Puntlanders routinely travel outside their own State—to Mogadishu and Hargeisa—for medical treatment. Why?
The answer is uncomfortable but cannot be ignored: a deep crisis of trust in the public health system.
At the heart of this crisis are persistent allegations of corruption, weak oversight, and systemic mismanagement within the health sector. Reports—circulating for years among patients, practitioners, and local observers—point to the diversion of donated medicines, misuse of public resources, and the growth of private interests linked to individuals within the system. While not every claim is formally documented or prosecuted, the consistency of these complaints has eroded public confidence.
This pattern is not unique to Puntland. Across Somalia, weak institutional controls have historically enabled leakages in aid delivery. During the aftermath of the Ogaden War, for example, there were widely reported cases of relief supplies being diverted into black markets. Today’s concerns echo that legacy—though the contexts differ.
The consequences are visible:
Public hospitals struggle with shortages of essential medicines and equipment.
Patients are often advised—informally—to seek treatment elsewhere.
Those who can afford it travel; those who cannot are left with limited options.
It is important to be clear: Puntland does not lack trained health professionals. On the contrary, there is a growing pool of qualified doctors and nurses. The issue is less about human capital and more about governance—how resources are managed, monitored, and protected from abuse.
Claims that public institutions have enabled the enrichment of individuals—particularly within key ministries—are serious. However, such assertions require careful verification and should be backed by audits, investigations, or documented evidence. What is beyond dispute, however, is the perception among citizens that accountability is weak and enforcement mechanisms are ineffective. Perception, in governance, often shapes reality.
The result is a two-tier system:
A fragile public sector struggling to deliver basic services
A parallel, often unregulated, private sector that fills the gap—at a cost
This dynamic pushes patients toward external options, including hospitals in Mogadishu and Hargeisa, where services are perceived—rightly or wrongly—to be more reliable.
A Test for Reform
The administration of Said Abdullahi Deni (and any successor government) faces a structural challenge: restoring credibility in the health system.
This requires no more rhetoric. It demands:
Independent audits of health sector funding and procurement
Transparent supply chains for medicines and equipment
Enforcement of anti-corruption measures within public hospitals
Protection for whistleblowers and frontline staff
Investment in a small number of well-equipped, fully functional referral hospitals
Without these steps, the outward flow of patients—and trust—will continue.
Postscript
Reports from facilities in Qardho, Galkayo, and Garowe have repeatedly highlighted concerns about missing medicines and equipment, as well as weak accountability mechanisms. These claims warrant formal investigation. Where wrongdoing is proven, consequences must follow—not as an exception, but as a norm.
Feature image: Nurses protesting the reinstatement of a disputed official at Qardho General Hospital.
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