Community-based

Animal Health Care

in Somali Areas of
Africa: A Review

Prepared for

The Participatory Community-

based Vaccination and Animal
Health Project (PARC-VAC)
of the

Organization of African Unity/

Interafrican Bureau for Animal
Resources (OAU/IBAR)

Andy Catley
1999

vetwork uk
Executive Summary

This review is based on the question AAre community-based animal health systems a realistic option
for improving primary veterinary services in Somalia?@ This question has arisen due to positive
experiences with community-based animal health in remote, pastoral areas of eastern Africa. Lessons
from southern Sudan indicate that well-coordinated, large-scale community animal health worker
(CAHW) systems can form the basis for improved service delivery in conflict zones. On a smaller
scale, reviews of CAHW projects in dryland areas of Kenya demonstrate substantial cost-benefit
through the prevention or treatment of a few important livestock diseases. In some areas, such as the
Afar region of Ethiopia, CAHWs have played an essential role in rinderpest eradication. To varying
degrees, these areas were characterised by limited government veterinary services, civil disorder and
logistical problems related to large systems boundaries and poor infrastructure. These constraints are
also highly relevant to the current situation in Somalia/Somaliland.

This review collated a number of experiences related to CAHW systems in Somali areas which
indicated that community-based approaches are an appropriate way of improving basic veterinary
services for pastoral communities. These experiences show that:

C within Somali pastoral communities generally, there is a high demand for animal health
services. These communities are characterised by well developed indigenous institutions and
livestock knowledge, very strong traditional social support mechanisms and willingness to
pay for private services.

C the Somali pastoral economy is closely linked to an active livestock export trade and the
market orientation of livestock production systems is increasing.

C there are many useful lessons arising from projects such as,
- the Nomadic Animal Health Auxiliaries (NAHAs) in the GTZ Central Rangelands
Project in Somalia up to 1988;
- the ongoing CAHW system supported by ActionAid-Somaliland in Sanaag region,
northern Somalia/Somaliland which has been self-sustaining since 1994;
- positive reviews of Oxfam UK/Ireland=s CAHW project with Somali communities in
northern Kenya;
- large-scale, integrated and community-based rural development programmes in the
Somali region of Ethiopia which have been developing CAHW systems and
restocking activities since 1994. CAHWs are accepted and promoted by Somali
veterinarians, both government and private.

In summary, CAHW systems appear to be highly relevant to Somalia/Somaliland. Private veterinary

activities are already self-sustaining in urban centres and ports, and there are opportunities to work
with the private sector to expand basic services into pastoral areas. Such initiatives might build on
both the previous veterinary privatisation programme supported by the European Union and the
experience of PARC-VAC in community-based animal health systems. Lessons learned from CAHW
projects in other areas indicate that in the absence of official regulation, ineffective or dishonest
CAHWs are not tolerated by the communities who select them and pay their incentives. Somali
herders want good quality medicines for their animals, they want to know how to use the medicines
properly and they pay for services which they consider to be valuable. These conditions very much
favour the establishment of small-scale, pilot CAHW systems by PARC-VAC in Somalia in order to
test ways of working with local partners.
Some specific recommendations are as follows:

C Identification of local partners. The most useful local partners for the implementation of
CAHW systems in Somalia are probably private veterinarians and associated traders who
have already taken the initiative to establish associations, pharmacies or clinics, and who
might view CAHWs as a mechanism for expanding their businesses into pastoral areas.
Indigenous or international NGOs with long-term experience of working in Somali areas and
institutional commitment to participatory, community-based approaches should also be
considered as implementing partners.

C Inclusion of key stakeholders. In addition to working with livestock keepers and

veterinarians, PARC-VAC will also need to ensure that stakeholders such as influential
Somali traders, elders and military leaders are consulted. In some cases, a business person
who is already supplying drugs to veterinarians might be willing to invest in CAHW systems
if PARC-VAC can provide technical support. Stakeholder analysis might be usefully applied
in Somalia.

C Experience of Somali veterinarians in private and community-based animal health systems.

There are probably few Somali veterinarians who have experience in community-based
approaches and those that do possess relevant skills are likely to be employed by NGOs
already. Therefore, PARC-VAC will need to invest in training in participatory methods and
on-the-job support to professionals working in the field.

C Sharing resource inputs. As a general rule, PARC-VAC should limit it's inputs to training,
technical advice, monitoring, coordination, and possibly vaccine supply. Material inputs for
clinical animal health services such as equipment and drugs should be avoided as ideally,
these should be provided by Somali veterinarians and traders in partnership with community-
level forums.

C Roles of CAHWs in vaccination. Given the successful use of CAHWs in rinderpest control in
other areas, particularly southern Sudan, there seems to be no reason why Somali CAHWs
could not handle heat-stable rinderpest vaccine under similar arrangements to those used in
other countries.

C Scope of operations and time scales. It is notable that many of the positive experiences of
CAHW systems outlined in this review are all associated with NGOs who have long-term
experience of participatory development in Somali areas. In view of PARC-VAC's limited
experience in Somalia, a small-scale pilot approach over a 3 year period is probably
appropriate.

C A role for ‘government’ in Somalia/Somaliland. Ideally, CAHW systems should be linked to

official veterinary services for certification, quality control and disease surveillance. In a
climate of veterinary service reform in the Horn of Africa, PARC-VAC will need to consider
how future public sector services in Somalia/Somaliland might develop and the roles which
they might usefully fulfil. In this respect, the trend towards a regulatory, epidemiology and
epidemic disease control function that is evident in other countries should be promoted in
Somalia/Somaliland.

Rather than regarding the absence of government as a threat to the delivery of basic clinical animal
health services in Somalia, the presence of an established private sector should be seen as an
opportunity for developing better services in more remote areas. Ultimately, pastoralists will decide
whether these services have value and should be sustained.
CONTENTS

1. INTRODUCTION ........................................................................................................................................ 1

2. THE SOMALI CONTEXT .......................................................................................................................... 2

2.1 NOTES ON SOMALI PASTORALISM ............................................................................................................ 3
2.1.1 Livestock trade and changes to traditional pastoral systems.......................................................... 6
2.1.2 Overseas remittances...................................................................................................................... 7
2.1.3 Access to information...................................................................................................................... 7
2.2 SOCIAL ORGANISATION............................................................................................................................ 7
2.3 CONFLICT AND POLITICAL GROUPS ........................................................................................................ 11
3. COMMUNITY-BASED DEVELOPMENT IN SOMALI AREAS ........................................................ 12
3.1 INDIGENOUS SERVICES AND SOCIAL SUPPORT SYSTEMS USED BY SOMALI ............................................ 14
PASTORALISTS....................................................................................................................................... 14
3.1.1 Koranic schooling......................................................................................................................... 14
3.1.2 Traditional medicine..................................................................................................................... 15
3.1.3 Traditional restocking................................................................................................................... 15
3.2 USE OF COMMUNITY PARTICIPATION BY DEVELOPMENT AGENCIES IN SOMALI AREAS ........................... 16
3.2.1 Support to traditional restocking in the Somali National Regional State (SNRS), Ethiopia ......... 16
3.2.2 Lessons from primary human health services ............................................................................... 18
4. AN OVERVIEW OF VETERINARY SERVICES IN SOMALI AREAS ............................................. 19
4.1 TRADITIONAL VETERINARY PRACTICE ................................................................................................... 19
4.2 MODERN VETERINARY SERVICES IN SOMALI AREAS .............................................................................. 20
4.2.1 Somalia/Somaliland ...................................................................................................................... 20
4.2.2 South East Ethiopia....................................................................................................................... 22
4.2.3 North East Kenya.......................................................................................................................... 24
5. PRIMARY ANIMAL HEALTH SERVICES IN SOMALI AREAS: EXPERIENCES WITH
COMMUNITY-BASED SYSTEMS.......................................................................................................... 24
5.1 THE NOMADIC ANIMAL HEALTH AUXILIARY (NAHA) SYSTEM, CENTRAL RANGELANDS, SOMALIA ... 25
5.1.1 Entry points and selection of NAHAs............................................................................................ 27
5.1.2 Training ........................................................................................................................................ 27
5.1.3 Drug supply system....................................................................................................................... 27
5.1.4 Monitoring .................................................................................................................................... 27
5.1.5 Evidence of impact and efficiency................................................................................................. 28
5.1.6 Conclusions................................................................................................................................... 28
5.2 THE ACTIONAID-SOMALILAND ANIMAL HEALTH PROGRAMME, SANAAG REGION ............................... 29
5.2.1 Entry points and selection of CAHWs........................................................................................... 30
5.2.2 Programme design........................................................................................................................ 30
5.2.3 Programme review, 1993: discussions with herders and traders ................................................. 31
5.2.4 Support to private veterinary pharmacies..................................................................................... 33
5.2.5 Conclusions................................................................................................................................... 34
5.3 COMMUNITY-BASED ANIMAL HEALTH IN THE SOMALI NATIONAL REGIONAL STATE, ETHIOPIA:
EXPERIENCES OF WORKING WITH GOVERNMENT ..................................................................................... 35
5.3.1 Project overview ........................................................................................................................... 35
5.3.2 The problem of veterinary drug supply and monitoring ............................................................... 38
5.3.3 The use of stakeholder analysis .................................................................................................... 38
5.3.4 Conclusions................................................................................................................................... 41
5.4 THE OXFAM UK/I WAJIR PASTORALIST DEVELOPMENT PROJECT, KENYA: EVIDENCE OF ECONOMIC
IMPACT IN A CAHW SYSTEM .................................................................................................................. 41

6. DISCUSSION.............................................................................................................................................. 42
 6.1 WILLINGNESS AND ABILITY TO PAY ....................................................................................................... 43
6.2 THE BEHAVIOUR OF ANIMAL HEALTH CARE SEEKERS............................................................................. 45
6.3 MISUSE OF DRUGS, QUALITY CONTROL AND COMMUNITY-LEVEL INFLUENCES ...................................... 47
6.4 EXPERIENCE AND ATTITUDES AMONG VETERINARY PERSONNEL ............................................................ 48
6.5 THE BASIC PRIVATISED AND COMMUNITY-BASED SYSTEM ..................................................................... 49
7. RECOMMENDATIONS FOR IMPLEMENTATION OF COMMUNITY-BASED ANIMAL
HEALTH SYSTEMS IN SOMALIA ........................................................................................................ 50

REFERENCES ................................................................................................................................................... 53

Abbreviations

AHP ActionAid-Somaliland Animal Health Programme

CAHW community-based animal health worker
CHW community health worker
CBPP contagious bovine pleuropneumonia
CCPP contagious caprine pleuropneumonia
CRDP Central Rangelands Development Project, Somalia
EU European Union
FAO Food and Agriculture Organisation
GTZ Deutsche Gesellschaft für Technische Zusammenarbeit
ICRC International Committee for the Red Cross
NAHA nomadic animal health auxiliary
NGO non governmental organisation
OAU/IBAR Organisation of African Unity/Interafrican Bureau for Animal Resources
PARC Pan African Rinderpest Campaign
PARC-VAC Participatory Community-based Vaccination and Animal Health Project
PRA participatory rural appraisal
SCF Save the Children Fund United Kingdom
SERP South East Rangelands Project
SNRS Somali National Regional State, Ethiopia
VSSP Veterinary Services Support Project, Somali National Regional State, Ethiopia

The author takes sole responsibility for the views expressed in this report. The term northern
Somalia/Somaliland is used to refer to the self-declared independent Republic of Somaliland. Various maps have
been reproduced in the report and no endorsement of boundaries or place names is intended.
1. INTRODUCTION
There is an increasing body of evidence from dryland areas of the Horn of Africa that community-
based services can provide effective animal health care for pastoral communities. Although used
initially by non governmental organisations in the1970s on a relatively small-scale, community-based
animal health systems now cover a substantial area of southern Sudan and are found in pastoral areas
of northern Kenya, north-east Uganda, the Afar region of Ethiopia and northern Tanzania (Catley et
al., 1998). Veterinary service reform in these countries and increasing privatisation of clinical
veterinary services has also prompted interest in combined community-based and privatised systems
in pastoral areas (Leyland, 1997) and policy debate on the need for official recognition of community
animal health workers (CAHWs) is in progress in some countries. CAHWs also continue to play an
important role in rinderpest eradication in pastoral areas that are inaccessible to conventional
government veterinary services. This activity was made possible by the development of a heat-stable
rinderpest vaccine that can be used by CAHWs without the need for extensive cold chains (Mariner et
al., 1994). Some common features of CAHW projects are summarised in Box 1.

Box 1
Common features of community-based animal health worker (CAHW) projects

Where are CAHW projects appropriate?

C In areas where a government or private veterinary service does not exist. For example, the area may
be a war zone or recovering from conflict.

C In areas where a government or private veterinary service exists but does not extend into more
remote or marginalised areas. Commonly, veterinary services are restricted to urban centres.

C In areas where livestock owners prioritise animal health and are willing to pay for veterinary
medicines. Payment may involve sale of livestock.

What is a CAHW?

C A CAHW is a part-time animal health worker who ideally, owns livestock and in the case of
pastoral communities, is able to travel with herds to remote grazing areas. The CAHW aims to treat
diseases which are prioritised by the community.

C The role of the CAHW can vary. Some communities will want their CAHW to diagnose and treat
diseases. Other communities feel more confident in their own ability to diagnose disease and may
want a CAHW mainly as a source of veterinary drugs and advice.

C The definition of community is important. It may vary between a permanent settled village to an ad
hoc group of pastoralists who happen to be sharing resources at a particular time.

C A CAHW is a private worker who receives incentives from the community, sometimes in the form
of a surcharge on veterinary drugs. CAHWs should not be government employees but they can be
linked to state systems e.g. for reporting disease outbreaks.

Although for many years there was very little data on the impact of CAHW projects, recent
evaluations in northern Kenya have demonstrated high cost-benefit of the community-based approach
in dryland areas (Holden, 1997a; 1997b). CAHWs were also a crucial factor in the eradication of
1
rinderpest from the Afar Region of Ethiopia and reduced rinderpest outbreaks in southern Sudan
(OAU/IBAR/PARC, 1996; 1997; Jones et al., 1998).

In the Horn of Africa, the Somali-occupied areas form a substantial livestock-rearing zone comprising
northern Kenya, Somalia/Somaliland, and eastern Ethiopia. The Somali economy is highly dependent
on livestock trade with the Gulf States and Kenya, and pastoral production systems contribute most of
the animals to these markets. Somalia/Somaliland also possesses long and remote borders with Kenya
and Ethiopia, and there is substantial movement of livestock across these borders for seasonal grazing
and trade. Consequently, Somalia/Somaliland is a major player in terms of both the livestock
economy and animal health situation in the Horn of Africa.

Regarding veterinary services in Somalia/Somaliland, many outsiders associate these areas with
constitutional chaos, no recognisable government and levels of insecurity that limit the capacity of
external agencies to support development activities. However, veterinary services do exist in
Somalia/Somaliland and in the absence of government an active private sector responds rapidly to
market opportunities. To date private veterinary work seems to have been concentrated around urban
centres and ports leaving few opportunities for pastoralists to access modern medicines.

This review was commissioned in order to collate experiences in community-based animal health care
in Somali areas for the PARC-VAC Project of OAU/IBAR. The review was a desktop study that used
grey and published literature from projects in Somalia, Somaliland, eastern Ethiopia and northern
Kenya. Much of this literature arose from aid-related interventions and some of the project activities
and results described in these documents were not subject to independent assessment. The review
focuses on projects that were attempting to take a long-term perspective for improving animal health
services rather than emergency/relief projects of short duration. Despite the operational difficulties in
Somali areas, the review was able to identify a number of useful and well-documented accounts of
projects using CAHWs (or an equivalent type of worker) in different geographical areas and
operational contexts.

2. THE SOMALI CONTEXT

The Somali people are one of the largest ethnic groups in the Horn of Africa, occupying Somalia,
south east Ethiopia and parts of northern Kenya and Djibouti (Figure 1). Somali society is largely a
pastoralist society that has adapted over many years to survive in a semi-arid and arid environment.
The area stretching northwards from the Tana River in Kenya, through Somalia and the Ogaden to the
Awash valley in Ethiopia and northern Somali coast forms one of the largest livestock grazing areas
in Africa and is occupied predominantly by Somalis. Livestock numbers have not been determined
with any accuracy but in Somalia, northern Somalia/Somaliland, the Somali National Regional State
(SNRS) in Ethiopia and the Somali districts of northern Kenya combined probably exceed 7 million
camels, 10 million cattle and 40 million sheep and goats1. Although this land mass exceeds 1 million
square kilometres, human population is probably in the order of 7 to 10 million2.

1
In Somalia and SNRS, livestock populations estimated at 6.29 million and 1.5 million camels, 4.64 and 6.0 million cattle
and 31.3 million and 11.5 million sheep and goats respectively (Baumann, 1993; Catley et al., 1997). Figures for northern
Kenya should be added.

2
In 1993 Somalia’s human population was estimated at 6-7 million in an area of 638,000 km2 (Janzen, 1993). In 1996, the
population of the SNRS was estimated at 3.5 million in an area of > 350,000km2 (Catley et al., 1997). Figures for northern
Kenya should be added.

2
 Figure 1
Somali-occupied
areas of the Horn of
Africa

2.1 Notes on Somali pastoralism

In common with many other pastoral groups, Somali pastoralists keep mixed herds in order to
maximise use of grazing and water resources, and reduce losses from disease. While these herds can
comprise camels, cattle, sheep, goats and donkeys, in general the camel is the preferred livestock
species in Somali areas.

3
 "To the Somali pastoralist the camel is the most valuable animal of all, and a large herd
is a sign of strength, power and prestige. As a form of property the camel is strongly
associated with patrilineal kinship, which is a major structural principle in Somali
society and culture..........camels are not primarily disposable income. Their value lies in
the material and social survival capacity that they offer the families that keep them. The
camel, which in Somali culture represents the image of continuity and reproduction, is a
source of security in case of drought and misfortune. In beings able to sustain long
periods of drought, a recurrent phenomenon in the area, camels have a great potential
for survival"

(Talle and Abdullahi, 1993).

Also in common with other herding communities, Somalis use division of labour by age and sex to
manage their livestock. While men and male youths tend camels and cattle, it is usually women who
care for sheep and goats and manage young stock (Talle and Abdullahi, 1993). At household level,
the pastoral food economy is characterised by high milk consumption and the sale or exchange of
small ruminants for grain (Holt and Lawrence, 1991; Abdullahi, 1993). In much of Somalia, milk is
plentiful during the main gu rains when the pasture and browse are lush, and offspring are born. Later
in the year as the jilaal dry season progresses, the teenage boys and young men take camels to remote
browsing areas. The camel herders rely almost totally on camels' milk for the dry months and
supplement their diet with wild fruits or occasional meat from an animal that has died. At this time of
year it is easy to see why camels are so revered by Somalis and why they rear more camels than any
other nation. When other livestock are suffering from lack of water a single camel will continue to
produce around 6 litres of milk a day (Mekonnen, 1994) - two camels will meet the daily calory needs
of 3 active adults3. Camel milk is also rich in vitamin B and contains three times the vitamin C content
as cows' milk.

Although farming and agropastoralism is practised by Somalis, these activities are restricted to areas
with relatively high rainfall such as western parts of northern Somalia/Somaliland and mid-land areas
of the Somali National Regional State, Ethiopia (i.e. areas equivalent to the former Eastern Hararghe
administrative zone). Permanent settled farming occurs along the banks and flood plains of the Wabi
Shebelle and Juba rivers. As noted in section 2.1.1, traditional pastoral systems have been undergoing
gradual change in Somali areas for at least 30 years and in particular, increasing sedenterisation and
market orientation is encouraging more rearing of cattle and sheep.

Some of the most detailed information on the Somali pastoral economy and livestock production was
collected by the GTZ Central Rangelands Development Project between 1982 and 1989 (Abdullahi,
1993). Regarding the food and cash economy at household-level, data was obtained for two sizes of
household termed ‘small’ and ‘large’ according to livestock holdings4.

3
Based on adult daily energy intake 2530 kcal and camel milk energy content of 70 kcal/100g.

4
This classification was based on Tropical Livestock Units per Active Adult Male Equivalent (TLU/AAME). Small
households averaged 3 TLU/AAME and therefore, reared less animals than larger households which averaged 8
TLU/AAME.

4
 small stock 76 .0 %

Figure 2a.
Sources of cash income for ‘small’ Somali
pastoral households
milk 9.0 %

other 9.0%

hide s & skin s 5.0%

camel sales 1 .0%

small stock 59.6%

Figure 2b.
Sources of cash income for ‘large’ Somali pastoral
households

milk 1 5.2%

camel sale s 10.1%

other 6.1%
hides & skins 9 .1%

grain 36.5%

meat 3.4%

Figure 2c.
Sources of food for ‘small’ Somali pastoral milk 22.2%
households

others 4.3%
sugar/tea 33.6%

grain 36.0%

Figure 2d. meat 5.4%

Sources of food for ‘large’ Somali pastoral

households

milk 32.2%

sugar/tea 22.8%

others 3.6%

5
This kind of information reflects the high economic and food dependency of Somali herders on their
animals. Cash generated from the sale of small stock (Figures 2a and 2b) is largely used to purchase
grain which features as a main foodstuff (Figure 2c and 2d). Other main foods, particularly milk, are
obtained directly from livestock. This type of information helps to explain why Somali pastoralists
prioritise livestock issues and indicates that their interest in animal health is a very logical concern.

2.1.1 Livestock trade and changes to traditional pastoral systems

While traditional Somali herding systems have much in common with those used by other pastoralists,
there are key differences between Somalis and other herding communities in the Horn of Africa. For
example, Somalia’s close proximity to the Gulf States favoured close economic and cultural links for
hundreds of years and the oil boom in the early 1970s led to the emergence of a considerable livestock
export trade from Somalia (Reusse, 1982; Janzen, 1986). As trade developed, a class of wealthy
herders and urban-based livestock traders appeared who appropriated key grazing areas and
encouraged the production of small ruminants over other livestock types. Hence, traditional
pastoralism began to change as less powerful herders were diverted from their traditional grazing
areas and faced increasing competition for water and other resources. In some areas, new settlements
began to appear which were associated with agropastoralism and increased ownership of cattle. As
animals became more concentrated in these areas and were moved less extensively, livestock disease
patterns began to change (Edelsten, 1995).

While the number of animals exported from Somalia has fluctuated during the last 25 years and trade
was interrupted during the civil war (1988-91), a substantial unregulated trade developed soon after
the war ended. As a measure of the scope of the trade, in 1995 the value of livestock exports from the
northern Somali ports of Berbera and Bossaso was recorded as $12.5 million (Stockton and Chema,
1995). However, the weak point in the Somali livestock export trade has been its almost total
dependence on the Saudi Arabian market. In 1983 a Saudi ban on cattle imports from East Africa led
to dramatic reductions in Somali cattle exports and more recently, another Saudi ban related to
outbreaks of Rift Valley Fever in Kenya has seriously affected the Somali livestock trade. Somalis are
also active traders of livestock with neighbouring countries, particularly Kenya. The livestock market
in Garissa for example is highly dependant on cattle from Somalia and in 1995, generated $11.3
million in cattle sales alone (Little, 1996).

"Years ago when you were travelling on foot and arrived at a homestead, the
pastoralist would immediately slaughter an animal for you. They were very
hospitable and always treated guests in this way. Nowadays he thinks twice and
prefers to buy some rice for you rather than kill one of his sheep - now he knows
the real value of his animals"

(Dr. Mohammed Sheik Said - cited in Catley et al., 1997).

The influence of market-orientation on livestock management and ecology in Somalia has been a
regular feature of the literature for many years. A complex picture involving human sedenterisation,
population growth, large refugee/returnee populations, conflict, increasing numbers of water points
and short-term, opportunistic use of grazing and forest resources have all been linked to changes in
pastoralism and the environment. Another factor is the presence of government and whether private
ownership of land can be regulated effectively. For recent information on these issues, readers are
advised to consult studies in Somali areas of Kenya (Department of Livestock Production/Oxfam
UK/Ireland, 1996), Ethiopia (Jama Suguule and Walker, 1997) and northern Somalia/Somaliland
(Hassan Mohammed Ali, 1997). In particular, the Kenya and Ethiopia reports are of interest because
in relation to this review, they show how community-based research can involve communities in the
analysis of problems related to natural resource management. The Ethiopia report notes how in the
6
absence of external agencies, Somali communities had already identified the disadvantages of
unregulated growth of water points and using traditional mechanisms, were taking action to solve
overgrazing problems.

2.1.2 Overseas remittances

Although a country with a livestock-centred economy, Somalia possesses the longest coastline in
Africa. According to Geshekter (1993), as early as the 1830s Somalis were travelling overseas to seek
income generation opportunities and send money home to relatives. Due to links with Arab traders
and merchants, Somalis regularly travelled to the Gulf States and in the colonial period, Somalis were
employed as sailors. Pilgrimages to Islamic centres also helped to ensure that Somalis were not
isolated from news and experiences from other countries.

Economic prosperity in the oil-producing countries of the Middle East was a major attraction for
Somalis in the 1970s and by 1986, they were estimated to number 300,000 in the United Arab
Emirates and Saudi Arabia (Janzen, 1986). Undoubtedly, these workers sent a substantial proportion
of their earning back to Somalia and this remittance was estimated at $280 million by the
International Labour Organisation (ILO) in 1987 (cited by Geshekter, 1993). Rather than describing a
nation of nomadic herders, the ILO characterised Somali families as multi-occupational, multi-
national production units whereby a family grazing their livestock on the Ethiopian border could, via
the clan system and "several hands that stretched from overseas", receive support from relatives
abroad. In 1999, the number of private money transfer agencies in the main Somali towns is a
reflection of the continuing movement of funds into Somalia from outside sources.

2.1.3 Access to information

Somalia has a strong oral culture and the Somali language was only produced in written form in 1972.
The oral tradition is demonstrated by the significant status of poets and poetry in Somali society
(Andrzejewski and Lewis, 1964) and the traditional way of passing messages and news across the
range using messengers who were able to memorise very long and intricate poems.

In recent times, the combination of international trading activities, diaspora and cultural desire for
news has led to the development of very effective communication networks both within Somalia and
between Somalis internationally. Despite the destruction of telecommunications in Somalia during the
civil war, privately operated short-wave radios and even satellite phones were available in many of
the major Somali towns soon after the war ended. In particular, radio is the ideal medium for Somalis
and herders in remote areas will meet daily to drink tea and listen to the BBC Somali Service.
Consequently, even most isolated of communities in Somalia are not necessarily ill-informed about
world events.

2.2 Social organisation

Somali society is based on a patrilineal and highly segmented clan system. At birth, a person
automatically becomes part of a lineage through which they are linked to clan. The largest clan unit is
the clan family, of which there are six - Dir, Isaq, Darod (including the Ogaden clan), Hawiye, Digil
and Rahanweyne. Although traditionally, the clan families are located in fairly well-circumscribed
geographical areas (figure 1), these groups are generally too large and widely distributed to act as
useful political entities (Lewis, 1961). The next level of organisation, the clan, is a more important
political unit and in some cases has a clan head called a Sultan. In common with clan families, the
clans are also associated with geographical areas. However, a person's sense of clan membership is
more closely related to common kinship than territorial affiliation.

7
Within the clans, there are sub-groups which due to the intimacy of their kinship ties can be
considered as distinct units. According to Lewis (1961) these units are "the lineage of which a person
normally describes himself as a member" and consequently can be termed primary lineages. However,
for Somali pastoralists the strongest social institution is a smaller kinship unit called a dia-paying
group. The male members of a dia-paying group are united by lineage and they have collective
responsibility for payment of blood-money compensation or dia. Dia is usually valued at 100 camels
for the life of a man and 50 camels for a woman5.

Clan family
Figure 3
Basic social organisation of Somali
pastoral society (source: Lewis, Clan Clan
1961)

Primary lineage Primary lineage

Dia-paying group Dia-paying group

Within the dia-paying group, the need for collective action to pay dia is a powerful binding influence
on group members - it is at this level of social organisation where traditional law and kinship
responsibilities are most evident. Dia-paying groups vary in size from a few hundred to a few
thousand men and in common with other clan-based units, are associated with home territories. Figure
4 overleaf shows the distribution of some dia-paying groups in Somalia, Ethiopia and Kenya, and
illustrates how a Somali's name and genealogy are sometimes described as his ‘address’.

While the dia-paying group has been a subject of much interest to anthropologists, it also has practical
significance. For example, the colonial administration of the Somaliland Protectorate recognised the
value of the dia-paying group as an entry point to Somali communities and diligently recorded the
names, sizes and locations of every one of the 361 dia-paying groups under their jurisdiction. (Hunt,
1951). Although it was noted that the dia-paying groups often had no traditional leadership, the
colonial authorities appointed dia-paying group headmen called Akils who acted as a point of contact
with herders. However, "As far as the members of the dia-paying group are themselves concerned,
these official headmen exercised representative rather than authoritative functions" (Lewis, 1961). In
other words, the Akils were expected to act as messengers for the dia-paying groups rather than
making decisions on their behalf.

5
In agropastoral areas cattle tend to replace camels in dia transactions and a buulo donation of an ox, cow or sheep is
immediately given to the family of an injured person.

8
In the immediate post colonial era between 1960 and 1969, the Akils received less support from government
because they were associated with tribal groupings which were considered to be detrimental to a modern Somali
state (Ahmed Yusuf Farah, 1993). Furthermore, following a military coup in 1969 and the advent of socialism in
Somalia, the Akils were abolished and expected to work for the government as watchmen in local government
departments. For reasons unknown, this decision was soon reversed and the government reinstated the Akils
under the new name of nabadoon (literally: peace maker) in the early 1970s. At this time the government was
clearly trying to persuade former Akils to transfer loyalty from their clans to the state and a range of anti-clan
initiatives were implemented. For example, in the mid 1970s clan effigies were ceremonially burnt, ‘comrade’
replaced uncle or cousin as the official form of address, the death sentence was reintroduced to
replace dia, marriages were stripped of their clan significance and the countries eight provinces were
reconstituted and renamed to exclude clan names and undermine the traditional sense of identification
(Bradbury, 1993). Consequently, the dia-paying group as an institution was weakened and the Somali
government had ostensibly declared tribalism illegal. In 1978 the Akils attended military training and
socialist orientation programmes in Mogadisho and soon after, they became an important mechanism
through which Siad Barre could incite inter-clan violence.

According to the anthropologist Ahmed Yusuf Farah (1993), despite their previous links to
government the Akils and nabadoons are still important political leaders in northern
Somalia/Somaliland. However, they are not traditional leaders but ex-government appointees whose
authority is dependent on support from their clan. Therefore, it cannot be assumed on meeting a
nabadoon that he effectively represents a dia-paying group. In addition, due to the suppression of
tradition social structures during the Barre regime, people are not always willing to discuss their
membership of a dia-paying group. Despite the turbulent recent history of the dia paying groups, they
continue to be recognised as important, indigenous social institutions for pastoral development
activities (VetAid, 1992, Prior, 1994; Catley, 1994).

While on paper it would be convenient to consider the dia-paying groups as entry points for
community-based animal health, their value for this purpose remains untested. The traditional roles of
the unit are payment of dia and conflict resolution, and the members of the group do not necessarily
live close together or share a common means of livelihood. When meeting pastoralists on the range,
they may or may not be from the same dia-paying group and discussions with ad hoc committees of
elders are the norm. In addition, while the dia-paying groups are bound by customary law, and control
contracts and decision-making, it has been suggested that the ability to manage these processes resides
with elders whose knowledge has not been transferred to a younger generation (Lewis, 1995).

To a certain extent, the home territories of the dia-paying groups can be regarded as areas where
pastoralists with close kinship ties will congregate during the wet season These traditional areas are
sometimes called deegaans and have been used by development projects to characterise project areas
or target communities. However, the behaviour of Somali pastoralists is more strongly influenced by
their membership of dia-paying groups than their occupancy of particular deegans. Some projects
have also used the concept of beel to describe Somali communities. Beel seems to be associated with
the common use of a particular resource, such as a well, and can involve different clan groups. It is
the need to agree on access to the resource and cooperate with respect to resource management that
determines the identity of the beel members. The beel is most clearly defined in agropastoral or
recently sedenterised areas where individuals from different clans may need to reach consensus over
the management of land or water.

9
Figure 4
Distribution of dia-paying groups in Somali areas

10
2.3 Conflict and political groups

In addition to pastoralism and clan, the other key facet of Somali society is conflict. The traditional
classification of Somali men into either warriors (wranleh) or religious leaders (wadaad) is an
indication of the importance of war among Somalis and the literature makes frequent reference to this
point. Lewis (1961) described northern Somali pastoralists as “essentially a warlike people who
readily engage in battle or raiding to redress wrongs and injuries, to release pent-up enmities, to
acquire or maintain honour, and to gain access to natural resources or covey their rights over them”
and thirty years later Samatar (1991) noted that “Somalis live in a state of egalitarian anarchy, a
world of camel husbandry and clan families and are as liable to be at war with one another as to
assemble under an acacia tree for poetry contests”. The Ogaden war (1977-78), the Somali civil war
(1989-91) and ongoing civil disorder in Somalia are reflections of a virtually continuous state of
conflict in Somali areas since the beginning of the century.

Levels of conflict vary and whereas local feuds over resources such as wells or grazing can usually be
solved relatively easily through traditional mediation among elders, wider scale conflict involves
more parties and is difficult to resolve. According to Bradbury (1993), in the post colonial era in
Somalia “The development of a parliamentary democracy and state structures did nothing to change
traditional clan allegiances. They merely provided a new medium of expression for Somali clan
politics. The significant change was in the way that the scope of political expression and action was
widened from the parochial level of the dia-paying groups to the level of clan families” and that an
effect of a centralised government was to “undermine the participatory nature of Somali politics”.

The influence of the Siad Barre regime on traditional political units such as the clan and dia-paying
group has been outlined in section 2.2. While officially trying to remove tribalism, clan politics were
used to maintain the government’s power along divide and rule principles. Consequently, when the
Barre government collapsed, inter-clan conflict soon became the dominant political issue in Somalia.
Warlords and ex-generals battled for supremacy with support from their clans and in the process, the
capital Mogadisho was more or less destroyed. In 1999, the country remains unique because it exists
in the absence of government. In the self-declared independent Republic of ‘Somaliland’ in the north,
the government awaits international recognition. In both Somalia and the Ogaden, there is a complex
array of political parties with shifting allegiances and varying capacity for armed action.

In addition to traditional clan allegiances and struggles, another important factor influencing the
current Somali situation has been militarisation (Bradbury, 1993). Between 1963 and 1988 levels of
military expenditure in Somalia were staggering - Somalia used to possess the largest army in Africa
and in 1984, 36% of the national budget was spent on arms. Somalia’s strategic position in the Horn
of Africa and Cold War alliances with both the Soviet Union (1963-1977) and the United States
(1978-1985) were central to a massive insurgence of modern weaponry into the country

11
Box 2
Conflict in 20th Century Somalia

1900 Nationalistic religious (jihaad) war by Mohamed Abdille Hassan against foreigners led to
200,000 deaths (a third of the northern Somali population), countless loss of livestock and
left the ‘Somali peninsula in ruins’. Famine in 1920. Fascist rule begins in Somalia.

1930 1935 sees the start of the Italian Fascist campaign in Ethiopia and Somalia.

1940 Italians drive Britain out of Somaliland. 1941, Britain regains control of Somaliland and
defeats Italy in the south. The period led to a displacement of the rural population and rapid
urbanisation.
1950

1960 Border conflicts between Ethiopia and Kenya 1963 start a regional arms race.

1970
1977 Ogaden War with Ethiopia resulted in an estimated 25,000 Somali deaths and an
immediate influx of 700,000 refugees which rose to 1.3 million by 1981.

1979 - the Somali Salvation Democratic Front (SSDF) start first armed uprising against Barre
government. More than 2000 Majerteen civilians killed in central regions in counter-
insurgency campaign.
1980
1981, the Somali National Movement (SNM) begin military campaign against Barre regime.

1988 SNM capture Hargeisa and Burao. Government retaliation leads to an estimated 50,000
deaths and 360,000 refugees.
1990
1991 Barre regime overthrown by United Somali Congress (USC) though civil war continues
between military factions, leaving an estimated 400,000 dead, 1.5 million refugees and 4.5
million facing starvation by the end of 1992.

1993 UN sponsored international relief efforts backed by US military involvement; partisan

UN policy fuels conflict and leads to withdrawal of foreign troops from late 1993.

1994-1998, continued lack of internationally-recognised government and insecurity. Clan-

based militia and warlords dominant southern Somalia.

(adapted from Bradbury, 1993).

3. COMMUNITY-BASED DEVELOPMENT IN SOMALI AREAS

The community-based approach to development is based on the concept of participation. The
underlying theory behind participation is that local people are best placed to identify their own
problems and usually have rational ideas for solving these problems. Participatory methods such as
participatory rural appraisal (PRA) are tools used by development workers to facilitate change by
assisting communities to prioritise and analyse key issues, and take action to improve their situation.
Ultimately, community-based systems are characterised by local ownership and management with
people seeking technical support from professionals as and when they need it.
12
When using a community-based approach in the development of a local service, there are a number of
factors which tend to either favour or discourage high levels of participation and sustainability, as
outlined in Box 3.

Box 3
Some factors influencing the development of community-based services

Factors favouring participation: Factors discouraging participation:

• Strong, traditional social structures and decision- Erosion of traditional social structures e.g.
making forums. through long-term conflict, poverty, natural
disasters or aid dependency.
• Local prioritisation of the service in question i.e.
people will only contribute time or money to Provision of subsidised services by
services which they need. government or other agencies, sometimes
creating expectations .
• Pre-existing and functioning social support
mechanisms (designed to assist less wealthy Inappropriate government policy preventing
members through traditional loans, gifts, the use of alternative or innovative systems.
provision of labour or other means).
Exclusion of key stakeholders who therefore
• Pre-existing indigenous services e.g. traditional undermine the process/project.
healers, midwives or teachers.
Lack of knowledge among professionals of
• Local willingness to pay for the service in community-based approaches; tendency to
question or at least contribute to cost sharing. focus on technical rather than social aspects
of the service; ‘top-down’ planning.
• High levels of indigenous technical knowledge.
Professional biases e.g. lack of respect for
indigenous knowledge; urban bias.

In previous sections of this review, a number of key factors that influence community participation in
animal health in Somali areas have already been mentioned. From the positive perspective, Somali
pastoral society is based on well-defined and democratic social units (dia-paying groups, section 2.2)
and the high dependency of Somali pastoralists on their livestock (section 2.1) is demonstrated by
local prioritisation of veterinary services. On the negative side, continuing conflict and civil disorder
(section 2.3) tends to disrupt development activities and undoubtedly, there is widespread belief that
aid agencies are first and foremost, providers of free goods and food. In the author’s view, among
Somali pastoralists this attitude has more to do with opportunism rather than dependency. This section
aims to provide information on some of the other factors in Box 3 that encourage the development of
community-based services. Examples of community-based projects are also provided in order to show
that participation can be effective in Somali communities despite constraints such as long-term
conflict. In addition to these examples, there are experiences of using participatory methods in
Somalia that have been well-documented and include discussion of the value of participation in local
institutional development (Ford et al., 1994) and natural resource management (Inglis, 1997).

13
3.1 Indigenous services and social support systems used by Somali
pastoralists

Regarding pre-existing or indigenous systems used by Somali pastoralists, these systems are relevant
to community-based animal health because they demonstrate that communities are already organising
themselves, either collectively or individually, to use or provide a service that they perceive to be
beneficial. In areas where such services have existed for long periods, it is likely that effective
community-level forums already exist and people have developed a way of supporting the workers
involved. In this situation, there are often useful lessons to be learned about aspects of CAHW
systems such as CAHW selection, incentives and accountability. The most common, community-
organised and indigenous social support mechanism among Somalis is the giving of alms. This
Moslem practice requires the collection of money or livestock by elders from the community for
redistribution to less wealthy people. In terms of traditional services, these include Koranic schools
and a range of health practitioners from herbalists to bone-setters.

3.1.1 Koranic schooling

One of the best examples of a self-sustaining traditional service in Somali areas is the system of
Koranic education. This system is based on mobile schools or duksis that follow the herds as they
move in search of grazing. Koranic teaching takes place in the early morning or evening when
livestock are enclosed near the homesteads and children are free to attend classes.

Box 4
The Somali system of Koranic schools or duksis

"Traditionally the duksis are mobile, moving with the herders in their seasonal migration patterns. They utilise
available natural resources such as bark for writing boards and tree sap for inks, therefore never being reliant
on provision of textbooks, materials or salaries from outside. Koranic teachers working within the nomadic
sector are a crucial part of the community. As herders themselves, they move with the nomadic families, are
paid a wage in the form of stock or milk, and provide a continuous theological foundation for the children.

It is common for most pastoralists to diversify between livestock management and formal education. Out of 4
or 5 children it is likely that 1or 2 will be sent to a formal school, with the remainder staying within the olog to
receive Koranic teaching and look after the livestock. The Koranic schools however are considered to be the
most important form of education and if forced to prioritise between secular and Koranic schools, parents will
always chose the duksis."

(source: Pearson, 1996).

Some 35 years earlier, a similar system of Koranic education was described by Lewis (1961) and it
was noted that there were hundreds of traditional schools throughout northern Somalia. Regarding
payment of sheikhs for their teaching, "Often a lamb or the equivalent in cash is paid for every
section of the Koran which the pupil masters, and when he has finished the course, a young camel is
usually asked for by the teacher". It was also noted that religious teachers and sheikhs gained income
through the sale of Koranic verses to pastoralists for use in amulets6.

The benefits of these systems were noted by the Ministry of Education in Somalia many years before
the civil war. Realising that conventional education services based on modern, fixed point schools

6
These amulets, called xirsi or qardhaas, and used to protect both humans and animals (particularly young camels) from ill-
fortune and in the case of livestock, herders were effectively paying for a type of animal health service.

14
were largely unworkable for pastoralist communities, they sought to integrate Koranic schooling into
the official education programme (Gorham, 1978).

3.1.2 Traditional medicine

In common with other pastoralist societies, traditional healers in Somalia offer an important service to
people who have limited access to hospitals or other medical facilities.

"These healers use various methods in their practice. Some rely on magical rites, intended
to pacify spirits who are believed to have caused the illness. Others are specialised in
healing broken bones by manipulation, a practice which is very often successful. Many
healers use preparations of plants in their practice. Some of these use the plants as
adjuvants for a treatment which is mainly based on magical rites, whereas others regard
the plant preparations as real drugs which have a direct action on the body and can help to
heal a certain disease".

(source: Sameulsson et al., 1991).

In addition to spiritual healers, bone-setters and herbalists there are also traditional birth attendants,
dentists and other types of indigenous health worker and typically, they receive some form of
payment for their service. The potential value of medicinal plants in Somalia was recognised by the
Somali health authorities many years ago (Elmi, 1980) and prompted the Faculty of Medicine at the
Somali National University to begin researching this local resource with assistance from Swedish
partners. This work led to the development of an inventory of Somali medicinal plants for the
southern most regions of the country. More recently, there have also been calls to incorporate
traditional healers into primary health care systems in Somalia (Helander, 1990).

3.1.3 Traditional restocking

Many pastoral groups in eastern Africa and the Horn of Africa have traditional and often complex
methods for assisting poorer people or those who experience sudden loss of livestock through
calamities such as disease outbreaks or drought. In Somali society, membership of a dia-paying group
automatically provides access to an indigenous social support service to those who fall on hard times.
Somalis use the word cayd to describe someone who becomes destitute through the loss of all their
animals. When discussing how such people would survive, an elder in Somaliland explained that “He
depends on the dia paying group. He just lives with them. They nurse him, they feed him. He depends
on his family. Yesterday when we came we saw that there had been very strong rain and trees had
fallen. The rain took many sheep from one family and that family became totally poor, say in Somali,
cayd. Then the man of that family went to the relatives and dia paying group and they gave him many
animals. Now he has more than before. Every family he came to gave him one or two sheep and
goats" (Ahmed Aden and Catley, 1993a). In the Somali region of Ethiopia, four main types of
traditional restocking are used as detailed in Box 5.

In common with Koranic schooling, the existence of well-organised traditional restocking in Somali
areas is an indication that communities can organise and manage themselves effectively. Using the
principle of build upon things that people already know and do, Save the Children UK (SCF) in
Ethiopia worked with Somali communities do develop a large-scale restocking programme in
response to an influx of destitute returnees from Djibouti. This programme was ongoing at the time of
writing and in terms of participation, enabled communities to take responsibility for key aspects of
project design, implementation and monitoring.

15
Box 5
Traditional Somali systems for provision of livestock to poor families

Free gift - xologoyo

This is a free gift of livestock to a needy family. A committee of elders is organised to collect livestock from
relatives of the recipient family and the number of animals provided depends on whether the family is
expected to engage in farming or herding activities.

Loan – maalsin
A loan of animals is usually arranged between two individuals and involves lactating cattle or goats. The
borrower will return the original stock to the lender with any offspring, when the animals give birth.
Alternatively, the borrower may keep the offspring and return only the adult females to the lender. The terms
of the contract between lender and borrower depend on kinship ties between the two parties.

Marriage
When a poor man with no livestock marries, his relatives will give him livestock. There is no specific type
or quantity of animals which is provided. When a woman is married by a poor man, her relatives support her
through provision of livestock when she visits her father's family. Mostly, the providers are her father,
brothers and uncles.

Alms giving
Alms giving, when related to Somali customs and livestock provision, requires those people who hold a
certain number of livestock to provide animals to poor families as follows:

Livestock owned Number in herd Livestock to be

donated
Camel 5 or more 1 sheep, 2 years old
Cattle 30 or more 1 calf, 2 years old
Sheep/goats 40 or more 1 sheep, 2 years old

A man with 4 camels is not obliged to give alms until he has 5 camels. As the herd of an alms giver
increases, so does the number of animals that are donated - a man with 15 camels would provide 3 sheep.
Alms giving occurred once a year and was coordinated by a committee of elders who collect livestock from
the alms providers.

(source: Save the Children UK, 1996).

3.2 Use of community participation by development agencies in Somali areas

.
3.2.1 Support to traditional restocking in the Somali National Regional State (SNRS),
Ethiopia

When fighting in Somalia was at its peak or when conflict was compounded by drought (1973, 1988
and 1991), SCF's work in the SNRS focussed on emergency and relief inputs such as needs
assessments and emergency feeding programmes. In 1993 SCF took a more long-term view of
assistance to the region and developed rehabilitation programmes comprising inter-linked agriculture,
livestock, human health, education and water projects. During this period, the organisation embarked
on a process of learning how to do participatory development with Somali communities. The key
features of this process were training in and application of participatory rural appraisal and
commitment to the development of a strong team of Somali staff, some of whom were former
refugees themselves.

16
In 1995, participatory needs assessments in the SNRS identified ‘lack of livestock’ as a major concern
of agropastoral communities in Jijiga and Fik zones. When investigated in more detail, this problem
had arisen because of large numbers of Somali returnees who were being absorbed by their
communities and according to Somali custom, were entitled to receive traditional support such as that
described in Box 5.

However, the longevity and severity of conflict in the area had reduced livestock holdings to such an
extent that traditional restocking was no longer possible. Hence, the problem ‘lack of livestock’
referred to a well-established but exhausted traditional social support mechanism. Following a study
on traditional restocking, SCF began to implement a pilot project to test methodologies and determine
whether the traditional system could be assisted with external support.

The pilot restocking project relied heavily on community participation and an understanding of local
forums. The first visit to a target community involved the field team meeting with the whole
community in a shir beeleed7. At this meeting the team explained the objectives of the project and
sought general information on subjects such as traditional restocking practices, preferred types of
livestock and local veterinary services, if any. It was agreed that six adult female sheep and goats
were to be provided to beneficiaries. The number of animals provided was influenced by the project
budget and discussions with target communities - a local wisdom stated that after six years, six
females produce so many animals that the herd cannot be counted. Target communities were
responsible for selecting the beneficiaries and arranging procurement of livestock from local markets.

At the time of procurement, beneficiaries were able to select the animals that they preferred and
animals were then checked by staff from the government veterinary services. Once the animals had
been selected and checked for signs of ill health, letters of agreement were signed and SCF staff paid
for the stock. In order to increase the number of beneficiaries, a system for redistributing offspring
from the first beneficiaries to other needy families was designed. The system was based on ‘first-
level’ beneficiaries providing 50% of offspring to ‘second-level’ beneficiaries during the first year of
the project.

The team then split into three and arranged separate meetings with men, women, and women and
children. In these meetings focus group discussions were used to collect more detailed information on
livestock matters, including the livestock preferences of the particular groups and definitions of
wealth and poverty in relation to livestock holdings. Based on these meetings the team determined the
number of beneficiary households that could be restocked in the community. The number of
beneficiaries and the number of livestock to be provided was then discussed in a second shir beeleed
and was related to available water and grazing resources. At the end of the meeting the community
was asked to select beneficiaries according the lowest wealth grouping that they had defined.

The process of selecting beneficiaries took one to two days. Once completed, a third shir beeleed was
held and all beneficiaries (both first and second-level) attended with the rest of the community. In this
forum, the contract between every first and second-level beneficiary was discussed, clarified and
agreed. At this stage the agreement was oral but later, was written and signed by all parties.

The next stage of the project involved the formation of a gudiga xoologooyada (restocking
committee) that was responsible for overseeing both livestock purchasing arrangements and
distribution of livestock from first to second-level beneficiaries. The committee usually consisted of
two elders, two women and the chairman of the local farmers association. Veterinary care of livestock
was arranged in partnership with the local Ministry of Agriculture veterinary staff and by training

7
A beel can be regarded as a Somali agropastoral or farming community's home area, including land which is owned or used
by the community. A shir is a meeting.
17
community animal health workers. The latter were able to procure veterinary drugs from private
sources.

Apart from the system of redistributing livestock offspring from first to second-level beneficiaries, all
stages of the restocking project were closely linked to traditional systems. For example, livestock
were a traditional form of assistance to poor families and the recipients of livestock under traditional
restocking were similar to the project beneficiaries in terms of age, sex and wealth. Also, in both the
traditional systems and the project, communities were responsible for selecting beneficiaries; the type
of livestock provided by the project was similar to some methods of traditional restocking.

3.2.2 Lessons from primary human health services

The problems of delivering primary health services and primary animal health services to pastoral
communities are similar in terms of poor infrastructure, mobility of target communities and the
reluctance of professionals to work away from large towns or cities. When discussing primary health
care provision to pastoralists in southern Somalia before the civil war, Helander (1990) noted the
failure of the public sector to provide adequate services and the rapid expansion of private pharmacies
from urban to rural areas. The demand for health services from pastoralists prompted "... an enormous
enterprise potential in the form of privately organised health care". Some of the private pharmacies
developed into complete health centres by cooperating with local health workers and in some cases,
opening small diagnostic laboratories. These pharmacies appeared in many rural towns and were used
by pastoralists when they visited livestock markets. In terms of improving official primary health care
systems, Helander advised integration of the numerous drug traders and private pharmacies with
primary health workers and traditional healers.

Describing a primary health care project in north west Somalia between 1982 and 1986, Bentley
(1989) noted the success of a system based on community health workers who were selected and
supported locally. Various aspects of this system are relevant to discussion on CAHWs.

The entry point for the project was a village-scale administrative unit called a tuulo. The tuulo
was requested to establish a health committee whose main responsibility was to coordinate
the selection of community health workers (CHWs). The selection was done by the
community as a whole using criteria from the project as guidance. The criteria for selection
were that candidates should:
ƒ have lived all their lives in the community and should be established there, preferably
with family;
ƒ not be a close relative of a member of the health committee;
ƒ be literate;
ƒ have some history of community service where possible;
ƒ be between 20 and 45 years of age;
ƒ if possible, be female.

For CHW training, various training tools were compared and of these role plays were
considered to be extremely useful. This findings was related to the important role of song,
poetry and drama in Somali culture.

The CHWs provided curative treatments in addition to advice on disease prevention. The
curative aspect of their work was considered to be essential to their local acceptance.

It was stressed that the CHWs were intended to be an employee of the community rather than
the government and therefore, incentives for the CHWs were to be determined by the
community. This approach worked well and 75 out of 85 CHWs (88.2%) were still working
18
 after 3 years.

"There are many contributing factors as to why work continues. Often presents of cigarettes, grain,
sugar etc. are given periodically by the elders. In many cases, bachelor CHWs are provided with
accommodation - rent free. Also, often while making home visits to sick people there will be some
form of payment in kind, such as a meal, container of milk, or meat if available. Secondly, even the
CHWs working hard at their job usually have their own farms and herds. Thus, anything made from
his health activities is extra income. CHWs also received payments of cash and livestock” (Bentley,
1989).

4. AN OVERVIEW OF VETERINARY SERVICES IN SOMALI

AREAS
4.1 Traditional veterinary practice

Indigenous animal health knowledge and practices are placed at the beginning of this section on
veterinary services because their use pre-dates the arrival of western-style services in Somali areas
and continues up to the present day. It is noticeable that despite the lack of modern veterinary services
in many pastoral areas of Somalia and the Ogaden, these regions continue to supply the Somali
livestock export market and have done so for many years.

The first accounts of indigenous Somali animal health care appeared in records and published papers
arising from the colonial veterinary services of the Somaliland Protectorate. The information
presented included details of traditional grazing practices designed to prevent or limit tick infestation
and worm infection, the use of salt and minerals as dietary supplements, the treatment of wounds with
salt washes, the application of cautery and traditional vaccination practices. Somali names for
livestock disease and parasites were also reported at this time (Peck, 1939, 1940; Hunt,1951; Mares,
1951, 1954a, 1954b).
“... it is surprising to find that the nomad recognises the flies that spread trypanosomiasis;
that he has a good idea of the infective nature of disease and knows that cattle with rinderpest
are dangerous to other cattle; and that he has learnt logical and effective, though very
primitive, methods of immunisation” (Mares, 1954b).

The British veterinary team working in northern Somalia between 1969 and 1972 also realised that
herders possessed useful knowledge related to animal health. For example, when discussing
trypanosomiasis in camels it was concluded that despite laboratory facilities,

“...the best diagnostic tool was probably the camel owners own opinion. This is not something
to be dismissed lightly because a camel owner knows his animals and the disease intimately"
(Edelsten, 1995).

More than forty years after Mares’ publications, veterinarians in northern Somalia/Somaliland noted
virtually identical traditional practices and disease terminology to those reported previously (Catley
and Mohamed, 1995, 1996) and this was perhaps, a measure of the failure of modern veterinary
services to reach more remote areas.

While veterinarians might debate the value of some traditional practices, the sustainability of these
indigenous systems should not be overlooked. Many Somali remedies for livestock ailments utilise
locally available plants or other resources (Hadrill, 1993) and in some cases, treatment or disease
management strategies appear rational when compared with western, scientific knowledge. For
example, the use of salt in wound treatments; the separation of sick from healthy stock; the avoidance
19
of tick-infested areas. In general veterinarians have mixed opinions regarding the effectiveness of
traditional vaccination against bovine contagious pleuropneumonia, as reported by Mares (1951), and
according to Marx and Wiegand (1987), traditional responses to Q-fever in cattle were not effective8.
The Somali preference for camels over other types of livestock is also reflected in the literature on
indigenous livestock practices and detailed accounts of traditional breeding and husbandry are
available (Nur, 1984; Elmi, 1989; Mohamed and Hussein, 1996).

Interest in indigenous veterinary knowledge in Africa has been growing during the last ten years or so
and it is evident that Somali herders possess detailed animal management and health skills which have
evolved over centuries. The rich Somali vocabulary for livestock diseases and vectors, and the scope
of the traditional pharmacopoeia indicates that indigenous knowledge should feature more
prominently in the development of primary veterinary services (Catley and Walker, 1998). While
some documentation of indigenous veterinary knowledge has taken place and more than 135
veterinary medicinal plants have been recorded in the Ogaden alone (Catley et al., 1996), much more
work is required to validate plant remedies. Indigenous knowledge is not only part of the Somali
cultural heritage, but also has practical applications for the development of community-based
approaches to service delivery. The latter are discussed in more detail in section 5.0.

4.2 Modern veterinary services in Somali areas

Until the late 1980s, the development of veterinary services in Somali areas followed a similar pattern
to many other African countries. Colonial governments established modern veterinary infrastructure
and facilities for quarantine, food hygiene, research and clinical work. At independence, colonial
facilities and systems were inherited by new African governments and in the post-colonial era,
veterinary services attracted considerable donor support. However, the world recession in the 1970s
and 1980s prompted the emergence of structural adjustment policies and worsening veterinary service
delivery by the public sector (Holden et al., 1996).

4.2.1 Somalia/Somaliland

The development of livestock services in Somalia began in the early 1900s with the arrival of an
Italian administration in the south and a British administration in the Somaliland Protectorate. The
Italians established the first veterinary institute in southern Somalia at Merka in 1914 whereas British
veterinary facilities were based in Hargeisa in the north. Soon after the arrival of the first British
veterinary officer in 1924, Somalis were trained as part of a rinderpest and CBPP disease reporting
system (Baumann, 1993). The Somaliland Camel Corps comprising mobile teams of veterinary
personnel was also established and numerous field scouts were employed (Peck, 1962).

In the post colonial period, government veterinary services in southern and northern Somalia were
merged and up until 1975 activities focussed on rinderpest eradication, latterly through the JP15
campaign. In the 1980s, government veterinary services in Somalia were reviewed in detail by GTZ
and it was noted that while the livestock sector accounted for 41.5% of gross domestic product, the
budget for the Ministry of Livestock Forestry and Range amounted to only 1% of the national budget
(Baumann, 1993). In common with veterinarians in many other national veterinary services facing
financial constraints at this time, Somali veterinarians were concentrated in urban centres and basic
services in the main livestock producing areas deteriorated. Veterinary manpower levels were also
considered to be far below those required for preventive disease control measures in nomadic systems
(Table 1).

8
Note that in this study, a causal agent was not identified and the disease in question, called qanje, was never fully
characterised by the researchers.

20
In part, the combination of inadequate budget and low manpower levels led GTZ veterinarians to seek
alternative solutions to delivering primary animal health services to pastoralists, leading to the
development of the Nomadic Animal Health Auxiliary (NAHA) system in the Central Rangelands of
Somalia. This system used NAHAs as both providers of a basic curative service and a source of
information on livestock disease. Although the system was brought to a premature end at the outbreak
of the Somali civil war, it demonstrated that basic level veterinary workers were an extremely useful
way of complementing a depleted government veterinary service. The NAHA system is discussed in
more detail in section 5.1.

Structural adjustment in Somalia in the 1980s included attempts to reorganise state veterinary
services, improve cost recovery and liberalise the importation and sale of veterinary pharmaceuticals
(Costagli, 1996). In 1988 the Somali government allowed private companies to import veterinary
drugs for the first time and drugs became available through private pharmacies. However, the
outbreak of civil war in Somalia led to a dramatic cessation of both public and private sector
veterinary activities. The war resulted in widespread destruction of government veterinary facilities
and records. Many veterinary professionals left the country along with aid agencies who were
involved in livestock development.

Immediately after the overthrow of Siad Barre in 1991, veterinary inputs were included in the
emergency relief programmes of agencies such as the International Committee of the Red Cross
(ICRC). A number of other international non governmental organisations (NGOs) such as
ActionAid/VetAid, CARE, COOPI, Africa 70, Terra Nuova and Oxfam Quebec also became involved
in animal health work. Activities varied from support to livestock export facilities and diagnostic
laboratories to the provision of primary veterinary services for pastoralists through community-based
workers. Although many relief programmes provided veterinary treatments at subsidised rates at this
early stage in the rehabilitation process, as early as 1992 ICRC and CARE began to meet Somali
veterinarians in order to discuss options for developing more sustainable veterinary services. This
activity related to ICRC's desire to initiate more long-term approaches to service delivery before their
programme ended and CARE's institutional experience in small business development. These initial
meetings indicated that support to private veterinary systems was a logical option in an environment
characterised by the absence of government and the spontaneous emergence of a whole range of
private services, including health, education, electricity, water and communications. In this situation
‘privatisation’ was something of a misnomer because there are no recognisable government services
to reform or sell off to the private sector.

While and ICRC were holding discussions with Somali veterinarians, the ActionAid Animal Health
Programme in Sanaag region was also investigating options for moving away from a subsidised
veterinary drug supply system. Two studies with traders and livestock herders supported the findings
of the ICRC/CARE workshops and in addition, many NGO veterinarians were aware of the veterinary
service reform programmes in neighbouring countries. The ActionAid studies are described further in
section 5.2. In 1993, NGOs in northern Somalia began to coordinate their activities through meetings
organised by CARE in Hargeisa and it was agreed that the provision of subsided veterinary medicines
by NGOs should cease. As early as October 1993 and with support from the British Overseas
Development Administration, ActionAid were implementing a ‘privatisation’ project aimed at the
establishment of small veterinary pharmacies to supply an existing network of CAHWs. Credit to
veterinary personnel was made available in the form of kickstarts of veterinary medicines; these
activities are discussed in more detail in section 5.2.

In early 1994 the veterinary privatisation theme was adopted by the European Union (EU) and in July
1994, an EU programme began which coordinated 12 NGOs and the German bilateral agency, GTZ
(Costagli, 1996). These organisations operated in areas not already covered by the British NGOs in
21
Sanaag and Sool regions. The common approach of agencies within the EU programme was support
to Somali veterinarians and veterinary assistants in the form of business management training and
kickstart credit packages. In the context of this paper, it is interesting to note that whereas both Oxfam
UK/Ireland and ActionAid based their work around the perceptions of community-based, indigenous
institutions and livestock owners, the EU programme focussed on veterinary personnel, particularly
veterinarians, as the main project partners.

To date, a key and lucrative role for private veterinarians in Somalia has been the certification of
livestock for export to the Gulf States. This work is based on the testing of export stock for brucellosis
and to a large extent, the private veterinary associations involved have developed in the absence of
significant support from aid agencies. All private veterinary activities in Somalia, whether related to
the export trade or sale of veterinary pharmaceuticals in-country, continue to develop in the absence
of government regulations and market forces seem to be the main determinant of service quality. A
further crucial factor concerning private veterinary services in Somalia is the role of a small but
highly influential group of businessmen in the livestock export trade and the importation of veterinary
medicines. As extremely wealthy private operators, some of these individuals are likely to be key
stakeholders in any process that affects their business interests.

Table 1
Veterinary manpower in Somalia and the Somali National Regional State (SNRS) in relation to recommended
levels

Levels recommended by: Livestock production system VLU1/veterinarian VLU/veterinary assistant

SEDES/GTZ Nomadic and sedentary 240,000 12,500

systems

FAO Traditional 30,000 not stated

Somalia – actual levels Pastoral and agropastoral 484,835 16,425

SNRS – actual levels Pastoral and agropastoral 344,000 165,385

Notes:
- 1 VLU is equivalent to 1 camel, 1 cow, 10 small ruminants or 100 fowl.
- Recommended levels cited by Baumann (1993); VLU/veterinarian for Somalia quoted as veterinarians
in the field.
- Figures for Somalia are pre-civil war data; figures from the SNRS relate to 1997.

4.2.2 South East Ethiopia

The Somali-occupied area of Ethiopia in the south and east of the country measures more than
400,000km2 of semi-arid and arid land and accounts for more than 20% of the entire country. Now
called the Somali National Regional State (SNRS), this region has a long border with Somalia and
northern Somalia/Somaliland and as can be seen in Figure 4, traditional clan boundaries transgress the
official border along its entire length. Consequently, the economy and culture of the SNRS and
Somalia are intimately related. The profound lack of development in the SNRS can be explained by
reference to conflict and political instability on both sides of the Ethiopia-Somali border (see Box 2).
Conflict has resulted in large-scale displacement of Somalis between Somalia, Ethiopia and Djibouti,

22
and the emergence of long-term refugee/returnee camps. In 1997 approximately 200,000 people were
thought to reside in camps along the Ethiopia-Somali border. In addition to the adverse affects of the
Ogaden war, the Somali civil war and ongoing clan fighting in Somalia, the SNRS also suffers due to
its geographical size and isolation, very limited infrastructure and years of political marginalisation.
Although the recent move towards regional autonomy in Ethiopia has resulted in a regional
government for the SNRS dominated by Somalis, numerous armed opposition and fundamentalist
groups continue to disrupt security in the region.

In the SNRS there were two providers of government veterinary services, the Ministry of Agriculture
(MoA) and the South East Rangelands Project (SERP). The MoA veterinary service was organised
under the Animal and Fisheries Resources Department in the Regional Bureau of Agriculture. The
veterinary activities of SERP were organised under the Animal Health and Production Section. SERP
was a joint African Development Bank (ADB)/Federal Government of Ethiopia project and began
operations in 1990. The initial project period was six years although the project was granted
numerous extensions and continues to be operational in 1999.

All levels of veterinary staff - veterinarians, animal health assistants, laboratory technicians and
animal health technicians - were working in the SNRS, mostly with the MoA and SERP. The latter
recently reduced veterinary staff numbers from 91 to 49 as part of a restructuring process. Table 1
relates veterinary manpower in the SNRS with the livestock population and compares regional data
with the situation in Somalia prior to the civil war. The use of Veterinary Livestock Units (VLU)
enables a comparison of veterinary manpower resources between regions or countries but also, with
recommended staffing levels. In common with Somalia, staffing levels were far below the
recommended levels. More information on personnel, veterinary infrastructure, budgets, activities and
drug supply in the SNRS can be found in Catley et al. (1997) but in summary, the problems facing
government veterinary services in the region were typical - lack of budget, demoralised staff, limited
infrastructure and poor management. Despite a reasonable number and distribution of government
veterinary clinics and outposts, the lack of transport for staff led to poor coverage of these facilities to
approximately 2.7% of the region (Catley et al., 1997). However, the demand for basic veterinary
services from livestock owners remains high.

In response to the problem of poor animal health services in the SNRS, in 1995 Save the Children
(UK) began working with regional government veterinarians to implement a pilot community-based
animal health project. This project is described in some detail in section 5.3 as it shows how Somali
veterinarians became very committed to the community-based approach and saw opportunities for
private veterinary pharmacies to develop links with CAHWs .

Regarding policy on animal health services in the SNRS, the overthrow of the Marxist-Leninist
Mengistu regime in Ethiopia in 1991 led to a new transitional government and the introduction of
regional autonomy. The new economic policy of the transitional government included liberalisation of
the Ethiopian economy by stimulating private entrepreneurship. In line with this policy, the Ministry
of Agriculture produced provisional criteria and regulations for private veterinary practice and drug
handling, and a veterinary drug marketing policy in 1992. Further commitment to veterinary
privatisation in Ethiopia was demonstrated by the implementation of a nationwide Pan African
Rinderpest Campaign (PARC III) project that aimed to provide training and credit to veterinarians and
veterinary assistants who wished to engage in private practice.

Up until 1997, the beneficiaries of PARC III were mainly veterinarians in highland areas of Ethiopia
near to the capital Addis Ababa. In order to introduce aspects of veterinary privatisation into the
SNRS, Save the Children (UK) began the Veterinary Services Support Project (VSSP) with the SNRS
Regional Bureau of Agriculture in 1997. The first stages of this project included a technical situation
analysis, the results of which were combined with stakeholder workshops in order to produce a
23
regional policy statement on veterinary service delivery. At the time of writing, veterinarians in the
SNRS had received training in small business proposal writing and were working on business plans as
part of their credit applications to the VSSP. The stakeholder analysis conducted by the VSSP proved
to be a useful method for involving Somalis with different agendas and needs in joint analysis of
opportunities for improving basic animal health services. The methodology and findings of the
workshop are relevant to CAHWs are summarised in section 5.3.

4.2.3 North East Kenya

In north east Kenya there has also been a marked change in the provision of veterinary services. The
state previously played a major role in the livestock sector, with support to boreholes, purchase of
livestock through the Livestock Marketing Division and provision of veterinary services, including
vaccination campaigns and supply of veterinary drugs. However, service provision focussed on
settlements rather than reaching out to pastoralists.

Since the early 1990s the government role in service provision has reduced sharply under the pressure
of structural adjustment policies. Cost sharing was introduced in water, health and veterinary services
and some staff from the relevant line ministries were released from government employment.
Attempts to establish revolving funds included efforts by District Veterinary Offices to sell drugs to
pastoralists at prices greater than cost price. Separate, private veterinary drug supplies have also
developed alongside the government supply system. Due to the long border between north east Kenya
and Somalia, and the presence of clans whose territories cross the border, drugs available in Somalia
are frequently also available in Kenya.

Regarding the use of CAHWs, information on Oxfam UK/Ireland's daryelle programme is provided in
section 5.4. Within Kenya generally, there has been much discussion on the legal status of CAHWs
and the need for appropriate policy and legislative change that would allow CAHWs to receive
official recognition. In Somali areas of Kenya, a recent review of veterinary services in arid and semi-
arid lands concluded that CAHWs should be supported and that in Garissa for example, links between
a private veterinarian, animal health assistants and CAHWs may be viable (CONSORTIUM
BCEOM/SATEC, 1998). Also working in the Somali areas of Kenya, Little (1996) advocated more
investment in community-based animal health services, as have rinderpest control workers in the same
area (Mariner and Flanagan, 1996).

5. PRIMARY ANIMAL HEALTH SERVICES IN SOMALI AREAS:

EXPERIENCES WITH COMMUNITY-BASED SYSTEMS
It is evident from earlier sections of this report that Somali pastoral areas appear to be well suited to
CAHW systems. Government veterinary services are either poorly developed or non-existent in these
areas and private veterinary facilities, when present, tend to be limited to urban centres. In towns the
clientele of the private veterinary pharmacies and shops are wealthier livestock owners, livestock
traders and people involved in the livestock export trade. As a general rule, in most pastoral areas it
can be assumed that animal health services are still very much based on traditional medicine and
access to modern drugs and appropriate advice is limited.

In common with other pastoral areas, Somali regions are characterised by their large size, harsh
climate, poor infrastructure and insecurity. In these situations, the feasibility of establishing western-
style curative veterinary services using veterinarians to actually visit and treat sick livestock is low.
There is a wealth of published material to support this view. While short-term relief projects
implemented by external agencies can operate mobile teams of professional staff, particularly for
vaccination programmes, this approach cannot be regarded as a long-term solution to the provision of
24
primary veterinary services in pastoral areas.

Within the general theme of primary animal health services and community participation, there are a
number of recent and ongoing projects in Somali areas that are highly relevant to the community-
based and privatised approach favoured by PARC-VAC. In this section, an attempt is made to outline
some of the key features of these projects and in the case of ongoing work, show that community-
based animal health systems are already a reality in areas of northern Somalia/Somaliland, Ethiopia
and northern Kenya. Furthermore, reviews of ongoing community-based animal health projects in
Somali areas have been favourable and show that participatory approaches are a viable option in
Somalia.

In the absence of effective government in Somalia/Somaliland the problem of official CAHW

regulation and quality control is of particular interest. When considering this issue it should be noted
that even in those countries with established government veterinary services, capacity to monitor and
control CAHW activities in pastoral areas is limited - reports of problems such as misuse of drugs by
CAHWs are largely anecdotal and few in number. According to the benefits offered by CAHWs and
evidence of impact, many countries are in the process of reforming policy on CAHWs and
veterinarians are beginning to realise that more flexible legislative frameworks are required.
OAU/IBAR is promoting systems that link CAHWs to private veterinarians to ensure adequate quality
control. In addition, an involved participatory approach to the development of services automatically
helps to ensure local accountability. This is an important but often overlooked aspect of CAHW
systems - when communities have a clear stake in this type of service, they monitor CAHW behaviour
and activities. News of ineffective treatments travels quickly and ultimately, if CAHWs provide a
poor service they soon become redundant. It is noticeable that in the case of southern Sudan, there is
no effective government but CAHWs supervised by community-level forums and NGOs are proving
to be highly effective (Jones et al., 1998).

In the Somali context, the current lack of government means that most services currently operate in an
unregulated private sector. However, services do exist and presumably these are subject to market
forces and local perceptions of need. At the present time, there seems to be no practical reason why
this situation should prevent the development of primary animal health services.

5.1 The Nomadic Animal Health Auxiliary (NAHA) system, Central Rangelands,
Somalia

The Nomadic Animal Health Auxiliary (NAHA) system was established as a component of GTZ’s
Central Rangelands Development Project (CRDP) in Somali between 1982 and 1989. The NAHA
system is a useful example of a primary animal health service because although it was not described
as ‘participatory’ at the time of implementation, it was probably the first CAHW-type system to be
established in a Somali area. GTZ’s experiences with the NAHA system are also very well-
documented (Baumann, 1990; Zessin et al.,1993). Unfortunately, the project was closed prematurely
in 1989 due to civil unrest.

25
Figure 5
The Central Rangelands Development
Project area in Somalia.

The decision to establish the NAHA system seems to have been influenced by two key factors. First,
a comprehensive review of government veterinary services in Somalia was conducted and this
highlighted a number of serious financial and manpower constraints which were hindering the
delivery of services to pastoralist communities (Baumann, 1993) as outlined in section 4.2.1. Second,
the veterinarians in the GTZ team had prior experience of conditions in pastoral areas and were
familiar with the barefoot vet and basic-level epidemiological surveillance systems described by other
workers, notably Halpin (1981), Schwabe, (1980;1981), Schwabe and Kuojok (1981) and Sandford
(1981). Consequently, at the onset of the NAHA system the objectives were twofold:

• Improvement of clinical services and therapeutic measures in terms of availability,

accessibility and efficiency for nomadic livestock owners in remote pastoral areas.

• Use NAHAs in an ongoing disease surveillance system to enhance veterinary services

delivery in traditional grazing areas (deegaans) by more selective and effective actions in
disease control and prevention (Baumann, 1990).

Due to longitudinal disease surveys conducted by the CRDP, the project had relatively good baseline
data on important livestock diseases in the project area. The NAHAs were expected to diagnose and
treat infectious diseases and were supplied with an initial kit comprising basic veterinary equipment
and drugs. As the government veterinary service had a long history of conducting vaccination
campaigns, the NAHAs were not expected to vaccinate livestock. The NAHAs were expected to
interview livestock owners in order to collect information on livestock disease that would feed into
the epidemiological surveillance system. Rather than being a government employee, the NAHA was
described as follows.

26
 “............. in our system, the NAHA is an independent, privately-practising,
informally-trained person of pastoral origin who is not on the payroll of any
government service nor development project. He is an auxiliary in the sense of
being a self-employed complement to official services, a person who lives a
pastoral life himself .................. “ (Baumann, 1990)

5.1.1 Entry points and selection of NAHAs

The community level entry points in the NAHA system were Range and Livestock Associations
(RLAs) in traditional grazing areas and village committees. When used, the RLAs had been
established by the extension component of the CRDP and the village committees were part of the
government administration. It was hoped that these structures would provide ‘community recognition
and cooperation’ and they were provided with criteria on how to select NAHAs (Zessin et al., 1993).
The criteria included intelligent, innovative, literate and less than 30 years of age; leaders, elders,
Koranic teachers and religious leaders were excluded as possible candidates. A quota of at least one
woman per deegaan or village was also set by the project in order to acknowledge the role of women
in caring from small ruminants.

5.1.2 Training

The training methods used in the NAHA system comprised both conventional and participatory
techniques and emphasised practical demonstration. Lectures were both informal and conversational
and language of instruction was Somali. Each training session lasted 7 to10 days and the curriculum
included basic anatomy and physiology, diagnosis and therapeutics for important diseases, ticks and
tick control, principles of preventive medicine and disease surveillance. Practical sessions included
clinical examinations, drug administration, castration methods and post mortem examination. The
training also included discussion on the revolving drug fund which was established within the CRDP
to supply the NAHAs (see section 5.1.3 below). The initial training took place in July 1986 and
involved 54 NAHA trainees, including 6 women (Baumann, 1990).

Refresher trainings for NAHAs were organised in mid 1988 and early 1989. These were 4 day courses
in which disease surveillance needs were emphasised and a written disease reporting system was
introduced.

5.1.3 Drug supply system

At the time of the CRDP the supply of veterinary medicines in Somalia was monopolised by the
Ministry of Livestock, Forestry and Range. Therefore, the CRDP established a revolving fund system
for the procurement and re-supply of drugs to the NAHAs. This system was dependent upon existing
government structures for drug procurement and government regulations required the project to
designate village committee chairmen or similar individuals as responsible for overseeing the drugs
used by the NAHAs and revenue collected. Drugs were sold at cost price plus a small mark-up for
transport and wastage. Details of incentives for NAHAs were not available.

5.1.4 Monitoring

Follow-up of CAHW activities took the form of regular bi-monthly visits by project staff to interview
NAHAs and collect information on disease incidence and economics, local knowledge of diseases and
treatment and other factors. NAHA records were also inspected in order to check drug usage and the
NAHA’s equipment was inspected.
27
5.1.5 Evidence of impact and efficiency

In terms of assessing the impact and sustainability of the NAHA system, various measures can be
used. For example, the number of workers remaining in a system is an indication of local demand for
the service and levels of incentive for NAHAs. In the GTZ project 53 trainees completed the original
training course in July 1986 and at the beginning of 1989, 47 NAHAs were still active (89% of the
original NAHAs). This is a strong indication that NAHAs were supported locally and received
sufficient income from their activities to continue working with the project. Another measure of
NAHA impact can be obtained from records of number of treatments by disease (Table 2).

Table 2
Examples of NAHA activity in two districts of the Central Rangelands, Somalia, 1987 and 1988

Drug Quantity Value Treatments per NAHA

(SomSh)
total per day

1987
Trypanocide (camel and cattle doses) 7320 doses 717,950 236 0.8
Oxytetracycline (sheep and goat doses) 1560 bottles 372,000 2515 6.9
Anthelmintic (sheep and goat doses) 8000 doses 63,360 645 1.8
1988
Trypanocide (camel and cattle doses) 2100 doses 168,000 68 0.4
Oxytetracycline (sheep and goat doses) 1560 bottles 58,800 451 2.5
Anthelmintic (sheep and goat doses) 17000 doses 302,600 1436 7.9

exchange rate: 1 USD = 100 SomSh

(source: Baumann, 1993).

These figures show that in the two districts in question, NAHAs were very active in treating stock for
diseases such as trypanosomiasis, contagious caprine pleuropneumonia (CCPP; treated with
oxytetracycline) and helminthiasis. The presence of these diseases had been confirmed in longitudinal
surveys and hence there was technical data to show that these problems were indeed local priorities.
In addition to treatments, NAHAs castrated 8829 animals between February 1987 and November
1988 and this work was considered to an important income-generating activity for them.

Regarding the value of NAHAs for disease diagnosis and surveillance, the most detailed disease
surveillance data collected from NAHAs related to a respiratory disease in small ruminants called
sambab, which was thought to be CCPP. The project was able to compare NAHA reports with
serological survey results and concluded that the two sets of data were not statistically independent.
Consequently, it was suggested that NAHAs could be a useful means of CCPP surveillance in the
Somali rangelands (Baumann, 1990). Readers are advised to consult GTZ reports and Dr.Baumann=s
MPVM thesis for more details of information collected by NAHAs on CCPP, abortions, contagious
ecthyma, footrot and foot and mouth disease.

5.1.6 Conclusions

From the numerous reports and publications that were produced by the CRDP, it is evident that the

28
NAHA system provides many useful lessons for the future development of primary animal health
services in Somalia. Not least, the project demonstrated that with adequate supplies of veterinary
medicines it was possible for basic level Somali veterinary workers to provide a valuable service to
pastoralists and contribute towards a disease reporting system. GTZ recognised that aspects of the
system needed improvement and for example, questioned procedures for NAHA selection and the
effectiveness of community-level forums that were part of the government administration (Baumann,
1990). Considering the Somali government’s attitude towards indigenous institutions during this
period, it may have been extremely difficult for the project to identify entry points into communities
which had not evolved via the government system. Despite these problems, GTZ concluded that
"trainee selection is community based and one integral task of the village committees and
associations is to monitor the performance of their NAHA" (Baumann, 1993). This is an important
statement as it reflects both local ownership and control of the NAHA system. In addition, as
livestock owners were willing to pay in kind or in cash for the services, the financial sustainability of
the system looked promising.

A major determinant of the success of the NAHA system appeared to be drug supply and it was
evident that the project staff considered liberalisation to be the logical step forward. In a climate of
veterinary service reform and privatisation in Africa, it was felt that NAHAs "suggest a practical and
sustainable level for veterinary privatisation under African pastoralist conditions" (Baumann, 1990).
These sentiments have much in common with the community-based and privatised approach
currently being advocated by OAU/IBAR in pastoral areas.

5.2 The ActionAid-Somaliland Animal Health Programme, Sanaag Region

The British NGO ActionAid has been supporting an animal health programme in Sanaag Region,
northern Somalia/Somaliland since 1992. ActionAid had been involved in developing participatory
approaches for many years and prior to the Somali civil war, had long experience of working with
Somali communities in both the north and south of the country. The Sanaag animal health programme
is of particular relevance to this review because after the civil war it was one of the first initiatives to
train CAHWs and link them to private sources of veterinary medicines. As this system evolved more
than four years ago and was still operational at the time the writing, it represents an important
example of a community-based animal health system which continues to function in a Somali area
with minimal external support.

Even considering conditions in other Somali areas, Sanaag is a very isolated and poorly developed
region; it covers around 60,000 km2 and has no tarmac roads or telecommunications. During the civil
war, virtually all government buildings were destroyed, and records and equipment looted. In 1991 an
assessment team from ActionAid and another British NGO called VetAid visited Sanaag in order to
identify local priorities for relief and rehabilitation work and assess the feasibility of ActionAid
becoming operational in the region (Hunter, 1991). This initial assessment identified poor animal
health and water constraints as the two most important problems in the region and recommended
interventions in these two sectors.

The ActionAid Animal Health Programme (AHP) began in May 1992 with funding from the British
Overseas Development Administration and aimed to improve food security in Sanaag by establishing
a primary animal health care service based on a network of CAHWs9. The CAHW approach was
considered to be appropriate because of the relative isolation of the region, it's very poor
infrastructure, and the absence of Somali veterinarians (although some veterinary assistants with two

9
The animal health workers in the AHP were actually called Primary Veterinary Assistants (PVAs) but this term is
synonymous with community animal health worker.

29
years formal training were present in the region). Also, it was thought that a CAHW system would
utilise local knowledge of livestock ailments and would suit the pastoral production systems that were
in use in the area (Catley, 1996). In order to design and implement the AHP, an expatriate veterinarian
was recruited whose experience included the development of community-based animal health services
with the Intermediate Technology Development Group in India. Consequently, this individual was
familiar with participatory approaches in pastoral areas.

5.2.1 Entry points and selection of CAHWs

At this time, no formal government structures existed in Sanaag. The local community was
represented by the quurti, a traditional council of elders representing the lineages of the various clans
in the region. During the feasibility study, ActionAid worked directly with the quurti and the structure
of this institution and other aspects of social organisation in the region are described by Ahmed Yusuf
Farah (1993). One of the main functions of the quurti was to ensure that people in Sanaag were aware
of the AHP and understood that the programme was operating through the authority of the elders. The
quurti also assumed responsibility for the selection of CAHWs. It should be noted that during the
early stages of the AHP , Sanaag was a highly insecure region and there was considerable pressure on
the programme to demonstrate to the Sanaag community that it could provide useful assistance.
Hence, negotiations which might have been more prolonged in other situations were conducted
according to time and security constraints. As the AHP developed, a sub-group of nine elders was
selected by the quurti to work with the programme. This group of elders, called the NGO Committee
were selected by the quurti to act as a link between the local community in Sanaag and ActionAid on
a more or less daily basis.

5.2.2 Programme design

The AHP was based on a network of 30 CAHWs who were trained and linked to ex-Ministry of
Livestock, Forestry and Range (MoLFR) veterinary staff and facilities. The three district veterinary
department buildings in the region were rehabilitated and four ex-MoLFR veterinary assistants and
other personnel were encouraged to form new 'District Veterinary Departments'. These departments
received a monthly grant of $450 from the AHP and the veterinary assistants were trained as trainers
of CAHWs. This training was based on participative training techniques.

The initial feasibility study conducted by ActionAid/VetAid in Sanaag indicated that herders
considered the most important livestock health problems to be helminthiasis and tick-associated health
problems, and therefore the AHP was based on the control of worms and ticks. The programme also
trained CAHWs to treat trypanosomiasis in camels and use antibiotic for a range of bacterial and other
diseases. In order to understand local perceptions and descriptions of other livestock ailments, the
AHP formulated a 'pastoralists' dictionary' for livestock diseases and causal agents and documented
the use of indigenous disease control strategies and plant remedies (Catley and Mohammed, 1995;
1996). The distribution of medicines to the CAHWs and monitoring their work was the responsibility
of the district veterinary departments. Monitoring took the form of monthly reports by the CAHWs
which detailed their activities and revenue collected from drug sales. ActionAid supplied drugs to the
district veterinary departments but from the onset of the AHP, livestock owners had to pay for
veterinary drugs and the cost of each item was agreed in meetings with the NGO Committee. At this
early stage of the programme, the plan was to create a 'reserve fund' from the revenue gained from
drug sales but also to support the CAHWs by allowing them to retain a proportion (70%) of the
money collected. The NGO Committee was responsible for the collection and maintenance of money
in the reserve fund.

30
Figure 6
Training of CAHWs in the ActionAid
Animal Health Programme, 1993

In order to improve knowledge among herders about correct drug usage, ‘drug information leaflets’
were designed for distribution via the CAHWs to livestock keepers. The leaflets were written in
Somali but contained minimal text and were illustrated with simple line diagrams. Although levels of
herder literacy were unknown, the behaviour of pastoralists in the programme area indicated that if
they were unable to read themselves, they would find someone who could read and explain the leaflet
to them. Although it proved to be extremely difficult to collect regular reports from all CAHWs, those
reports that were received gave an indication of the activities being carried out. Table 3 summarises
treatments administered by a single CAHW in Ragas, Erigavo district in a five-month period between
May and September, 1993.

Table 3
Example of CAHW activities, Erigavo district, May to September 1993

Drug Disease Number sheep/goat Number camel

treatments treatments
total per month total per
month

Anthelmintic helminthiasis (caal) 2746 549.2 32 6.4

Acaricide tick infestation (shilin) 3280 656.0 77 15.4
Trypanocide trypanosomiasis (gendhi) na na 87 17.4
Oxytetracycline miscellaneous infectious diseases 151 30.2 39 7.8

na = not applicable

5.2.3 Programme review, 1993: discussions with herders and traders

Six months into the AHP a security incident in Erigavo forced the temporary withdrawal of expatriate
staff and prompted a review of the programme. At this time it became apparent that the programme
had not been able to monitor the CAHWs effectively. The basic recording and accounting system set
up by ActionAid did not run smoothly and written agreements between the programme and the district
veterinary departments were not honoured. Although these agreements detailed the responsibility of
the departments to collect monthly reports from the CAHWs and provide ActionAid with accounts, in
practice they were meaningless because of the lack of accountability of the department staff. For
example, when a veterinary assistant absconded with one month's supply of medicines, neither the
NGO Committee or ActionAid was able to recover the loss because the individual concerned was
31
supported by his clan. Furthermore, the retention of drugs in the AHP stores provoked threats of
security incidents against the programme. In this situation, the AHP had to either ignore the
irregularities which occurred or withdraw from the area.

Hence, by December 1992 a number of important questions arose regarding the future of the project
(Hadrill, 1992). For example,

How effective was the CAHW system in terms of making a basic diagnostic and curative
service available to herders?

Was the AHP addressing the most important livestock diseases?

Could herders afford to buy the medicines being offered by the CAHWs? How did herders
value veterinary services?

How sustainable was the AHP considering the relatively low cost recovery for veterinary
medicines achieved by the present system? What were the alternatives, if any, to modern
veterinary drugs?

In an attempt to answer the above questions an assessment was conducted in some of the main grazing
areas of Sanaag. During the design of the assessment, programme staff were aware that up to that
point in time they had been very reliant on the views of elders in the quurti and later, the NGO
Committee. While information obtained from these sources had been essential in establishing the
AHP it was felt that the views of more pastoralists should be sought and therefore, a way of accessing
and defining groups of pastoralists was needed. In this respect, the dia paying groups were identified
as a possible entry points and their traditional home areas were mapped out.

In each assessment area, participatory methods were used to collect information on social
organisation, systems boundaries, seasonal livestock movements and natural resource management,
and understand issues such as important livestock diseases, people’s access to veterinary services,
their knowledge of the AHP and their willingness to pay for services. Secondary data collection
included a review of literature on livestock diseases and more general pastoral development issues in
northern Somalia/Somaliland. At this preparatory stage of the assessment it was noted that veterinary
drugs had been sold in northern Somalia since the 1950s or before when colonial veterinary services
began selling trypanocides in response to high demand from herders (Mares, 1954b). There were also
more recent records of herders in Bay region, Somalia, buying veterinary drugs (Al-Najim, 1991). In
addition to this information, it was evident that even in remote areas people were accustomed to
paying for private services such as education and water. The traditional pastoral education system in
Somali areas was based on payment of livestock to Koranic teachers and in some areas, water was
purchased from privately owned birkads or other sources. Hence, the concept of payment for a service
was not new in pastoral areas.

In addition to the participatory assessment with herders (Ahmed Aden and Catley, 1993a; 1993b), the
AHP also commissioned a study on private trade in veterinary medicines in Sanaag and Somaliland
and interviewed livestock traders and businessmen (Omer Edleh, 1993). The combined findings from
the herder and trader assessments were as follows:

• The large demand for basic veterinary services in Sanaag was not met by the existing AHP.
The number of CAHWs and the quantities of medicines supplied to each CAHW were
insufficient.

32
 • When evaluating the cost-recovery system for veterinary medicines used by the AHP it was
evident that the sale price of veterinary drugs was between 42% and 89% of the actual cost
(including freight and insurance) depending on the item. However, despite these sale prices,
which had been negotiated with the NGO Committee, fieldwork with herders indicated that
they were willing to pay the full price of veterinary medicines. For example, the sale of 1
sheep to buy medicine to treat a sick camel was often stated as a fair price for the medicine.
One herder explained that this was similar a local remedy which involved the slaughter of a
goat to make broth for a sick camel.

• For some areas visited, CAHW activities were localised around villages. In these areas,
herders claimed to be unaware of the CAHWs' activities; representation of herders by urban-
based elders was considered to be poor.

• Other CAHWs were found to be working effectively and were much appreciated by their
communities. Usually, these CAHWs kept their own animals and travelled on the range.

• Those herders who did not have access to a CAHW produced clear and logical criteria for
selecting someone for training. These criteria included honesty, ability to read and write, good
livestock knowledge, well known and respected, strong and able to walk long distances and
good tempered.

These findings indicated that the AHP should either move rapidly towards a full cost recovery system
for veterinary medicines or aim to replace ActionAid with private traders as the main supplier of
veterinary drugs. The final decision over which of these options to choose was heavily influenced by
two factors.

First, the new district veterinary departments supported by the AHP were unable to manage
themselves effectively and their staff were involved with the programme for personal gain only.
Reporting and accountability were inadequate, and most of the money collected from the sale of
veterinary drugs and intended for the reserve fund had disappeared. Although written agreements
existed between the AHP and the veterinary departments, neither ActionAid nor the NGO Committee
were able to recover the lost funds. Furthermore, as the AHP lacked capacity to manage rather than
simply advise the district veterinary departments the involvement of these departments in the project
seemed to be increasingly untenable. One of the departments was actually disbanded by the quurti in
early 1994.

Second, no qualified Somali veterinarians were resident in Sanaag at the time of this work. Elsewhere
in Somaliland, ICRC and CARE had organised workshops with local veterinarians and veterinary
assistants to discuss the development of animal health services following the completion of the ICRC
emergency programme. In particular, these meetings focussed on the potential for 'privatisation' of
veterinary services in Somaliland and the establishment of private veterinary practices. This approach
was supported by the National Charter of the new Somaliland Government that advocated
privatisation of services.

5.2.4 Support to private veterinary pharmacies

Considering the AHP's own assessments, the results of the ICRC/CARE workshops and the attitude of
the Somaliland Government, the best option available to the AHP was to encourage the establishment
of private outlets for veterinary medicines in Sanaag and link the CAHWs to these outlets. Between
December 1993 and January 1994 the initial stages of the 'privatisation' plan for veterinary services in
Sanaag were implemented. Individuals or groups who were interested in this aspect of the AHP had to

33
be supported by the NGO Committee and the following assistance was provided:

• The one-time sale of veterinary drugs by ActionAid to veterinary assistants/traders at cost

price to act as a 'kick start'.

• Assistance with communication between traders and veterinary pharmaceutical suppliers

overseas by use of facsimile and e-mail facilities at the ActionAid office.

• To provide information on the quality, quantity, and types of medicines required, and training
in the correct storage and use of medicines.

By mid-1994, six veterinary pharmacies with 13 sub-agencies had opened in the region with
assistance from the AHP (Hunter, 1994). Four of the pharmacy managers were ex-veterinary
department employees, one was a CAHW who had also been selling drugs during the civil war and
one was a veterinary undergraduate whose training had been interrupted by the war. In late 1994, a
participatory review of the AHP included before-and-after measures of the uptake of services offered
by CAHWs and veterinary pharmacies since the onset of the programme. This indicated very high
uptake of the new, private services and reduced use of indigenous veterinary practices (Table 4).

Table 4
Summated scores of herders' treatment strategies ‘before’ and ‘after’ the ActionAid Animal Health Programme

Indigenous veterinary practice Animal health service introduced

by the programme
Indigenous Religious CAHWs Private veterinary
medicine healing pharmacies
Location
before/after before/after before/after before/after

Yube 130/82 76/44 0/248 0/248

Jidali 1 (male informants) 123/82 83/47 0/233 0/233
Jidali 1 (female informants) 118/81 ns ns ns
Jidali 2 156/131 ns ns 65/175

Notes: The numbers in the table show the results of numerous scoring exercises which required informants in
three areas (Yube, Jidali 1 and Jidali 2) to score treatment strategies for different diseases from 0 to 10 ‘before’
and ‘after’ the AHP. The scores have been summated by the author for the sake of brevity and show trends
rather than precise quantities. Readers are advised to consult the original ActionAid report (ActionAid, 1994) for
more detailed information. ns = not scored.

5.2.5 Conclusions

When discussing community-based animal health in Sanaag region it should be noted that no effective
national or local government existed in Somaliland from the onset of the AHP in 1992 until the time
of writing. Local traditional institutions such as the quurti in Sanaag were not accustomed to working
with NGOs and considerable time was invested in developing a good working relationship with the
quurti and NGO Committee. The resources available to the AHP, both in terms of trained staff and
materials were limited considering the size of the target area (cf. the NAHA system). Despite these
difficulties, ActionAid has been able to work with community-based institutions to develop a basic

34
veterinary service involving small private pharmacies linked to CAHWs. Although this system has
received minimal external technical support in the last three years, it demonstrates that as predicted by
GTZ veterinarians in the 1980s, a combined private and community-based approach is feasible in
remote Somali areas.

One of the problems predicted with the AHP was the lack of formal regulation of the importation and
use of veterinary medicines and the absence of trained veterinarians in Sanaag. To some extent this
concern was offset by the knowledge that news of medicines that were not effective or had been
diluted by pharmacies before sale would travel quickly across the range. Also, herders were aware of
the advantages of purchasing good quality products in sealed containers and they were suspicious of
unlabelled products or broken packaging.

The 1993 assessment with herders and traders showed that both of these stakeholder groups supported
'privatisation' of clinical veterinary services. Even herders with relatively small herds of around 40
sheep and goats seemed ready to purchase medicines at higher prices than those proposed by the
elders. In Sanaag, herders recognised the cost-benefit of curative treatment of livestock diseases and
their main problem was one of availability of veterinary services rather than cost. The approach of the
AHP was supported in discussions with Somali traders and the National Charter of the Somaliland
government.

Due to the long-term presence of ActionAid-Somaliland in Sanaag, it is likely that their staff and
community-level partners have much to contribute toward debate on the development of appropriate
veterinary services in pastoral areas. In the last few years there have been few technical reports
available from the programme although an assessment by a veterinarian was being prepared at the
time of writing this review.

5.3 Community-based animal health in the Somali National Regional State,

Ethiopia: Experiences of working with government

Background information on the Somali National Regional State (SNRS) in Ethiopia and the work of
the British NGO Save the Children UK (SCF) is provided in section 4.2.2. Among NGOs, SCF has a
distinctive approach that was characterised by working through government and support to the public
sector, particularly in human health and education. This section summarises SCF’s experiences of
developing community-based animal health systems with regional government in the SNRS since
1995.

The first point to note is that despite it's limited organisational knowledge of veterinary services, SCF
had been aware of the importance of animal health in Somali communities for many years. During the
Ogaden crisis in 1991, SCF staff were repeatedly told by villagers, "If you can bring nothing else for
us and our children, at least bring us medicines for our animals". At a time of drought and refugee
influx, it was concluded that emergency provision of veterinary medicines, even for sale, was feasible
(Holt and Lawrence, 1991). In participatory needs assessments conducted by SCF since 1991,
livestock disease continued to be a major problem expressed by rural communities in the SNRS.

5.3.1 Project overview

SCF's community-based animal health work in the SNRS was implemented in partnership with the
South East Rangelands Project (SERP) within the Regional Bureau of the Ministry of Agriculture.
SERP was a large, integrated rural development project funded by the African Development Bank and
Ethiopian government. Within SERP, an Animal Health and Production Section was responsible for
delivering veterinary services in much of the SNRS and for the purposes of this review, it can be
regarded as the government veterinary service in the region at that time. Two important features of the
35
Animal Health and Production Section were the employment of a large number of Somali
veterinarians, some of whom were refugees from Somalia, and a dependency on a revolving fund
system for the supply of veterinary drugs to the project. The revolving fund was based on Ethiopian
government procurement and accounting procedures.

The SCF/SERP community-based animal health project aimed to expose government veterinarians to
alternative approaches to service delivery and test a small-scale CAHW system. At the start of the
project, it was known that veterinary drug supply was likely to be a major determinant of project
success and there were concerns that the revolving fund system within SERP would not be able to
provide drugs to CAHWs on reliable basis. Consequently, SCF also provided technical advice to
SERP on the management of the revolving fund and contributed a substantial supply of veterinary
drugs.

Initially, the SCF/SERP project focussed on developing SERP's capacity to train and manage a
network of CAHWs. SERP veterinarians were exposed to CAHW projects in northern Kenya via
study tours and workshops organised with NGOs (primarily ITDG, Oxfam and FARM) and they were
trained in participatory rural appraisal and new approaches to project design. Materials were
developed for CAHWs training courses and two SERP veterinarians received training in participative
training techniques at a specialist centre in Kenya. The CAHW training was designed to focus on
problems such as worms, ticks and trypanosomiasis. These aspects of the project were funded and
managed by SCF and progressed smoothly.

Figure 7
Fieldwork during a PRA training course for
veterinary staff in the Somali region of Ethiopia

Figure 8
Use of participatory appraisal methods by
veterinarians in the Somali region of Ethiopia -
local prioritisation of animal health problems
using livestock disease scoring.

36
The initial training inputs in the project included discussion on appropriate methods for selecting
CAHWs and through visits to other projects, veterinary staff were aware of the need for careful
selection of CAHWs via community-based forums. However, this approach received very little
support from senior management within SERP and therefore resources such as transport and per
diems for veterinary staff were not forthcoming. In part, this problem was due to regular staff changes
at the senior management level in both SERP generally and the Animal Health and Production
Section, amounting to five changes over an 18 month period. Hence, although project veterinarians
were committed to testing a community-based approach, this enthusiasm was not shared by their
superiors.

These problems were overcome by using SCF resources to transport government veterinary staff to
the field but by this stage, there was an overriding need to select CAHWs as quickly as possible due
to donor pressure to deliver quantifiable outputs. Consequently, the selection process involved a
variety of local government staff, elders or even the veterinarians themselves according to location.
Very little effort was made to involve indigenous institutions or encourage CAHW selection through
some form of local consensus.

In 1996 three CAHW training courses were organised in different locations of the SNRS. The training
methodology was similar to that used by other projects and comprised practical demonstration and
learning combined with participative techniques such as brainstorming and role plays (Catley, 1995).
Group sizes varied from 4 trainees using a single trainer to 25 trainees using 2 trainers.

Training materials included illustrated handouts in the Somali language and cloth flip charts.
Following training, CAHWs were equipped with basic equipment such as syringes, needles, Burdizzo
castrator, sterilising pan, notebook and pens.

Figure 9
CAHW training in Fik, Somali
National Regional State,
Ethiopia - use of brainstorming
as a training tool.

37
5.3.2 The problem of veterinary drug supply and monitoring

In common with many other projects, incentives for CAHWs were designed as a surcharge on the sale
of veterinary drugs. However, as early as 1995 SCF recognised that the key constraint facing the
government veterinary service in the region was the dramatic failure of the revolving fund coupled
with limited options for developing the system on a sustainable basis. Cost recovery within the system
was running at around 20% or less and in meetings with SERP project management the following
problems were acknowledged:

• the absence of a clear strategy for setting prices for veterinary medicines;
• bureaucratic procurement procedures;
• devaluation of local currency;
• limited capacity within SERP to manage the revolving fund;
• failure to develop a long-term perspective;
• limited understanding of how livestock owners valued the service;
• users were not well-informed about the correct prices of the drugs.

In addition, the low salaries of SERP project staff, a thriving local black market in veterinary drugs
and the considerable distances between SERP's central office and rural veterinary clinics were all
factors which encouraged abuse of the revolving fund system (Save the Children, 1996). The poor
drug supply to CAHWs created frustration as CAHWs were constantly refused access to drugs or
drugs were not available.

By December 1996 and according to reports received from the CAHWs it was estimated that only 27
out of the 45 CAHWs trained were still working. Crucially however, a small number of CAHWs were
able to obtain drugs through unofficial relationships with government veterinary staff (who had their
own ‘private’ sources) and records from these CAHWs showed that they were very active in treating
livestock. For example, one CAHW in an area called Arabi treated 2618 sheep and goats, and 92
camels in one month, and sold drugs to the value of Eth.birr 1344.58 (USD 207.00) during this period
(Save the Children, 1996). In effect, these links between government veterinarians and CAHWs were
an indication that a fully private system might be feasible if the drug supply could be liberalised.
Veterinary staff, although employed by the government, were already using CAHWs to distribute
drugs. Other CAHWs were travelling long distances by public transport to buy drugs. In some cases
these journeys took them outside the SNRS to search for private pharmacies in major towns such as
Harar and Dire Dawa. This was seen as another indication that some of the more dynamic CAHWs
realised that a market for their services existed and they were willing to invest time and money to
access veterinary drugs.

5.3.3 The use of stakeholder analysis

The experiences of the SCF/SERP project led to the development of the Veterinary Services Support
Project (VSSP) which aimed to link CAHWs to private veterinary clinics and pharmacies (see section
5.2.2). The VSSP was in progress at the time of writing but in terms of the scope of this review, some
of the early project activities are of interest because they involved joint analysis of animal health
services by veterinary professionals, livestock keepers, traders and other stakeholders. This
stakeholder analysis involved two workshops with livestock owners, community elders, religious
leaders, women, traditional livestock healers, private veterinary drug traders, livestock traders and
government veterinary personnel. The workshops were opened in a traditional manner using a well-
known Somali poet to introduce the theme of the workshop and describe the various options for
treating sick livestock that were available at that time. Workshop participants were divided into
groups to discuss topics such as:
38
 The main benefits and diseases of livestock
The role of women in animal health care and options for treating sick livestock
The role of traditional medicine verses modern medicine for treating livestock diseases
Livestock disease, veterinary services and livestock trade as perceived by livestock traders
Strengths and weaknesses of the existing veterinary services
Ability and willingness to pay for veterinary services
Opportunities for improvement and risks

During the discussions, participatory appraisal tools such as proportional piling, ranking and scoring
were used to identify and prioritise issues, problems and solutions. For example, ranking was used to
understand how different stakeholder groups were treating their animals (Box 6).

Representatives from each stakeholder group then presented the findings of their discussion to the rest
of the workshop participants and the whole workshop voted on key issues and ideas for improving
veterinary services. When discussing the role of external players such as aid agencies in the
development of services it was evident that although veterinary privatisation programmes have tended
to offer credit to Somali veterinarians, there were well-established traditional credit systems in Somali
society which were considered to be effective. These systems are outlined in Figure 10.

Some of the other interesting findings arising from this process were:

There were already private sources of veterinary drugs in the region but these outlets were
unlicenced and restricted to urban centres. Drugs in these outlets probably originated from
two main sources - suppliers in Somalia and northern Somalia/Somaliland, and government
veterinary stores.

In pastoral areas, although people used traditional practices they recognised that modern
drugs were more effective for some diseases. They were ready to pay for these drugs and
accepted the rational for CAHWs to act as a supplier of drugs and information.

Government policy and employment regulations were perceived to be important constraints to

private veterinary activities.

Figure 10
Sources of credit for Somali veterinarians in Jijiga (left) and Fik (right) zones, and their relative
importance (source: Save the Children, 1997)

NGOs NGOs
bank
bank
friends

friends

relatives

relatives

39
Notes for Figure 10:
Some features of the traditional loan system involving relatives and friends were:
- according to Islamic law, all loans were interest-free;
- the loan recipient usually required guarantors such as respected elders or wealthy business
people.
- in the event of failure to repay the loan a committee of elders would be formed to investigate
the problem. In some cases, the repayment period would be extended and in others the
relatives or guarantors of the debtor would repay the loan. Sometimes the debtor would be
taken to court. In the case of non-repayment, the guarantors will repay the cost in around 90%
of cases.
- The size of the loan depended on the wealth and willingness of the creditor, though
approximate sums of 5,000 to 10,000 birr per creditor were mentioned (Eth.birr 6.2 = 1 USD).
A borrower might approach several creditors simultaneously, thereby increasing the size of
the loan by up to five times or more.

Table 5
Understanding how different stakeholders treat sick livestock

Options for treating Ranking of options by stakeholder groups

livestock

Women Livestock herders and Livestock traders

traditional healers

Zone 1 Zone 2 Zone 1 Zone 2 Zone 1 Zone 2

Koranic prayers 1st 1st 1st 1st nm nm

Traditional medicine 3rd 2nd 2nd 2nd 2nd nm
Private drug sellers 2nd 3rd 4th 4th 1st 1st
Government service nm nm 3rd 3rd 3rd 2nd

(source: Save the Children, 1997)

Notes:
The table shows how different stakeholder groups were treating their animals. Each group was asked
to explain what they did when their animals became sick. These options were than ranked in order of
importance.
- nm = not mentioned or ranked by informants
- Traditional methods include plant-based medicines, cautery, and soups/broths

The stakeholder analysis approach was useful because each stakeholder group was able to voice their
opinions and needs. More powerful stakeholders such as government veterinarians had to discuss the
weaknesses of the existing veterinary service with different end-users and work with them to identify
a way forward. The stakeholder approach also helped to ensure that less powerful groups were not
misrepresented. The results of the stakeholder workshop were combined with a technical assessment
of veterinary services in the region in order to advice the regional government on appropriate policy.
40
This resulted in a government sanctioned policy statement supporting the development of private
clinical veterinary services.

5.3.4 Conclusions

SCF's experiences showed how weak government partners could undermine the development of
community-based animal health services. Although Somali veterinary professionals became
committed to the CAHW approach, inappropriate government control of veterinary drugs meant that
the sustainability of CAHWs depended on their personal ties to veterinary staff. To a certain extent,
the project was also an example of how substantial material inputs (veterinary drugs) by an aid agency
can be misused by senior government staff when the government structure itself suffers from poor
accountability.

As the VSSP evolved, Somali veterinarians received training in small business proposal writing and
during the formulation of business plans many of them included CAHWs in the business. This was an
indication that some positive lessons had been learnt from their experiences with CAHWs and they
realised the potential for CAHWs to distribute medicines to remote areas.

The stakeholder analysis approach proved to be a useful melting pot for opinions and ideas from
different service providers and users. In the Somali context, it was particularly useful to place
veterinarians, pastoralists and other key stakeholders face to face and enable them to identify common
ground for the improvement of animal health services.

5.4 The Oxfam UK/I Wajir Pastoralist Development Project, Kenya: Evidence of
economic impact in a CAHW system

Oxfam UK/Ireland has been working in Wajir District, north east Kenya since 1994. During the first
ten years their work was based on emergency and relief inputs in response to major droughts in 1984
and 1991-92. In 1992, Oxfam developed the Wajir Pastoralist Development Project (WPDP) as part
of a nine year development strategy and the first phase of this project began in 1994. According to the
findings of participatory assessments and planning, the WPDP included improvement of animal
health, human health and water services through local institutional development. The project was
funded by the Department for International Development (UK) and Comic Relief (Oxfam (UK/I). For
the purpose of this review, information on Oxfam UK/I’s work in northern Kenya was obtained from
a mid-term assessment report (Oxfam (UK/I) Kenya, 1996) and an economic impact assessment
(Holden 1997a) only. Therefore, the notes that follow focus on the impact of a combined community-
based animal and human health system which developed over a three year period from 1994 to 1997.
The community-level workers involved in this system were called daryelles.

The focus of Oxfam UK/I’s work in Wajir was the development of pastoral associations (PAs) which
worked on behalf of communities in the project area. The pastoral associations were supported by a
pastoral steering committee which included NGO staff and district veterinary staff. For the delivery of
basic animal health care, an important role of the PA was to manage veterinary drug supply to
daryelles via revolving fund systems10. The main source of drugs for the PAs appears to have been the
District Veterinary Officer. Rather than discuss the pros and cons of this arrangement and the
daryelles’ dependency on drugs channelled through a government employee and the PAs, it was
evident that livestock owners were using the daryelles and buying veterinary drugs. An assessment of
the daryelle system produced a number of interesting findings:
10
The revolving fund approach via local associations was also being used by the Arid Lands Resource
Management Project (ALRMP) in Wajir. The associations in the ALRMP were called user associations and the
project was implemented by the Government of Kenya with World Bank funding.
41
 Of the 87 daryelles who were originally trained, 60 were still working in 1997. Between them
these workers treated approximately 35,000 animals per year in the project area. “The
improvement in drug supply and information on their correct use was commonly cited by
pastoralists as an important factor explaining improvements in the quality of their life and
their better capacity to withstand the future effects of drought” (Holden, 1997a).

Comparison of project and non-project areas indicated lower livestock mortality in project
sites, as detailed in Table 6. This reduced loss of livestock was valued at KSh. 22,853
(approximately USD350) for each household in the project area and this sum was sufficient to
buy grain to feed 2 adults and 4 children for 250 days. This finding was used to support
pastoralists’ claims that due the project had improved their wellbeing.

For CAHW systems in Africa, the impact assessment summarised above is a rare example of a
systematic study of benefits offered by CAHWs in pastoral areas. Although the study was conducted
in a post-drought situation and livestock mortalities were higher than in ‘normal’ years, the findings
indicate that CAHWs can deliver a useful service to Somali herding communities.

Table 6
Herd mortality rates reported by 200 households in project and non project-sites during the previous
year, Wajir Pastoral Development Project

Project sites Non-project sites

Mortality rate Annual loss Mortality rate Annual loss
(%) (number of animals) (%) (number of animals)
Camels 20 21,520 31 33,325
Cattle 17 10,836 32 20,398
Sheep and 18 3,571 25 5,057
goats
Total 35,927 58,780

(source: Holden, 1997a).

Note:
The high mortality in both project and non-project sites was related to severe drought in the previous
year.

6. DISCUSSION
This review has attempted to outline some of the main contextual issues affecting the development of
community-based systems in Somalia and by reference to actual or recent experiences with CAHWs,
summarises some of the main lessons learned.

Regarding existing conditions which favour the development of community-based animal health
services in Somalia/Somaliland, the review indicates that the pastoral economy (micro- and macro-
levels, section 2.1), types of social organisation (section 2.2) and presence of well-developed
indigenous technical knowledge (section 4.1) are all factors which are amenable to the community-
based approach. Somali communities have been managing and sustaining their own traditional
42
services for many years and the continuing presence of these services shows that effective,
community-based structures are already functioning (section 3.0). There are now many examples of
the use of basic level workers to deliver services to remote pastoral communities in Somalia,
including experiences from primary human health and animal health systems (sections 3.0 and 5.0).
This approach appears to be highly appropriate in areas with large systems boundaries, poor
infrastructure and communications, and relatively small but mobile human populations. It has also
been argued that in the absence of government in Somalia, there seems to be little option for long-
term development other than to support participatory, community-based approaches (Ford et al.,
1994).

Looking more closely at primary animal health systems, basic level workers have been a feature of
veterinary services in Somali areas since colonial times. The overriding trend since that period has
been the development of systems that shift responsibility for sustaining and monitoring this type of
worker from the government to the community. Whereas the vetscouts in the days of the Somaliland
Protectorate were government salaried (Peck, 1962), GTZ's Nomadic Animal Health Auxiliaries were
private operators albeit, dependent on a government-managed drug supply system (Baumann, 1990).
More recently, the CAHWs in the Somali region of Ethiopia were also relying on drugs that often
originated from government sources but due to the low performance and sustainability of this
approach, veterinarians were planning to link CAHWs to private pharmacies (Save the Children,
1996; 1997). The trend towards community-based and private animal health systems in Somali areas
is most evident in projects in Somaliland (ActionAid-Somaliland, 1994) and northern Kenya (Holden,
1997a). The ActionAid project in Sanaag Region was able to begin linking CAHWs to private
veterinary pharmacies in early 1994 and this system continues to operate with minimal external
assistance. In Wajir, CAHWs are associated with membership organisations and function as private
providers of animal and human health care. In most of these projects, there is evidence to show that
CAHWs not only treat large numbers of livestock but they can also act as effective reporters of
disease outbreaks.

When these experiences are viewed in the context of veterinary service reform in Africa generally and
the lack of effective government in Somalia/Somaliland, it is evident that the provision of primary
animal health care by the public sector in Somalia is not a viable option. In those countries
neighbouring Somalia/Somaliland, veterinary privatisation is a reality and the public sector is
gradually being re-orientated towards a focus on policy and legislative functions, and control of
diseases of major economic importance.

6.1 Willingness and ability to pay

As part of the ongoing debate on veterinary privatisation in pastoral areas, a number of key issues are
relevant to the Somali situation. First, there has been much discussion on the willingness of
pastoralists to pay for basic veterinary services. The lesson from Somali areas is that herders have
been paying for veterinary medicines for years and when approached in the correct manner, have few
difficulties in relating the cost of treatment to benefits gained. In areas where services are not
available, there are numerous accounts of herders' willingness to pay for veterinary drugs (Box 7).

Like most pastoralists, and indeed livestock owners everywhere, Somalis will try to negotiate a good
deal and veterinarians should not be misled by calls for free or subsidised drugs. An important finding
of this review was that in Sanaag Region, private veterinary pharmacies linked to CAHWs developed
within a year of the cessation of a subsidised drug supply system via an aid agency.

Part of the debate on payment for services has been concern that only wealthier herders buy veterinary
drugs. To the author's knowledge, there have been no reports of differential use of CAHWs in Somali
areas according to wealth. However, it is likely that when veterinary drugs are in short supply,
43
CAHWs will face pressure from elders and more powerful community members to treat their animals
first. This issue was discussed at some length in stakeholder workshops on animal health in the
Somali region of Ethiopia and the workshop participants made reference to local definitions of wealth
and poverty (Table 7) and traditional systems for supporting poorer herders.

Box 7
Will Somali herders pay for veterinary medicines?

“Whenever the disease called dhukaan (trypanosomiasis) is recognised the Somali now
wants treatment with Antrypol or Antrycide and he will drive his animal long distances
and pay good money to get it” (Mares, 1954b).

“Treatment for endo- and ecto-parasites was given without cost from 1970 to 1976 for
demonstration purposes. After 1976 it became necessary to charge pastoralists for such
treatments in order to cover the operational costs of drug importation. Informal
discussions with the local people of Bay Region in 1994 showed that the livestock owners
were in fact willing to pay for the drugs they needed, but that the drugs were frequently
unavailable from the local veterinary services” (Al-Najim, 1991).

“The tremendous demand for services helped Nomadic Animal Health Auxiliaries to
generate income and brought them into contact with large numbers of herds. Livestock
owners were willing to pay in kind or cash for the services” (Zessin et al, 1993).

"Establishing veterinary pharmacies in livestock markets would provide drugs

commercially and could also give technical advice. Nomads did not demand free hand-outs
but wanted the availability of supplies and services" (Nathanail and Hussein S.Nur, 1993).

"In Sanaag Region in 1993, the sale of one sheep to buy medicine to treat a sick camel was
often cited as a fair price for the medicine. One herder explained that this was equivalent
to a local remedy which involved the slaughter of a goat to make a broth for a sick camel.
Even herders with relatively small herds of around 40 sheep and goats seemed ready to
purchase medicines at much higher prices than those proposed by the elders when the
project began" (Catley, 1996).

"In Arabi and Kebribeyeh meetings were held with community elders in order to discuss
the activities of the paravets, problems faced by the paravets and opportunities for
improving the system. In both sites the paravets were thought to be working well but were
constrained by limited supplies of drugs and a large coverage area. Although drugs were
sold with a mark-up on top of the cost price, there were no complaints about the cost of the
drugs" (Save the Children, 1997).

44
Table 7
Some Somali definitions of wealth and poverty

Wealth category Livestock holdings

Sheep and Cattle Camels
goats

Rich (malqabeen, a person who can donate livestock) >100 >80 >100
Medium (danyar, a person who is self-sufficient) 60-90 15-30 20-35
Low (sabool, a needy person) <50 <10 <15
Lowest (barlaawe, a person who asks others for help) <10 <5 <10

(source: Save the Children, 1997).

When discussing the lowest wealth group barlaawe, the following ‘fair’ prices for medicines were
suggested: Eth.birr 5-10 to treat a camel; Eth.birr 5 to treat a cow; Eth.birr 1 to treat a sheep or goat
(exchange rate: Eth.birr 6.5 to 1 USD). The workshop also revealed some traditional systems that
were used to assist less wealthy people, such as alms-giving, loans and gifts of livestock and
commodities between relatives. It was suggested that these systems would also be used to obtain
drugs and that the relative benefit of treating sick livestock increased as livestock holdings decreased.
Regardless of numbers of animal owned, herders were ready to buy veterinary drugs and the value or
fair price of drugs for specific diseases could be calculated.

This information supports earlier descriptions of wealth groups among Somali pastoralists (Haroon
Yusuf, 1992) and indicates that the social support mechanisms outlined in this review (section 3.0)
would be used to assist poorer herders to access a service, should it become available. In addition to
this information, within Somali pastoral society clan wealth is partly determined by livestock holdings
and therefore there are clan-based reasons for ensuring that livestock owned by clan members are
maintained in good health. Also, one of the lowest wealth definitions in Somali areas is cayd - a
person who has lost all their livestock and lives as a destitute herder in a town. Consequently, even
those herders with relatively few animals are not considered to be the ‘poorest of the poor’.

6.2 The behaviour of animal health care seekers

Within much of the literature on primary animal health services in pastoral areas there is a tendency to
regard livestock owners within a particular community as homogenous mass who all decide to use one
type of service in preference to another. In reality, livestock owners make choices and as individuals,
select whether to use traditional methods, seek modern drugs or advice, or even do nothing at all when
animals become sick. The preferred method is also influenced by access to and cost of the different
options available, and previous experience. In addition, different methods may be tried one after the
other until a result is achieved. When all these factors are considered in relation to mixed herds
comprising species of different values, uses and ownership, and a range of diseases affecting single or
multiple species, it is evident that the process of selecting one animal health care option over another
is far from simple.

In common with many pastoral communities, Somali herders tend to have a great deal of confidence
in their own ability to recognise different livestock diseases. Consequently, it seems likely that within
community-based systems in Somalia, the CAHW will be used mainly as a source of veterinary drugs
and advice on the correct use of the drugs. In this situation, it might be argued that herders could go
45
directly to veterinary pharmacies and perhaps obtain the drugs at a lower price i.e. without the CAHW
surcharge. The first point to note when discussing this issue is that private veterinary pharmacies and
drug shops already exist in urban centres in Somalia/Somaliland and yet, it seems that few pastoralists
from remote areas are using these outlets to acquire veterinary drugs. There are at least four possible
reasons for this situation:

Herders in remote areas are not aware that veterinary drugs are available in the towns. This
seems unlikely considering the indigenous information networks that exist in Somali areas.

Herders are unfamiliar with modern veterinary services and are unaware that drugs are
effective. This also seems unlikely considering the presence of veterinary services in Somali
areas, albeit of limited coverage, for more than eighty years and herders’ access to news from
the outside world via radio and relatives living overseas.

The distance to the pharmacy/store is too great and does not warrant a long journey; this
problem is compounded if drug supplies in the pharmacy/store are unreliable and there is a
risk that the required medicine might not be available.

Herders do not trust urban-based traders or veterinarians; they prefer to buy drugs from
someone they know personally and who has proven knowledge of animal health matters.

In relation to this last point, when describing human health care seeking in Somalia, Helander (1990)
noted that personal relations between service users and providers was an essential element of primary
health services.

“Few people are prepared to visit a herbalist they had no previous knowledge of,
nor would they consult with a sheikh unless they regarded him as “their” particular
sheikh. The emphasis put on personal knowledge of medical practitioners is
understandable from the perspective of how social relations work in every-day life.

Few people among the Hubeer11 enter into any kind of exchange or communication
with people they do not know. This is one of the reasons why ambulatory health
services will not be the solution to the Somali nomad’s health care. Strangers who
drop down for a few days in the grazing lands will not appear particularly
approachable, unless they are preceded by favourable rumours” (Helander, 1990).

In animal health, the attitude of Somali pastoralists towards town-dwelling veterinarians and drug
merchants was reflected in the work of the poet Mohamud Tukaale Osman. When describing a herder
who is considering his options for treating a sick camel, Tukaale wrote,

What can the vet doctor do?

My place is remote and the doctor is townfolk,
Who has never even crossed the valley from his home,
I'm sure he'll become tired. Will I carry him on my shoulder?
The doctor is pampered townfolk, he never rides the camel,
And he knows not the rural area, nor distinguishes a lion from a bull!
Supposes he assumes the camel a beast? Or gets confused, yelping "Help"!

And the merchant, he loves money and strives to make profit,

11 A sub-clan of the Rahanweyn, southern Somalia.

46
An opportunistic foe, he shows no mercy for the rural people,
And of the modern drugs, I know not the expiry dates,
how to mix the injection, or even read the label.
I am completely ignorant of it!
For the powdered medicine to be mixed with the water,
The merchant may defraud me, and wrongly wrap for me in a paper,
The poison for hyenas and beasts.
If I pour this into the water, and the animals drink,
They may swell and stagger,
And all will be killed.
This is like suicide, I will be ruined and poor.
Leave this idea, don't mention it again
(source: Save the Children, 1997)

One important advantage of community-based animal health systems is an element of local ownership
and the use of CAHWs who people know and respect. Although not all livestock keepers in a
particular community will use the CAHW at all times for all problems, the presence of the CAHW
provides people with an extra option for animal health care and overcomes constraints such as
distance to a service and mistrust of the service provider. Herders in Sanaag Region recognised the
rationale for a single worker, selected by and responsible to them, to travel to a pharmacy on their
behalf. In some cases, the CAHW would walk for three days in each direction in order to collect drugs
and submit a report on his activities (Catley, 1994). Herders realised that the alternative to this system
was for each of them to travel a vast distance every time their animals needed treatment and
traditional medicine had not been effective.

Rather than discuss at length the whole range of constraints and solutions for improved animal health
care, it can be noted that the participatory approach allows communities to identify and analyse
options for themselves. Pastoralists can decide which type of service best suits their needs and in
community-based systems, they have a major stake in influencing the design of a service and
sustaining it. When combined with stakeholder analysis, all key players in a system can agree to
develop services in such a manner that each benefits from the new system.

6.3 Misuse of drugs, quality control and community-level influences

Another important issue in CAHW systems is quality control and concerns that CAHWs might sell
adulterated drugs, underdose, or encourage over-use of drugs. It has been argued therefore, that
CAHWs should only operate where they can be supervised by veterinarians. While this level of
supervision is desirable in an ideal world, many CAHW systems have been implemented with very
little monitoring by public or private sector veterinary professionals.

When CAHW systems involve a high level of community participation, the CAHW is responsible
first and foremost to the community. The latter usually select someone for training who they know
well and respect, and the CAHWs are dependent on the community to use their services and provide
an income. In this system, some fundamental rules apply. Pastoralists are usually very pragmatic and
use a service if it has value and discard it if it fails to provide benefits. While many veterinarians still
consider nomadic herders to be ignorant in animal health matters, there is a substantial literature on
indigenous veterinary knowledge to show that pastoralists are very capable of monitoring the health
of their animals. Medicines that fail to work are no longer used and failed treatments by CAHWs soon
become a topic of discussion within communities. There are examples of herders in the Somali region
of Ethiopia demanding oxytetracycline which was manufactured in Europe rather than in other
countries (Catley et al., 1997) and in the Ogaden, elders were resorting to traditional methods of tick
control after realising that acaricide procured via the black market was not always effective
47
(Abdullahi Hirad, 1994).

Once drugs are known to be useful, pastoralists also seem to make logical decisions regarding the best
time to use drugs. Baumann (1993) noted how herders developed their own strategic deworming
methods and Löhr (1997) described the use of veterinary medicines after the rains and in response to
poor performance of livestock as ‘remarkably rational’. Consequently, there is evidence to indicate
that either alone or with advice from CAHWs, pastoralists can make rational decisions about the
efficacy and use of veterinary drugs.

In common with many NGO projects, the PARC-VAC methodology for establishing CAHW systems
includes post-training community dialogue sessions and refresher training for CAHWs. Both these
activities are important for checking that the CAHWs are working properly. The post-training
dialogue enables initial problems to be resolved and the refresher training is an opportunity to
reinforce earlier learning on the correct use of drugs and provide information on new products which
have appeared on the market. Regarding the need for public sector recognition and supervision of
community-based animal health systems to ensure quality of service, even in those countries with
well-established government veterinary services there is limited capacity to monitor CAHWs in
pastoral areas. To the author's knowledge, eastern African countries have yet to develop procedures
for the systematic documentation and collation of reports that detail problems with CAHW projects.

6.4 Experience and attitudes among veterinary personnel

During the last ten years or so veterinary professionals in much of eastern Africa have been exposed
to veterinary service reform programmes implemented in partnership with government. Very
gradually, attitudes towards private services and community-based approaches in countries such as
Kenya, Tanzania, Sudan, Uganda and Ethiopia have changed and although much work remains to be
done, at least these issues are being discussed within official bodies and private services are
developing with government approval. External agencies are able to work with professional
associations, government departments and private operators who have official recognition and in
general, veterinarians are aware of the policy changes that are being considered.

Just before the civil war in Somalia it is likely that veterinarians were in a similar position to those in
neighbouring countries. However, the absence of government and civil disorder has created a highly
fragmented veterinary profession with no official representation or methods of certification and self-
regulation. In this situation a number of self-motivated veterinarians tried to establish private
businesses and those who succeeded probably possessed an entrepreneurial spirit and were able to
function in Somalia’s political, clan-based and insecure environment. Other veterinarians are known
to be unemployed and it is likely that within this group there are individuals who still crave for a
government salary and the resurrection of the public sector in Somalia12. Although veterinarians have
been exposed to veterinary privatisation programmes, there have been relatively few initiatives to
introduce community-based approaches into the privatisation process. NGO reports indicate that
livestock owners have little confidence in veterinarians whose professional experience does not
include working directly with livestock owners or their animals. Other Somali veterinarians have
sought employment in Ethiopia, Kenya and the Gulf States or are living in countries such as the
United Kingdom, Italy, Scandinavia, Canada and the United States of America.

In summary, knowledge of participatory community-based animal health services among Somali

veterinarians is probably limited to a small number of people who have worked with NGOs such as

12 A third and important group of ‘veterinarians’ are people who have no veterinary qualification or in the absence of
regulated certification, have promoted themselves from vaccinators to veterinary assistants to veterinarians. Inevitably,
qualification documents have been lost.
48
Oxfam UK/Ireland and ActionAid. These professionals are likely to be a useful source of advice for
PARC-VAC. However, a key constraint facing the development of CAHW systems in Somalia is
likely to be the attitude of Somali and expatriate veterinarians who have no practical experience of the
approach and believe that CAHWs will undermine their own economic and professional status. While
critics of CAHW systems identify problems such as quality control and financial sustainability, these
issues have not been studied or documented in a systematic manner. Consequently, much of the
debate concerning the non-viability of community-based approaches to animal health care is
characterised by hearsay and technocracy. This review presents information from a number of
veterinary projects in Somali areas that shows that CAHWs are already operating successfully in
some areas and that these projects are demonstrating social and economic impact. In view of this
evidence, experiences from other pastoral areas of the Horn of Africa and OAU/IBAR’s growing
institutional knowledge of community participation, it is evident that investments in CAHW systems
are warranted. Successful alternative models to the community-based approach to veterinary service
delivery in pastoral areas are notable by their absence.

6.5 The basic privatised and community-based system

A basic system for linking private veterinary pharmacies to CAHWs is shown in Figure 11. Some of
the key aspects of the system are that the veterinary pharmacy is managed by a veterinarian(s) who
provides the appropriate technical input and advice to the pharmacy users and CAHWs. In the vicinity
of the pharmacy, clients include livestock traders and those livestock owners who are within travelling
distance. More remote livestock owners access veterinary medicines and advice on the correct use of
the medicines via CAHWs who have been selected by the communities in question. During the initial
stages of setting up this type of system it is usually beneficial for the veterinarian to be involved in the
community dialogue, the training of CAHWs and perhaps the supply of the start-up kit of drugs and
equipment to the CAHW. Hence, both the community of livestock keepers and the private
veterinarian begin to develop a working relationship. All these processes can be facilitated by external
agencies such as PARC-VAC or NGOs.

This system should be viewed as a first step in improving the delivery of a basic clinical veterinary
service to more remote communities. Sustainability is dependent on sufficient numbers of livestock
keepers using the CAHWs and a reliable supply of good quality drugs to the CAHWs from the
pharmacies. To a large extent, incentives for CAHWs can be defined by the communities and
veterinarians involved, and other than ensuring that incentives are a feature of the system they need
not be a concern of the project. As explained in section 6.2, not all livestock keepers will choose to
use the CAHWs but the aim of the system is to improve choice and accessibility of service rather
generally than provide a panacea service to satisfy all potential users at all times.

49
Figure 11
Linking community-based animal health workers to veterinary pharmacies

Urban areas
Veterinary drug importer

Livestock
traders
Veterinarypharmacy
Veterinary pharmacy

Direct sales Direct sales

Community
Community Community
Community

Service via
CAHWs

Service via
CAHWs CAHW
CAHW

Community
CAHW
CAHW
CAHW
Community
Community
Remote areas Community

7. RECOMMENDATIONS FOR IMPLEMENTATION OF

COMMUNITY-BASED ANIMAL HEALTH SYSTEMS IN SOMALIA
The PARC-VAC project within OAU/IBAR is considering if and how to implement community-
based animal health projects in Somalia. PARC-VAC’s recent experience includes support to CAHW
systems in pastoral areas of southern Sudan, northern Kenya and north-east Uganda and typically, the
project works through local partners such as NGOs, government veterinary staff or private
veterinarians. This approach allows PARC-VAC to utilise a relatively small team of in-house staff
who offer technical support to implementing partners in the field. When PARC-VAC implements
directly, it tends to use local veterinarians with long-term experience of both the communities in the
project area and community-based approaches.

In Somalia a number of conditions favouring the development of community-based animal health

systems have been summarised above. In particular, Somali pastoralists prioritise animal health and
will pay for veterinary medicines when these products are available. Somali communities can organise
themselves very effectively and tend to use democratic decision-making forums to solve problems or
respond to development opportunities. The concept of basic-level workers is not new in many areas
and there is useful ongoing experience to draw on in the form of NGO projects in
Somaliland/northern Somalia and northern Kenya. In addition, the EU veterinary programme in
Somalia has raised awareness of privatisation among veterinarians and promoted the development of
private veterinary pharmacies and clinics. Consequently, there seems to be an opportunity to link
50
private practitioners to CAHWs in order to expand basic clinical services to rural areas and improve
the financial viability of the private pharmacies. Such an initiative could utilise PARC-VAC
experience and build-on previous EU investments.

In terms of actual implementation of projects in Somalia, PARC-VAC will need to consider the
following points:

Identification of local partners.

In the author's view, the most useful local partners for the implementation of community-
based animal health systems in Somalia are:
- private veterinarians and associated traders who have already taken the initiative to
establish associations, pharmacies or clinics, and who might view CAHWs as a
mechanism for expanding their businesses into pastoral areas. Somali veterinarians in
Ethiopia realised this potential during stakeholder workshops.
- indigenous or international NGOs with long-term experience of working in Somali
areas and institutional commitment to participatory, community-based approaches.
The former have the benefit of financial sustainability while the latter are better able to work
with communities to design appropriate services.

Inclusion of key stakeholders

In addition to working with livestock keepers and veterinarians, PARC-VAC will also need to
ensure that stakeholders such as influential Somali traders, elders and military leaders are
consulted when establishing projects. In some cases, a business person who is already
supplying drugs to veterinarians might be willing to invest in CAHW systems if PARC-VAC
can provide technical support. Methods such as stakeholder analysis that bring different
interest groups together might be usefully applied in Somalia. Exclusion of key stakeholders
will increase the risk of security incidents aimed at the project.

Experience of Somali veterinarians in private and community-based animal health systems.

There are probably few Somali veterinarians who have experience in community-based
approaches and those that do possess relevant skills are likely to be employed by NGOs
already. Therefore, PARC-VAC will need to invest in training in participatory methods and
on-the-job support to professionals working in the field.

Sharing resource inputs

As a general rule, PARC-VAC should limit it's inputs to training, technical advice,
monitoring, coordination, and possibly vaccine supply. Material inputs for clinical animal
health services such as equipment and drugs should be avoided as ideally, these should be
provided by Somali veterinarians and traders in partnership with community-level forums. At
no time should PARC-VAC consider subsidising veterinary drugs or using free drugs for
demonstration purposes.

Roles of CAHWs in vaccination

In most of the CAHW projects discussed in the review, CAHWs were not used to vaccinate
livestock. However, given the successful use of CAHWs in rinderpest control in other areas,
particularly southern Sudan, there seems to be no reason why Somali CAHWs could not
handle heat-stable rinderpest vaccine under similar arrangements to those in other countries.

Filling an information gap

Radio is a very popular form of communication in Somalia. Human health messages have
been disseminated by radio in the past and there is considerable scope to use radio to channel
animal health messages to pastoral communities in remote areas. Messages could be specific
51
 information (e.g. how to read expiry dates on medicines) or might be more general
information that is incorporated into song, drama or poetry (e.g. the problem of credit from
CAHWs). At some stage, PARC-VAC should investigate options for veterinary radio
messages in Somalia and draw on resources such as the BBC Somali Service and research
which has already been conducted (Hadrill, 1993).

Scope of operations and time scales

It is notable that the positive experiences of CAHW systems outlined in this review are all
associated with NGOs who have long-term experience of participatory development in
Somali areas. ActionAid, Save the Children UK and Oxfam UK/Ireland have been learning
how to work with Somali communities since 1983, 1973 and 1984 respectively, with
intermittent breaks during major conflict. They also employ local staff who are Somalis. In
view of PARC-VAC's limited experience in Somalia, a small-scale pilot approach over a 3
year period is probably appropriate.

A role for ‘government’ in Somalia/Somaliland

Ideally, CAHW systems should be linked to official veterinary services for certification,
quality control and disease surveillance. In a climate of veterinary service reform in the Horn
of Africa, PARC-VAC will need to consider how future public sector services in
Somalia/Somaliland might develop and the roles that they might usefully fulfil. In this
respect, the trend towards a regulatory, epidemiology and epidemic disease control function
which is evident in other countries should be promoted in Somalia/Somaliland.

A useful staring point for the implementation of community-based animal health in Somalia would be
a either a seminar to bring together livestock workers and NGO staff with experience in Somali areas
or a brief study tour of projects for PARC-VAC staff e.g. visits to ActionAid-Somaliland in Sanaag
Region, SCF in Ethiopia and Oxfam UK/Ireland in Wajir District, Kenya.

52
REFERENCES
Abdullahi, A.M. (1993). Economic evaluation of pastoral production systems in Africa: An analysis of pastoral farming
households in central Somalia. In: Pastoral Production in Central Somalia. M.P.O. Baumann, J. Janzen and H.J. Schwartz
(eds). Deutsche Gesellschaft für Technische Zusammenarbeit (GTZ) GmbH, Eschborn.

Abdullahi Hirad (1994). Indigenous knowledge of ticks in the Ogaden. South East Rangelands Project, PO Box 32, Jijiga,
Ethiopia.

ActionAid (1994). ActionAid Somaliland Programme Review/Evaluation October 1994. ActionAid, Hamlyn House,
MacDonald Road, Archway, London N19 5PG, United Kingdom.

Ahmed Aden and Catley, A. (1993a). Report on a visit to Ceeryan, Goof and Durdur. ActionAid-Somaliland Animal Health
Programme, ActionAid, Hamlyn House, MacDonald Road, Archway, London N19 5PG, United Kingdom.

Ahmed Aden and Catley, A. (1993b). Report on a visit to Jidali, Kulmiye, Midhisho and Hamas. ActionAid-Somaliland
Animal Health Programme, ActionAid, Hamlyn House, MacDonald Road, Archway, London N19 5PG, United Kingdom.

Ahmed Yusuf Farah (1993). Somalia: The Roots of Reconciliation. ActionAid, London.

Al-Najim, M.N. (1991). Changes in the species composition of pastoral herds in the Bay region of Somalia. Pastoral
Development Network Paper 31b, Overseas Development Institute, London.

Andrzejewski, B.W. and Lewis, I.M. (1964). Somali Poetry: An Introduction. Clarendon Press, Oxford.

Baumann, M.P.O. (1990). The Nomadic Animal Health System (NAHA-System) in Pastoral Areas of Central Somalia and
it’s Usefulness in Epidemiological Surveillance. MPVM Thesis, University of California.

Baumann, M.P.O. (1993). Animal health services in Somalia: Can centralised structures meet demand in the field? In:
Pastoral Production in Central Somalia. M.P.O. Baumann, J. Janzen and H.J. Schwartz (eds). Deutsche Gesellschaft für
Technische Zusammenarbeit (GTZ) GmbH, Eschborn.

Bentley, C. (1989). Primary health care in north west Somalia: a case study. Social Science and Medicine, 28 no.10, 1019-
1030.

Bradbury, M. (1993). Development in Conflict: Experiences of ActionAid in Somalia. A report for the Responding to
Conflict Unit and ActionAid. ActionAid, London.

Catley, A. (1994). The ActionAid-Somaliland Animal Health Programme, Sanaag Region: Annual Report, 1993-1994.
VetAid, Midlothian.

Catley, A. (1995). Paravet Training Course - Phase I. Save the Children (UK), Jijiga Programme. Save the Children (UK),
Ethiopia.

Catley, A. (1996). Pastoralists, Paravets and Privatisation: Experiences in the Sanaag region of Somaliland. Pastoral
Development Network Paper 39d, Overseas Development Institute, London.

Catley, A. and Mohammed, A.A. (1995). Ethnoveterinary knowledge in Sanaag region, Somaliland (Part I): Notes on local
descriptions of livestock diseases and parasites. Nomadic Peoples, 36/37, 3-16.

Catley,A.P. and Ahmed Aden (1996). Use of participatory rural appraisal (PRA) tools for investigating tick ecology and
tick-borne disease in Somaliland. Tropical Animal Health and Production, 28, 91-98.

Catley, A. and Mohammed, A.A. (1996). Ethnoveterinary knowledge in Sanaag region, Somaliland (Part II): Notes on local
methods of treating and preventing livestock disease. Nomadic Peoples, 39, 135-146.

Catley, A.P. and Mohammed, A.A. (1996b). The use of livestock-disease scoring by a primary animal health programme in
Somaliland. Preventive Veterinary Medicine, 23(3), 175-186.

Catley, A.P., Kuchar, P., Kidar, M.M., Abdihakim, A.M. and Abdirazak, A.A. (1996). Veterinary Uses of Plants in Region
5, Ethiopia: Extracts from the "PALQU" database of the Range Monitoring and Evaluation Unit, South East Rangelands

53
Project. South East Rangelands Project, PO Box 29, Jijiga, Ethiopia.

Catley, A., Mohammed Sheik Said, Mohammed Ali Farah, Ahmed Sheik Mohammed and Ismail M. Handule (1997).
Veterinary Services in the Somali National Regional State, Ethiopia. A Situation Analysis. Save the Children (UK)-
Regional Bureau of Agriculture Veterinary Services Support Project, Somali National Regional State. SCF(UK), PO Box
7165, Addis Ababa, Ethiopia.

Catley, A. and Walker, R. (1998). Somali ethnoveterinary medicine and private animal health services: Can old and new
systems work together? Proceedings of the International Conference on Ethnoveterinary Medicine, Research and
Development. Pune, India, 4th-6th November, 1997. BAIF, Pune.

Catley, A., McCauley, H.M and Delaney, P.D. (1998). Community-based Animal Health Services in the Greater Horn of
Africa: An Assessment for USAID - Office of Foreign Disaster Assistance in cooperation with the USDA - Famine
Mitigation Activity. April - May 1998. OFDA/USAID, Washington D.C.

CONSORTIUM BCEOM/SATEC (1998). Improved Delivery of Animal Health Services in Kenya. Draft report. Ministry of
Agriculture, Livestock Development and Marketing, Republic of Kenya.

Department of Livestock Production/Oxfam UK&I (1996). Pastoralists Under Pressure: The Effects of the Growth in Water
Sources and Settlements on Nomadic Pastoralism in Wajir District. Oxfam UK&I, PO Box 40680, Nairobi, Kenya.

Edelsten, R.M. (1995). Livestock Diseases in the Northern Regions of Somalia. A Report of the British Veterinary Team,
1969-1972. 1994 Condensed Version. VetAid, Midlothian.

Elmi, A.A. (1989). Camel husbandry and management by Ceeldheer pastoralists in central Somalia. Pastoral Development
Network Paper no.27d. Overseas Development Institute, London.

Elmi, A.S. (1980). Present state of knowledge and research on the plants used in traditional medicine in Somalia. Journal of
Ethnopharmacology, 1, 23-27.

Ford,R., Hussein Adam, Adan Yusuf Abubaker, Ahmed Farah and Osman Hirad Barre (1994). PRA with Somali
Pastoralists: Building Community Institutions for Africa's Twenty-First Century. Program for International Development,
Clark University.

Geshekter, C.L. (1993). Somali Maritime History and Regional Sub-cultures: A Neglected Theme of the Somali Crisis.
Paper presented at the First Conference of the European Association of Somali Studies, School of Oriental and African
Studies, University of London.

Gorham, A.B. (1978). The Design and Management of Pastoral Development: The Provision of Education in Pastoral Areas.
Pastoral Development Network Paper, 6b. Overseas Development Institute, London.

Hadrill, D. (1992). Report on the Sanaag Animal Health Programme. VetAid, Midlothian.

Hadrill, D. (1993). Veterinary radio messages for Somalia/land, Ethiopia, and Eritrea. BBC World Service Education
Project, London.

Hadrill, D. and Haroon Yusuf (1994). Mapping of seasonal migrations in the Sanaag region of Somaliland.
RRA Notes, 20, 106-112.

Halpin, B. (1981). Vets - Barefoot and Otherwise. Pastoral Development Network Paper 11c, Overseas Development
Institute, London.

Haroon Yusuf (1992). Definitions of wealth and poverty in Somali herding society. ActionAid-Somaliland, Djibouti.

Hassan Mohammed Ali (1997). Pastoralism and Sedenterisation in Waqoyi and Galbeed Region, Somaliland. A report for
Oxfam. VetAid, Midlothian.

Helander, B. (1990). Getting the most out of it: nomadic health care seeking and the state in southern Somalia. Nomadic
Peoples, 25/27, 122-132.

Holden, S., Ashley, S. and Bazeley, P. (1996). Improving the Delivery of Animal Health Services in Developing Countries.
A Literature Review. Livestock in Development, PO Box 20, Crewkerne, Somerset, UK.

54
Holden, S. (1997a). Wajir Pastoral Development Project. Notes for the final report on an assessment of economic impact.
Livestock in Development, Crewkerne, Somerset, UK.

Holden, S. (1997b). Community-based Animal Health Workers in Kenya: An Example of Private Delivery of Animal
Health Services to Small-Scale Farmers in Marginal Areas. DFID Policy Research Programme R6120CA. DFID and IT
Kenya, Nairobi.

Holt, J. and Lawrence, M. (1991). An End to Isolation: The Report of the Ogaden Needs Assessment Study 1991. Save the
Children UK, 17 Grove Lane, London SE5 8RD, United Kingdom.

Hunter, A. (1991). Collaborative ActionAid and VetAid programme for Sanaag Region, Somaliland. Phase I VetAid Report.
VetAid, Midlothian.

Hunter, A. (1994). Visit Report. ActionAid Animal Health Programme, Sanaag Region, Somaliland. VetAid, Midlothian.

Hunt, J.A. (1951). A General Survey of the Somaliland Protectorate 1944-1950. Crown Agents, London.

Inglis, A. (1997). Innovative participatory methodologies for environmental interventions at community level. IUCN Somali
Natural Resources Management Programme, Nairobi.

Jama Suguule and Walker, R. (1997). Changing Pastoralism in the Somali National Regional State (Draft Report). South
East Rangelands Project/United Nations Development Programme Emergencies Unit for Ethiopia. UNDP-EUE, PO Box
5580, Addis Ababa, Ethiopia.

Janzen, J. (1986). Economic relations between Somalia and Saudia Arabia: Livestock exports, labor migration and the
consequences for Somalia's development. Northeast African Studies, vol.8, no.2-3, 41-51.

Janzen, J. (1993). Mobile Livestock Keeping in Somalia: General Situation and Prospects of a Way of Life Undergoing
Fundamental Change. In: Pastoral Production in Central Somalia. M.P.O.Baumann, J.Janzen and H.J.Schwartz (eds).
Deutsche Gesellschaft für Technische Zusammenarbeit (GTZ) GmbH, Eschborn.

Jones, B.A., Deemer, B., Leyland, T.J., Mogga, W. and Stem, E. (1998). Community-based Animal Health Services in
Southern Sudan; the experience and the future. Keynote paper presented to the Association of Institutes for Tropical
Veterinary Medicine conference, Harare 1998.

Lewis, I.M. (1961). A Pastoral Democracy. Oxford University Press, Oxford.

Lewis, I.M. (1994). Of Blood and Bone: The Call of Kinship in Somali Society. The Red Sea Press, New Jersey.

Lewis, I.M. (1995). The Uncentralised Somali Legacy. In: A Study of Decentralised Political Structures for Somalia: A
menu of options. London School of Economics and Political Science, EU Somali Unit, Nairobi.

Leyland,T. (1997). Delivery of Animal Health Services to Pastoralists Areas: The Case for a Community-Based and
Privatised Approach. Paper presented at the 5th OAU Ministers of Livestock Meeting, Swaziland. PARC-VAC Project,
OAU/IBAR/PARC, PO Box 30786, Nairobi, Kenya.

Little, P.D. (1996). Cross-border trade and food security in the Kenya/Somali borderlands. A report for the Office of Foreign
Disaster Assistance, USAID. University of Kentucky.

Löhr, K.F. (1997). Private clinical veterinary services in Somalia. Unpublished contribution to the FAO electronic
conference on Rational Delivery of Veterinary Services in Africa, FAO, Rome.

Mares,R.G. (1951). A Note on the Somali Method of Vaccination Against Bovine Pleuropneumonia. Veterinary Record, 63
no.9, 166.

Mares,R.G. (1954a). Animal Husbandry, Animal Industry and Animal Disease in the Somaliland Protectorate, Part I. British
Veterinary Journal, 110:411-423.

Mares,R.G. (1954b). Animal Husbandry, Animal Industry and Animal Disease in the Somaliland Protectorate, Part II.
British Veterinary Journal 110, 470-481.

55
Mariner, J.C., Akabwai, D., Leyland, T.J., Lefevre, P.C. and Masiga, N.W. (1994). Strategy for the Eradication of
Rinderpest from Africa with Thermostable Vero Cell-adapted Rinderpest Vaccine. Proceedings of the International
Symposium on Morbillivirus Infections. Hannover Veterinary School, Germany, 12-13 June 1994.

Mariner, J.C. and Flanagan, F. (1996). Epidemiological Intelligence on the Incidence of Rinderpest in Somalia and North
Eastern Kenya. Food and Agriculture Organisation, Rome.

Marx,W. and Wiegand,D. (1987). Limits of traditional veterinary medicine in Somalia - The example of chlamydiosis and
Q-fever. Animal Research and Development, 26, 29-34.

Mekonnen, G. (1994). Camel Milk Records. South East Rangelands Project, Jijiga, Ethiopia.

Mohamed,H.A. and Hussein,A.N. (1996). Pastoralists: Their Knowledge Untapped. Journal of Camel Practice and Research,
vol.3, no.2, 143-146.

Nathanail,L. and Hussein Samater Nur (1993). First Steps to Recovery (Part 2): Urban Surveys in Somaliland. Save the
Children Fund (UK), Hargeisa.

Nur,H.M. (1984). Some reproductive aspects and breeding patterns of the Somali camel (Camelus dromedarius). In:
Mohammed Ali Hussein (ed.). Camel Pastoralism in Somalia. Proceedings of a workshop held in Baydhoba, April 8-13,
1984. Camel Forum Working Paper No.7.

OAU/IBAR/PARC (1996). PARC Annual Report 1996. OAU/IBAR/PARC. Nairobi.

OAU/IBAR/PARC (1997). PARC Annual Report 1997. OAU/IBAR/PARC. Nairobi.

Omer Idleh (1993). A survey of trade in veterinary medicines in Somaliland. ActionAid-Somaliland Animal Health
Programme. ActionAid, Djibouti.

Oxfam (UK/I) Kenya (1996). Wajir Pastoral Development Project Mid-Term Review March 1996, Final report. Oxfam
(UK/I) Kenya, Nairobi.

Pearson,E. (1996). A review of the impact of civil strife on pastoralist education in Somalia. Gedo Region case study. Save
the Children (UK), London.

Peck, E.F. (1962). The Somaliland Protectorate 1924-1960. In : G.P. West (ed.), A History of the Overseas Veterinary
Services, Part Two. British Veterinary Association, London.

Peck,E.F. (1939). Salt intake in relation to cutaneous necrosis and arthritis of one-humped camels (Camelus dromedarius) in
British Somaliland. Veterinary Record, 51, 1355-1361.

Peck,E.F. (1940). Ulcerative stomatitis of camels. Veterinary Record, 52, 602-603.

Prior, J. (1994). Pastoral Development Planning. Oxfam Publications, Oxford.

Reusse, E. (1982). Somalia's nomadic livestock economy: Its response to profitable export opportunity. World Animal
Review, 43, 2-11.

Samatar, S.S. (1991). Somalia: A Nation in Turmoil. Minority Rights Group Report.

Sameulsson, G., Mohammed H. Farah., Claeson, P., Hagos, M., Thulin, M., Hedberg, O., Ahmed M. Warfa, Adirizak O.
Hassan, Adulkadir H. Elmi, Abukar D. Abdurahman, Abdullahi S. Elmi, Yakoub A. Abdi and Mohamed H. Alin (1991).
Inventory of plants used in traditional medicine in Somalia. I. Plants of the families Acanthacaeae-Chenopodiaceae. Journal
of Ethnopharmacology, 35, 25-63.

Sandford, D. (1981). Pastoralists as Animal Health Workers: The Range Development Project in Ethiopia. Pastoral
Development Network Paper 12c. Overseas Development Institute, London.

Save the Children (1996). Report on the SCF/SERP Veterinary Component of the SCF(UK) Agropastoral Rehabilitation
Project, June 1995 to May 1996. Save the Children UK - Jijiga Programme, Ethiopia.

Save the Children (1997). Stakeholder Workshops on Veterinary Service Delivery in the Somali National Regional State

56
(English version), 12th-15th August 1997. Save the Children (UK)-Regional Bureau of Agriculture Veterinary Services
Support Project, Somali National Regional State. SCF(UK), PO Box 7165, Addis Ababa, Ethiopia.

Schwabe, C.W. (1980). Animal disease control. Part II. Newer methods with possibility for their application in the Sudan.
Sudan Journal of Veterinary Science and Animal Husbandry, 21 no.2, 55-65.

Schwabe, C. (1981). Animal diseases and primary health care: Intersectoral challenges. WHO Chronicle, 35, 227-232.

Schwabe, C.W and Kuojok, I.M. (1981). Practices and beliefs of the traditional Dinka healer in relation to provision of
modern medical and veterinary services for the southern Sudan. Human Organisation, 40(3), 231-238.

Stockton, D. and Chema, S. (1995). Somali Livestock Export Market Study. Joint EC-FAO Report. EC Somali Unit, PO
Box 45119, Nairobi, Kenya.

Talle, A. and Abdullahi, A.M. (1993). Labour resources in pastoral production: Some implications of increased trading. In:
Pastoral Production in Central Somalia. M.P.O Baumann, J.Janzen and Schwartz,H.J. (eds). Deutsche Gessellschaft für
Technische Zusammenarbiet (GTZ), Eschborn.

VetAid (1992). The Pastoral Economy of North East Somalia. A Consultancy Report for UNICEF-Somalia. VetAid,
Midlothian.

Zessin, K.-H., Heuer, C. and Schrecke, W. (1993). The Central Rangelands Development Project (CRDP) - Veterinary
Component. In: Pastoral Production in Central Somalia. M.P.O. Baumann, J. Janzen and H.J. Schwartz (eds). Deutsche
Gesellschaft für Technische Zusammenarbeit (GTZ) GmbH, Eschborn.

57