Supporting 'medicine at a distance' for delivery of hospital services in war-torn Somalia: how well are we doing?

BACKGROUND: We describe an innovative strategy implemented to support national staff at Istarlin Hospital in the conflict setting of Somalia; and report on inpatient morbidities, mortality and adverse hospital exit outcomes. METHODS: This was a retrospective analysis of hospital data for 2011. RESULTS: Of 8584 admitted patients, the largest numbers were for lower respiratory tract infections (LRTI) (2114; 25%), normal deliveries (1355; 16%) and diarrhoeal diseases (715; 8%). The highest contributors to mortality were gunshot wounds in surgery (18/30; 60%), LRTIs in internal medicine (6/32; 19%) and malnutrition in paediatrics (30/81; 37%). Adverse hospital exit outcomes (deaths and absconded) were well within thresholds set by Médecins Sans Frontières. CONCLUSIONS: With a support package, satisfactory standards of care were met for hospital care in Somalia.