As drought victims migrated, they introduced new strains of malaria infections, and at times new species of malaria, into towns and refugee camps. In 1954, for instance, the medical report excitedly noted “the discovery of a species of mosquito not previously recorded in Somaliland.”44 The specimen was discovered at Zeila and at Abdulkadir following the rains in September/October 1954. The species was identified as A. pharoensis. A sample was sent to the entomologist of the East Africa Malaria Research Unit who confirmed the identification.45 The introduction of new species often led to the spread of “seasonal epidemics,”46 particularly in towns along the border such as Borama, which had “an annual epidemic of greater or less extent.”47
The 1956-1957 malaria epidemic also followed the 1956 drought, which lasted from January to October. One month after the rains began in early October, an epidemic broke out throughout the country. In the Erigavo district, where the epidemic was most severe, 1,402 cases were reported. The medical department controlled the disease through a vigorous spraying campaign in, for instance, El-Afweyn, Garadag, Huberra, Badhan, and many other villages in the Erigavo district, as well as other districts.48 In 1957, another malaria epidemic swept the country, following the 1957 drought. The “greatest number of malaria (cases) occurred in the Southeast of the Protectorate.”49 Despite the high incidence of malaria throughout the country, neither the morbidity nor the mortality rates were as high as 1951–“a season of good rains following a famine.”50 The 1957 report maintained that the difference was that the control measures against the vector of the disease from 1951 to 1957, resulted in the “reduction of adult anophelines that their transport to, and re-establishment in, the casual breeding places in the southern grazing areas is hampered and delayed.”51 In reality, the difference lay in the severity of the droughts in 1950 and 1956-57, and the migration patterns of drought victims. The 1956-57 drought was not as severe as the 1950-51 drought, and so the people neither migrated in massive numbers nor severely weakened by hunger. Overall, 1,836 cases were treated in hospitals. Yet another mild epidemic broke out in the country in early 1958, in which the morbidity cases reported were 1,326.52 In general, droughts and migration across borders were a central factor in malaria epidemics.53 And the severity of the epidemic almost always depended on the severity of the drought, and the number of migrants.
The migration patterns of the population also played a key role in the spread of influenza, pneumonia, measles, and meningitis. Meningitis is a “highly seasonal disease” that spreads during cool dry seasons when overcrowding takes place, and people huddle together in small areas.54 It comes to an end once the rains fall. During the 1947-48 meningitis epidemic, for instance, a “large proportion of deaths was in the Midgan area of Burao township,”55 an overcrowded sector. One hundred eighteen cases were admitted to hospitals “with total case mortality of 10 percent.”56 Measles, however, was more prevalent than meningitis and broke out in epidemic form in 1954, 1955, 1956, 1957 and 1958. Measles, like meningitis, had a “winter-spring seasonality,” and had always been the “indirect effect of climate on socioeconomic conditions and population movements.”57 The 1954 medical report stated that “Measles is normally sporadic in incidence in this country with epidemics at intervals of two to three years.”58 The 1954 epidemic “was quite considerable,”59 as it was “country-wide and affected . . . young adults as well as children.”60 Among infants, broncho-pneumonia complicated measles infection. Overall, 712 cases were treated. In this epidemic “as in other (epidemic) diseases, the cases seen at hospitals represent only a fraction of the incidence and indeed it is probable that, at least so far as infants and young children were concerned, only the more seriously ill cases, with complications, were brought to the hospital.” 61
Another measles epidemic broke out in the country from January to April 1955. The epidemic affected both the Las Anod and Erigavo districts in the dry season, a vulnerable period for pastoralists: it is time “when families come to the permanent water for the small stock. It is also when they live in very close proximity and isolation is impossible to enforce.”62 The epidemic spread to Hargeysa in May and from there to Berbera in October. The infection was “probably the result of a fair number of families moving from Hargeysa to the coast in September-October, a normal movement of population, and carrying the infection with them.”63 About 845 infected cases were treated in the Hargeysa hospital.64 The disease continued to appear throughout the country in sporadic form and was a “frequent cause of broncho-pneumonia.”65 But the death rate was very low indeed. The 1956 epidemic, for instance, was a “small epidemic” that spread throughout the country, but which caused only three reported deaths (complicated by pneumonia). Its victims were “the children in the Famine Camp in May” but not “to a great proportion.”66 The total cases treated in the hospitals were 875.67 In 1957, the incidence of the disease declined slightly. Only 108 cases were reported. In 1958, it re-emerged in epidemic form in Borama where 720 cases were treated in the hospital.68 It was a “minor epidemic” that raged in the spring in Borama and Hargeysa and towards the end of the year in Burao. It spread as “a result of the overcrowding that results from the seasonal move to the towns.”69 It essentially consisted of “two minor epidemics.” The first one took place in the spring in Borama, when people moved from the Guban to the Borama area. In the spring the Guban is too hot, and people migrate southwards. The second one took place in the last two months of the year in Burao and Hargeysa, when people moved back from the Haud and the southern grazing areas as a result of water shortages. The 1958 medical department report maintained that “it is probable that the disease is smoldering in the interior,” follows people’s migratory routes, and reaches epidemic level in overcrowded conditions.70
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