Doctors Without Borders

Somalia and Ethiopia’s Somali region are on the front line of the climate crisis. After four consecutive failed rainy seasons, Somalia’s federal government declared a national drought emergency in November 2025. 

More than 6.5 million people, approximately 1 in every 4 Somalis, now face high levels of acute food insecurity, according to the widely used Integrated Food Security Phase Classification (IPC). More than 2 million people are in IPC Phase 4, indicating extreme food gaps and a high risk of malnutrition and death.

Over 1.8 million children under 5 in the country are expected to suffer acute malnutrition in 2026.

Doctors Without Borders/Médecins Sans Frontières (MSF) in Somalia is responding to this escalating humanitarian and climate crisis, yet needs far exceed available resources. 

A growing water crisis

“We were displaced because of the drought,” says Regay Ali, a displaced person who left her home in Weelbelil, around 100 miles from Baidoa in southwestern Somalia. She borrowed money from neighbors to reach a displacement camp in town. “We do get water, but it’s not enough: two jerrycans — per day — for washing, bathing, cooking and drinking. Even five would not be enough. Hunger is weighing heavily on us. We were displaced because of hunger, and where we are now, we still don’t have enough.”

Approximately 3.3 million people like Regay are internally displaced across Somalia, driven by drought and conflict, and more than 50,000 have crossed into Ethiopia in search of water and assistance according to the UN Refugee Agency. 

Displacement sites around Baidoa and Galkayo are filling rapidly, and water prices have risen beyond what most families can afford. The risk of waterborne diseases is also rising due to high numbers of people using the same limited — and at times unsafe — water sources. According to the United Nations Office for the Coordination of Humanitarian Affairs (OCHA), in Puntland, where Galkayo is located, approximately 170 boreholes and shallow wells were non-functional as of December 2025, severely limiting access to safe water for communities already under extreme pressure.

MSF’s facility in Baidoa is overwhelmed and treating patients beyond its capacity, as we are already recording an alarming number of severely malnourished children. This sharp rise at the very start of the lean season signals a worsening situation in the months to come.

The water crisis is spreading across the border

The consequences of failed rainfalls go beyond Somalia’s borders. In the south of Ethiopia’s Somali region, particularly dry lowlands near the Somali border, such as in Afder and Shebelle zones, insufficient rains have resulted in livestock losses, acute water shortages, and rising food insecurity. Pastoralist communities have lost their livelihoods, and competition over scarce water resources is increasing.

“Most people in this community were rearing livestock — that was how we survived,” says Isaq Ibrahim Mohamed, a resident of Barey District in Afder Zone. “When the rain stopped, we lost our livestock, and people fled to wherever they could find water to survive. Our lives are so harsh because there is nothing to depend on. People walk an hour or more just to fetch water from rivers, and we share it with the animals. We see diarrhea and malnutrition.”

During an assessment led by Ethiopia’s Somali Region Health Bureau in collaboration with MSF in both Afder and Shebelle zones, our teams identified urgent gaps in water and nutrition services, as local health capacity is overstretched.

Global funding collapses amid rising needs and the Middle East crisis 

This situation is aggravated as more medical and humanitarian organizations withdraw due to funding shortages, while rising fuel prices linked to the escalation of conflict in the Middle East and limited supply chain movement further constrain the response.

“From the areas we assessed with the regional health bureau, we saw a high number of malnutrition admissions in the existing facilities,” says Abdullahi Mohammad Abdi, deputy medical team leader at MSF Ethiopia. “What we are seeing on the ground is a reduction of the services that patients previously received, as partners scale back due to global funding cuts and shortages. This has created a heavy burden on the existing system. Water and sanitation programs are the ones most affected.” MSF is collaborating with local health authorities on nutrition and wash activities in Barey district, Afder Zone, and planning to expand support for Shebelle Zone.

In Somalia, MSF has been responding to the drought emergency since December 2025. In Baidoa, more than 7.9 million gallons of safe water have been distributed to over 21,000 people across 17 displacement sites. In Mudug, MSF is providing almost 800,000 gallons of drinking water, and sanitation and hygiene support to nearly 11,000 people near Galkayo, including borehole rehabilitation and the distribution of hygiene kits.

But just as the needs are increasing, global funding support has collapsed. Somalia’s Humanitarian Needs and Response Plan for 2026 is funded at only 10.9 percent according to OCHA. The World Food Program has cut emergency food assistance for over 2 million people to just over 600,000, so only 1 in 7 Somalis who need food assistance is now receiving it. More than 300,000 people have also lost access to safe water as a direct result of this underfunding, and over 70 health facilities in Puntland have closed.

Read more: Drought and displacement affect millions in Somalia and Ethiopia

Source: Doctors Without Borders