Mogadishu, the capital city of Somalia, offers both opportunities and challenges for private investors who want to run health facilities. The need and demand for high quality services is certainly there. The challenge is to navigate through the numerous hurdles, including lack of trained manpower.
Dr Mohamed Bodaye, the general Manager, Blue Star Hospital, sees the numerous opportunities, but he has also experienced the perils of operating a medical facility in the city. Badaye opened his centre towards the end of 2014, after Four years of research and planning. The facility is now fully equipped with an oncology department. It has a laboratory, a mammogram, a CT scan and a well stocked pharmacy. However, the beginning was not that easy. “Lack of qualified and technical staff was a big problem, and is still a big problem,” the medic stresses. For instance, he bought some of his equipment from Pakistan and had to get an engineer from the country to set them up.
One week after the engineer had left, a machine developed a problem and they had to wait for the same engineer from Pakistan to come and fix it. They were to realise it was a simple and minor issue. In the process of this interview, a young man walks into Dr Bodaye’s office and introduces himself as the new engineer. He has just arrived straight from the airport.
To address the challenge of lack of qualified staff, Dr Bodaye says that his facility will be a teaching hospital, and has already signed a memorandum of understanding with a local university to support training of medical students. In nearly all of the hospitals, you will find doctors, nurses and pharmacists, from countries such as South Africa, Sudan, Egypt, Kenya, Turkey and Pakistan.
Homegrown medics and investment by the government are therefore in great need, especially if the country is to build a sustainable health care system. Mohammed Daud, the managing director of Kalkal Hospital, concurs that the operating environment is not very conducive, including lack of policy guidelines and supervision by the Ministry of Health. Kalkal Hospital was opened in late 2014.
It specialises in reproductive health and dental care, and provides both secondary and primary health care. “There has not been any support or supervision from the Ministry of Health. This has been the biggest challenge, says Daud. Although the ministry responsible for regulations is in existence, it is not fully functional and lacks the capacity to provide proper regulation and supervision of the country’s private health care facilities. “It provides operational licenses, but that is as far as it goes,” says Daud. Most of the hospitals, therefore, have to self-regulate. They have put in place measures to ensure that they are in line with the World Health Organisation guidelines on standards and quality of health services they provide. For instance, Daud says they have an infection control team at the hospital, and that it meets every week.
There is also a waste management division, which is key to every hospital. Additionally, he says, the private health players have formed an association to help in self-regulation and create standards for health care in the country. “We try to improve every day, and now there is some information sharing with the other private hospitals,” Daud explains. As part of a solution to quality issues, some of the hospitals have decided to partner with more advanced hospitals in the region. Dr Bodaye says his hospital, for example, has established links with Aga Khan Hospital in Nairobi for quality control and other services provision, including analysing complex laboratory results.
However, Dr Mahad Hassan, the owner of Benadir Hospital and member of the Somali Medical Association, which has 223 professional members, says that very soon, the quality of medical facilities will get even better with the investment in sophisticated equipment and improved services. He further sees the need for investors to open up facilities in other parts of the country instead of concentrating in Mogadishu, in order to create accessibility. “Health service should not just be for the elite. We need to consider other people outside Mogadishu,” he says.