Public Health

Public health policies were predominantly preventive in form but did not ignore curative services. The policies addressed the rebuilding and expansion of medical institutions, public hygiene, control of the causes of endemic diseases, eradication of epidemic diseases, and rural health. The first priority of public health policies was the rebuilding of medical infrastructure. By 1943, the reconstruction of the old district hospitals and clinics was complete, and other new institutions were opened: a maternity and child welfare clinic at Burao and a school for civil dressers, sanitary workers, and nurses was at Hargeysa.155 By 1945, hygiene services were in operation in Berbera, Hargeysa, and Burao. Three years later, the construction of new hospitals was begun in Las Anod, Burao, Berbera, Hargeysa. In 1949 new dispensaries were opened at Odweina, Darburuk, Ainabo, Sheikh; and new wards added to the Burao (120 beds), Borama (three new 22-bed wards), and Las Anod (45 beds) hospitals. A venereal disease wing for women was also added to the Ruth Fisher Clinic at Hargeysa in 1949, as well as to the Burao maternity and child welfare clinic. The department also established an ambulance service that picked up sick cases in the interior and brought them to the main hospitals. By 1951, all the main hospitals had experienced surgeons. In addition, a new hospital for T.B. patients was opened at Hargeysa hospital in 1954. And in 1958, tuberculosis wards were added to the Burao, Hargeysa, Berbera, Borama, and Gabileh hospitals. By then dispensaries were also opened at Mandera, Abdulkadir, Gabileh, Las Korey, Zeilah, Hiis, Mait, Hudin, Tugwajalleh, Adadleh. As a result of the expansion of services, medical expenditure–which was financed through Colonial Development and Welfare funds–expanded.

Epidemics And Public Health In Late Colonial SomalilandThe second issue the medical department addressed was public hygiene in the main towns–Berbera, Burao, and Hargeysa–because their built environment and population were expanding. The medical department took an administrative approach to public hygiene. It divided the towns into sectors and detailed town-sweepers and inspectors to each sector with responsibility for its cleanliness. Drums for refuse were placed at street corners, which households and businesses were expected to use, and which the sanitary staff emptied each day into a truck operated by town-sweepers. The sanitary staff also patrolled the town daily and inspected abattoirs, public latrines, rubbish disposal areas and incinerators, restaurants, teashops, bathhouses, and treated wells against malaria. The sanitary staff, in addition, imposed a “dry hour” every Saturday morning on all the towns, which was designed to prevent mosquito breeding. The staff required that each “household place all the dry water-containers lying on their side outside the house. The inspectors then enter the house to ensure that no standing water is concealed.”156 The staff not only enforced public health policies but also “act[ed] as the eyes and ears of the Medical Officer or of D.C. if an M.O. (medical officer) is not yet appointed.”157 This multifaceted system was designed to “bring to light any unsanitary places and defects in the day’s work.”158 The staff, furthermore, built public pit latrines as well as incinerators in the towns. Slaughterhouses were also brought under inspection in order to prevent the “danger of contaminated, disease-ridden meat.”159 The staff feared that the slaughterhouses could become the center of the epidemic disease since “flies swarm over these places settling first on the human feces in the neighborhood and then on the meat.”160 Consequently slaughterhouses and meat markets were brought under the direct supervision of the public health staff. Indeed, in all the main towns, new markets and slaughterhouses were built which were then brought under strict supervision. Though initially unpopular, they were gradually adopted as business centers.


Food hygiene was given even more emphasis in the 1950s, as the number of restaurants and their customers increased, as more and more slaughterhouses were established, and as waste disposal became a problem. The supervision over food hygiene standards in the restaurants, teashops, and slaughterhouses were imposed not only on the main towns, but also on small villages as the resources of the department increased. Very small villages and settlements (on the coast and interior) were gazetted so as to facilitate supervision by the sanitary staff.161 By 1957, pit latrines were built, refuse collection organized, new markets and slaughterhouses established, a permanent sanitary staff hired for each town, water pipes laid (in the main towns), and the food-hygiene standard of coffee houses and restaurants kept under watch. District commissioners cooperated with the medical staff in the improvement of coffee shops and eating-houses. For instance, owners of such businesses were persuaded to “alter them [buildings] to ensure adequate ventilation, to provide reasonable washing up facilities, and furniture, crockery, and cutlery of a decent standard.”162 Those who refused to cooperate were put “under pressure” and threatened with a refusal to “renew the license.” In cases where buildings were found to be below standard, they were either condemned or the license to operate was not renewed.163 By 1958, all the main towns were reorganized into various types of residential, commercial, green zones, stock routes, and master maps produced that specified each zone.164

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