"‘Lives at Risk’: The Impact of Trump's Actions on Struggling Clinics"

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Fadumo (not her real name), a widowed mother of three, endured a two-day journey through intense heat with her children to reach a displacement camp near Baidoa in southern Somalia — a region already straining under immense pressure.

“I was displaced due to hunger and my inability to feed my children. Their father has passed away, so I came here seeking assistance. I’ve been here for two months now, but I haven’t received any help,” she told SBS News.

Similar to countless others, Fadumo is in a state of uncertainty, trapped between a past she has left behind and a future that hinges entirely on the prospect of aid arriving.

For many years, USAID — the US Agency for International Development — was fundamental to Somalia’s humanitarian efforts. At its peak, the agency provided 65 percent of the country’s foreign assistance, according to Dr. Abdiqani Sheikh Omar, a former health ministry director and current government adviser.

In 2019, the US supplied nearly half of all humanitarian aid to Somalia — $455 million out of $934 million — with USAID’s Bureau for Humanitarian Assistance significantly contributing to essential services like Save the Children’s malnutrition programs.

These vital resources are now disappearing following USAID’s formal closure, announced on Tuesday.

A woman standing outside a tent holding her child. Other children are standing around them.

‘Fadumo’ says she is displaced because of hunger and her inability to feed her children. Source: SBS News / Danielle Robertson

The dismantling of the agency, which Donald Trump had described as being “run by a bunch of radical lunatics”, began soon after the US president commenced his second term.

Critics, including authoritarian governments and some conservatives, have long viewed USAID as a tool for pushing US geopolitical interests and spreading socially progressive values — specifically through support for LGBTIQ+ and women’s rights.

To its its defenders, USAID is an essential humanitarian agency, whose work also boosts America’s soft power and champions democratic values.

The human cost of USAID cuts

Mu’awiye Mohamed is in charge at a camp for internally displaced people and says thousands will be left with nowhere to turn.

“This situation is not good. The aid was supporting a large number of internally displaced people, so the recent aid cuts of USAID by Donald Trump have had a negative impact on vulnerable communities,” he said.

In Somalia, international aid is not just about food and medicine. It holds up an entire system of camps that provide care, especially for families displaced by conflict and drought.

At malnutrition clinics in Baidoa, mothers like Layla (not her real name) wait for hours in the sweltering heat, desperate to get their children seen.

“I was told he’s malnourished,” she said quietly, cradling her baby, Bilal. “If I hadn’t brought him here, he could have died at home.”

This is one of the few remaining lifelines, and it’s slipping away fast, as US aid cuts force critical nutrition centres to shut their doors.

A woman holding her child while seated inside a clinic.

In Baidoa’s malnutrition clinics, mothers like ‘Layla’ endure long waits in the oppressive heat, eager for their children to receive attention. Source: SBS News / Danielle Robertson

Save the Children says all of its nutrition centres in Baidoa will shut down by the end of this month. More than 120 centres have already closed, leaving over 55,000 children at risk of dying from preventable hunger.

Dr Binyam Gebru, deputy country director for Save the Children in Somalia, says there was no fallback plan.

“This is a very dangerous turning point,” he said.

“All the services have been totally withdrawn, we were not prepared for it. These are sick children because of malnutrition and now if you do not provide services they will die.”

According to the United Nations, it’s estimated that by year’s end, around 1.7 million children under five in Somalia will experience acute malnutrition.

‘Sometimes we pool our money to help patients’

With formal support systems collapsing, local health workers — often unpaid, under-equipped, and overwhelmed — are stepping in to fill the void.

They are now propped up by volunteers like Sahra Abdullahi Aden, a nurse who keeps showing up even without pay.

“Many families can’t afford medicine,” she said. “When the clinic runs out of drugs, sometimes we pool our own money to help the patients.”

Local leaders are now sounding the alarm. Among them, Somalia’s vice-minister for humanitarian and disaster management, Abdullahi Isak Ganay.

“If the aid is cut during this crisis, we could end up in a situation like we did in 1991,” he said.

That year, famine swept across Somalia, driven by a deadly mix of civil war, drought and governmental collapse.

An estimated 300,000 people died — most of them children — in what became one of the worst humanitarian catastrophes of the 20th century.

“There is a serious difficulty. Al-Shabaab controls a large part of the country, making it unsafe for people to farm freely. This, combined with repeated rainy season failures, has led to frequent crop failures. Now, people don’t know what to do,” he said.

Some experts say US aid cuts in Somalia are fuelling a resurgence of al-Shabaab — the al-Qaeda-affiliated militant group that has long waged an insurgency against the Somali government.

The militant group is exploiting the collapse of essential services to regain territory, while the withdrawal of US support for elite Somali forces has weakened security operations. Al-Shabaab has launched its most aggressive offensive in years, edging closer to the capital, Mogadishu.

“If you look at what al-Shabaab has gained of late, it is a huge concern for us,” Gebru said.

The end of USAID

Gebru believes the USAID cuts will change the humanitarian aid sector forever.

“There is a lesson to be learned: we have been too dependent on one resource, he said. “We are looking at diversification and other funding instead of relying on aid.”

Founded in 1961 as then-US president John F Kennedy sought to leverage aid to win over the developing world in the Cold War, the USAID has now been incorporated into the State Department — after secretary of state Marco Rubio slashed 85 percent of its programs.

In a farewell to remaining staff on Monday (local time), former presidents George W Bush, a Republican, and Democrat Barack Obama — as well as U2 frontman Bono — saluted their work and said it was still needed.

Obama, who like Bush has been sparing in openly criticising Trump, said that ending USAID was “inexplicable” and “will go down as a colossal mistake”.

“Gutting USAID is a travesty and it is a tragedy because it’s some of the most important work happening anywhere in the world,” Obama said.

Rubio has painted a drastically different picture of USAID.

He’s said USAID’s “charity-based model” has fuelled an “addiction” among developing nations and argued that trade was more effective.

“Beyond creating a globe-spanning NGO industrial complex at taxpayer expense, USAID has little to show since the end of the Cold War,” Rubio wrote in an essay.

With additional reporting by Agence France-Presse.

Save the Children helped provide security while this reporter filmed at internally displaced people camps and assisted with local transport.