I had not enjoyed sleep for a long time, until I was diagnosed and given the free medications available 

Those were the words of Jama aw Dinle, a patient at a TB centre managed by SHiFAT in Somaliland's central Togdheer region.

Situated in one of east Africa’s unwelcoming dry lands,nomads here continue the ancient traditional ways of eking out a living. Nomads follow their herds of camels, goats and sheep to green pastures – often for hundreds of kilometers. However, these dry lands are not as productive as it once was for their forefathers. Somaliland lies in one of the most vulnerable regions in the world due to lack of development and climate change.

TB patients such as Jama aw Dinle speaking to the SHiFAT supervision team, benefits from free medications essential to eliminate the disease from his body.

Serving remote communities 

"The TB centers are situated huge distances from each other, and it take a lot of hard work, grit and determination to make sure all centres operate at optimum level. Most importantly the locals really do appreciate seeing us at work."

To check on progress, a SHiFAT team is led by the TB program manager on supervision visit to all locations, clocking over 2500 KMs, often along pumpy dirt track roads. Mr. aw Dinle's is story however, is no different from many of his peers across all the communities served by the TB program. After decades of not having access to any permanent access to healthcare, it is a welcome change. visiting them all in one go is no menial task by any means.

"The TBMU's are situated huge distances from each other, and it take a lot of hard work, grit and determination to make sure all centres operate at optimum level. Most importantly the locals really do appreciate seeing us at work."- says Mustakim Mohamed, TB program manager.

Improving health worker knowledge and skills

These field visits are incredibly important not just for the communities that benefit from the programme, but also for the health workers embeded in those that look after these patients. 

Emerging from the civil war over 25 years ago, Somaliland's health system, as with other sectors, was in complete ruins. Health professionals fled the country, creating one of the worst ratio disparities in the world of health worker against population served.  Available doctors, nurses and midwives estimated at the ratio of 0.4 per 1,000 population or 4 for a population of 10,000, seven times below the World Health Organisations' recommended ratio of 2.3 doctors, nurses and midwives per 1,000 population or 23 per 10,000 population.

Not do we only deliver supplies of quality drugs and other equipment, but we also make sure that adhere to high standards in screening and processing patients diagnosed with TB. We also listen to challenges they face on the field and provide support to overcome those hurdles" - says TB programme manager Mustakim Mohamed