Endemic Diseases

Meanwhile, diseases such as tuberculosis, gonorrhea, and syphilis became endemic in the towns. The urban history of Somaliland is still undeveloped: there are few studies on post-colonial97 and pre-colonial98 towns, but no studies on colonial towns. There is no space to discuss the issue in detail here. Suffice it to say that all the modern interior towns (not the coastal towns) of Somaliland were colonial towns. (Coastal towns such as Berbera, Xiis, Bulhar, and Zeila had ancient origins.) The modern interior towns were of recent origin, and their population was made up of recent migrants from the interior.99 In 1921, for instance, the built environment of Hargyesa consisted of one stone building, a small number of huts, and few administrative buildings.100 By 1945, Hargeysa had 255 stone buildings, and a few hundred huts,101 and by 1956, the town had over 7,020 registered stone buildings and a substantial number of huts.102 As the built environment of the town expanded so did its population. In 1921, its population consisted of a few hundred people, by 1946 its population reached over 40,000 and continued to expand.103 By 1959, “perhaps 10 percent of the population in recent years have become fairly permanent town-dwellers, developing many of the varied characteristics of townsmen.”104

Like all colonial cities, the built environment of modern towns in Somaliland was hierarchical and uneven. Fanon famously characterized the colonial town as a place of “reciprocal exclusivity”105 that consists of “two zones”: European space–a “brightly lit town,” and “native” space–a hungry town, “a place of ill fame.” “Native” spaces in colonial towns were not, however, homogenous. Rather, they were broken up into two different spaces, even if they were not reciprocally exclusive: the sector of the well-off Somalis, and the space of the poor migrants. The 1949 colonial report distinguished between the sector of the “modern permanent houses,” which are the “property of the wealthier Somalis,”106 and the sector of the “lower class” whose “housing standards are . . . universally poor.”107 The “lower class” lived in movable huts–“Aqal”–constructed of “wooden struts over which are thrown mats made locally from grasses and fibers of bark.”108 When the “Aqal” is used “under nomadic conditions (it is) comparatively clean and healthy, but when used as permanent and static dwellings on the outskirts of towns, slum conditions are quickly created.”109 In 1946, 32,000 of the 40,000 inhabitants of Hargeysa lived in the slums. The three spaces in the colonial towns were distinguished by architecture. The European space was marked by the bungalow110; the space of the “wealthier Somalis” by modern permanent stone buildings; and the space of the lower class by the “Aqal.”

In 1945, a committee of inquiry investigated the causes of poverty in the countryside and the towns. The “main recurrent cause of poverty in the interior is drought.” After a drought rural paupers, particularly the young, migrate to the towns in search of employment and better life.111 The paupers were attracted to the towns because of the increase in employment opportunities created by the government and private investment. In Berbera, “there has clearly been some increase” of the juvenile population “owing to additional chances of employment and pilfering.” And in Hargeysa, a “very considerable floating population” has been attracted to the town because “the largest circulation of money in the country may be found in Hargyesa and the greatest employment opportunity.”112 Although the economy of the main towns expanded during the war and the post-war period the available opportunities were not large enough to satisfy the hunger for the employment of the migrants. As a result, myriad social and medical problems emerged: “young men drift into crime and vagabondage and young women into prostitution.”113 In addition, since they could not afford to rent permanent stone houses, they congregated in the slums, which quickly created “insanitary conditions.”114 “Urbanised communities,” particularly low-income communities, as one report put it, were “subject to bad housing conditions, constant under-nourishment, poor sanitation and the risk of communicable diseases [such as] venereal diseases, tuberculosis and other respiratory complaints, tropical ulcer, conjunctivitis.”115 The 1951 medical report stated, for instance, that tuberculosis is becoming increasingly “endemic in the towns of Somaliland” but still “rare in the interior.” Because they had no immunity to the disease, new migrants were “exposed to special risk.”116


The rise in the incidence of tuberculosis, according to T. F. Anderson’s report, “The Medical History of Somaliland, 1939-1944,” was caused by “grossly overcrowded” living quarters in the slums and malnutrition.117 The 1956 report pointed to the “ample evidence that poor ventilation, bad lighting, and overcrowding in unhygienic huts contribute[d] to the spread of the respiratory type of tuberculosis.” “In theory,” the report added, “it should be easy to check. In practice, however, economics . . . present[s] a formidable barrier to desirable changes.”118 The economic problems of the urban poor in, for instance, the towns of the Makhir coast–Heis, and Mait–were manifested through “oedema, with transient cardiac murmurs in some cases. It was not a true Beri-Beri but appeared to be definitely a deficiency disease. It was rather prevalent in children than adults.”119 A “similar outbreak occurred in Berbera in the period May/July among the poorer section of the population of the town who were existing on very small quantities of parboiled rice with few extras.”120 The syndrome was also prevalent among the poor classes of Hargeysa as well as other towns. “The condition,” the report stated, “appears to be nutritional in origin.”121 The nutritional deficiency of the urban poor was further exacerbated by poor housing, which created the condition for the spread of infectious respiratory diseases. The 1951 report stated that the “vast majority of townspeople live in “gurgis,” round huts covered with matting.”122 There was housing available, but the poor could not “afford the rent of Sh. 30.00 per month or more, normally paid for the most inadequate stone or brick living place.”123 Income has always been the key determinant in the incidence of the disease: “when social conditions deteriorate,” William Johnson argued, “the incidence of tuberculosis rises quickly.”124

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