# Cancer care in Needle Hospital, Hargeisa, Somaliland

## TL;DR

Needle Hospital in Somaliland provides cancer care in a low-income setting but faces challenges like lack of data and late-stage patient presentations.

## Contribution

The paper highlights the operational realities and challenges of a new oncology clinic in a low-income country.

## Key findings

- Needle Hospital offers chemotherapy and oncology services for solid tumors in Somaliland.
- Cancer care in the region is hindered by lack of registries, late-stage diagnoses, and low public awareness.
- The hospital serves patients from Somaliland and neighboring countries despite significant resource limitations.

## Abstract

Somaliland is an autonomous region in the northern part of Somalia that declared its independence in 1991. It is a low-income country (LIC) with a population size of 5.7 million with a gross domestic product per capita of $775. Health services are delivered by public, private and non-governmental organisations. The public health care system in Somaliland is facing huge challenges. Seven percent of the population suffers from non-communicable diseases, but data on cancer incidence and mortality are not available. Much of the emphasis in public health has been placed on primary care and maternal and child health. There is still a large gap in cancer prevention, early detection and screening in the country. Additionally, there is no cancer registry or published data on cancer. Currently, there are a few private hospitals that provide chemotherapy services in Somaliland of which Needle Hospital is one. Services provided in this hospital include medical oncology for all solid tumours, palliative care, follow-up and cancer health education. The hospital provides services for patients from Somaliland and neighbouring countries including Djibouti, Somalia and Ethiopia. As a new oncology clinic in an LIC, the clinic is facing many challenges, like the absence of a multidisciplinary tumour board, presentation of patients at the advanced stage of tumours and poor cancer awareness in the general population.