London School of Hygiene & Tropical Medicine

Written by Jihaan Hassan Mohamed, Bashiru Garba, Rahaf Abu Koura and Fiona Majorin

Waking up every day knowing that you might not have enough water to drink, cook, or even wash your hands is a common experience for many people displaced in Somalia. Relentless droughts have transformed once-thriving communities into barren landscapes of desperation.

As we mark World Water Day, it is essential that we address the human and environmental emergency unfolding in Somalia, a country with a history of prolonged armed conflict fueled by climate change and worsening humanitarian conditions.

A climate of drought and despair

Somalia has always experienced unpredictable rainfall, but climate change is intensifying these challenges. The country is currently facing one of its most devastating droughts in recent years, alongside severe flooding in riverine areas such as Hiraan, Middle Shabelle, and Juba (UN News, ReliefWeb).

Paradoxically, while drought leaves rivers and wells dry, sporadic floods worsen the crisis by contaminating water sources, destroying infrastructure, and displacing thousands. Consecutive climate shocks including prolonged drought followed by severe flooding have also wiped out crops and livestock, deepening food insecurity and forcing entire communities into displacement (OCHA). This situation goes beyond a natural disaster; it is a crisis exacerbated by rising global temperatures, shifting weather patterns, and environmental degradation. For nearly 65% of the population whose major source of livelihood is agriculture and livestock, this is a difficult reality to fathom (OCHA). The result is 3.9 million people becoming displaced, seeking food, water, and safety in overcrowded displacement camps far away from their homes. The latest IPC report projects that 4.4 million Somalis, almost a quarter of the population, will face high levels of acute food insecurity in the coming months (UNHCR).

The human cost: water, sanitation, and disease

In Somalia, it is estimated that about 6.4 million people lack sufficient access to water, however, water scarcity isn’t just about thirst — it’s about survival. When water sources run dry, people are forced to rely on contaminated water and often lack enough for basic hygiene. The result can have life-threatening consequences, and deadly outbreaks of cholera and diarrhoea have already been reported (Jones et al., 2020, UNICEF 2019, OCHA 2024). In 2023 alone, Somalia reported over 11,000 suspected cholera cases, driven by the lack of clean water and sanitation, particularly in displacement camps.

This is what we found in one of our mixed method studies, where we collected data on hand washing and held group interviews with displaced residents in drought-affected areas of Baidoa, Somalia, to understand what influences hand hygiene behaviours in these communities. Hand hygiene, which is a simple yet life-saving practice, has become nearly impossible when there’s critically low access to clean water. Indeed, across four IDP camps where we conducted our research, only one has clean water available. In the rest of the camps, residents had to walk to other areas to obtain water, sometimes needing to pay.

Our study also found that when residents wash their hands, most wash them with water alone as soap is too expensive, unavailable or because using soap would require more water to completely rinse one's hands. Some people are relying on the cleaning they do during ritual washing, which is mandatory for all Muslims before praying, but does not require the use of soap. In extreme cases, people use sand (tayammum) instead of washing with water, which does not effectively remove pathogens, increasing the risk of disease transmission.

A crisis we can no longer ignore

Somalia’s water crisis is not just a local issue; it’s a global one. The increasing frequency of extreme weather events in Somalia is a warning sign of what’s to come for other vulnerable regions worldwide.

The irony? Somalia barely contributes to global warming, emitting less than 0.06% of global greenhouse gases, but it ranks among the top five most climate-vulnerable nations on the planet.

What can be done?

Investing in sustainable water solutions such as rainwater harvesting, solar-powered boreholes, and community-led water conservation can make a difference in significantly reducing reliance on unpredictable rainfall and improving resilience during droughts.

Equally important is supporting humanitarian efforts that integrate water, sanitation, and hygiene (WASH) programmes with food security and health services, as prioritising WASH alone will not improve health overall if residents are facing hunger. Humanitarian responses must follow global best practices, such as the SPHERE Standards, to ensure sustainable, impactful interventions.

Time for action

As the world reflects on the importance of access to safe, clean water, Somalia must not be forgotten. On World Water Day, let’s commit to ensuring that no one has to choose between drinking water and washing their hands. The time to act is now before the next drought tightens its grip on an already suffering nation. Achieving this would require immediate international action and sustainable, climate-resilient solutions. The cost of delay is measured in human suffering; we must act now to prevent another crisis and uphold dignity for all.

Jihaan Hassan Mohamed, Bashiru Garba, Rahaf Abu Koura and Fiona Majorin are collaborators on the Afya Consortium.