Since January, Médecins Sans Frontières has screened more than 21,000 children under five in Baidoa, in south-central Somalia. Among the displaced children screened, the organisation found acute malnutrition running at around 50 per cent.

That is one in two.

What a screening figure is, and is not

A figure like this needs handling carefully, and the qualification matters more than the headline. This is not a national rate, and it is not a random population survey. It is the result of screening among displaced people in and around one city, which is exactly the group you would expect to be worst affected. Somalia as a whole is not 50 per cent acutely malnourished.

What the number does tell you is what the situation looks like at the sharp end — among families who have already lost their land, their herds or their homes and moved to a city where they have nothing. Displacement camps are where the worst outcomes concentrate, and screening in them is how agencies find children before they arrive at hospital in a critical state.

The readmission problem

The detail from Baidoa that deserves more attention than it has received is this one: readmissions to MSF-backed programmes are running at over 60 per cent.

Treatment for severe acute malnutrition works. A child on therapeutic food gains weight and is discharged. Readmission means the child came back — recovered, went home to the same conditions, and deteriorated again. MSF’s epidemiologist in Baidoa described mothers as despondent because they can see the cycle coming and can do nothing about it.

A high readmission rate is a measure of something that treatment statistics normally hide. You can report a good recovery rate and a rising caseload at the same time, and both be true, because the same children are being counted more than once. It is also, in resource terms, the most expensive way for a system to fail: paying for the cure repeatedly because nothing addresses the cause.

Why prevention went first

Somalia’s humanitarian response plan was cut by 40 per cent for 2026, and by July it was still less than one-third funded. MSF says the consequence is that it and other organisations are prioritising life-saving work over preventative work.

That choice is defensible on its own terms — nobody argues for letting a critically ill child die in order to fund a supplementary feeding programme. But it produces exactly the pattern Baidoa is showing. Prevention is what stops the readmission; treatment alone cannot. Cutting the cheaper half of a system tends to increase demand for the expensive half, which is an argument made routinely in public health and routinely lost when a budget is being drafted under pressure.

The counter-argument from donor governments is that finite money should go where it saves the most lives immediately, and that prevention spending has a longer and less certain payback. That position is coherent. It is also, on this evidence, producing a cycle nobody chose.

Drought, not war, is moving people

In the first three months of this year, the UN recorded more than half a million Somalis displaced. Nine in ten of those displacements were caused by drought.

That ratio is worth pausing on, because Somalia’s coverage in international media is overwhelmingly about armed conflict. The conflict is real and continues. But the thing currently emptying rural areas and filling Baidoa is water, or the absence of it — a slower story, harder to photograph, and much less likely to lead a bulletin.

Related: One Hospital in Northern Yemen, and a 62 Per Cent Rise.

Sources

Screening figures, readmission rate and funding data from Médecins Sans Frontières, as reported by The New Arab; displacement figures from the United Nations.