors are crucial for adjusting interventions to the unique needs and dynamics of the community. The nurse would facilitate open discussions during these sessions, ensuring that community members were active participants in identifying difficulties, suggesting solutions, and establishing priorities regarding food security (Haldane et al., 2019). This collaborative approach encourages a sense of agency in bringing about change by empowering people to take ownership of the problem. For example, The Mama Amaan program, supported by a UW Population Health Initiative grant, addresses the critical aspects of pregnancy, childbirth, and postpartum well-being and indirectly contributes to food security within the East African immigrant and refugee communities (Callister, 2021). By providing education and support to women in South Seattle and South King County, the program helps empower mothers with the knowledge and resources needed for healthy pregnancies and early motherhood (Callister, 2021) . This, in turn, can positively impact food security within households, as mothers equipped with the correct information are better positioned to make informed decisions about nutrition and food access for themselves and their families.
Furthermore, the nurse would work towards enhancing the capacity of community members through education and skill-building initiatives. This could encompass nutrition workshops, agricultural training, and workshops on sustainable farming practices. By equipping individuals with the knowledge and skills needed to improve food production and consumption, the community becomes better prepared to address food insecurity independently. In addition to local stakeholders, engaging with governmental and non-governmental organisations is crucial. The nurse would liaise between these entities, facilitating communication and collaboration. This could involve advocating for policies that support food security, mobilising resources, and coordinating efforts to ensure a comprehensive approach to the issue (Kruk et al., 2019). Empowering women within the community is of particular significance. Women often play central roles in food production, preparation, and distribution. By providing them with resources, education, and support, the nurse helps to strengthen their capacity to contribute to household and community food security. The nurse would also support establishing community-based initiatives like community gardens, cooperatives, and local food banks. These projects provide immediate relief and promote sustainability by fostering a sense of collective responsibility and self-reliance. The nutrition nurse from the Save the Children program in Somalia plays a crucial role in conducting methodical nutrition assessments for children under five admitted to the Stabilization Centre (Kalid et al., 2019). They guarantee the prompt preparation and administration of the correct therapeutic feeds and medications for malnourished children in the centre. Additionally, they conduct routine checks on the nutritional status of severely malnourished children, adhering to established protocols. The nurse also offers tailored nutrition advice and imparts health-related knowledge to mothers and caregivers in the centre, following established guidelines and protocols.
Regularly monitoring and evaluating interventions are crucial to assessing the effectiveness of the strategies. In May 2022, the WFP (World Food Programme) provided crucial relief assistance to 2.3 million individuals. Pending necessary resources, they strive to expand this life-saving food and nutrition aid to cover 4.1 million people by June 2022 (WFP, 2023). Nurses can play a vital role in supporting this effort by actively participating in health assessments, mainly focusing on nutritional status and monitoring the status of those affected by food insecurity. The nurse would work with the community to track progress, identify areas for improvement, and adapt interventions as needed (Ziervogel et al., 2021). This feedback loop ensures that interventions remain responsive to the evolving needs and dynamics within the community. Ultimately, the community nurse's mission is to promote a sense of community resilience and collective agency. The nurse supports a sustainable and community-driven approach to addressing food insecurity in Somalia by empowering stakeholders, developing capacity, and fostering collaboration. This strategy aligns with the Ottawa Charter's focus on bolstering community initiatives to promote health and well-being.
Thus, Somalia's food insecurity is a complicated crisis caused by environmental, economic, political, and social problems. This crisis has affected millions of lives and has persisted due to conflict, droughts, poor infrastructure, and governance problems. Action Area, Three of the Ottawa Charter provides an essential framework for intervention. Nurses can empower communities as essential change agents by engaging, educating, and working with stakeholders. In line with the Charter's goal of promoting health and well-being through community-driven initiatives, nurses play a crucial role in fostering sustainable solutions to reduce food insecurity in Somalia by addressing the underlying problems and promoting resilience.Â
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