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2.13. Persons with disabilities and severe medical issues

Last updated: June 2022

This profile refers to people with disabilities, including mental disabilities, as well as those who have severe medical issues, including mental health issues.

COI summary

[Main COI reference: Socio-economic 2021, 1.3.4,, 2.3.4, 3.3.4]

Health services in Somalia, including in Puntland and Somaliland, have been described as insufficient, with most health facilities located in larger cities, including Mogadishu, Hargeisa and Garowe.

Medical services available in Mogadishu are of poor quality both in the public and in the private sectors. Although basic drugs are available, their proper storage is difficult and people lose their lives from normally easily treatable diseases. As for the treatment prospects for persons with mental disorders, it has been noted that there is a particularly acute shortage of mental health specialists throughout Somalia, including in Somaliland.

While healthcare in Somalia is generally not free of charge, services in public hospitals are mostly cheaper than in the private healthcare sector.

It has been reported that persons with disabilities are often excluded from humanitarian assistance either due to exploitation, pre-existing discrimination and stigma or due to a lack of adequate consideration. For people living with disabilities almost no provisions exist regarding housing. Therefore, they are generally entirely reliant on family members for support.

Furthermore, girls and women with disabilities face a heightened risk of SGBV [Targeting, 2.2].

The Covid-19 pandemic, with its impact on an already fragile healthcare system and socio-economic welfare mechanisms has further exacerbated the pre-existing dire situation of vulnerable groups, including of persons living with disabilities.

Risk analysis

The lack of personnel and adequate infrastructure to appropriately address the needs of individuals with (severe) medical issues fails to meet the requirement of Article 6 QD regarding the existence of an actor that inflicts persecution or serious harm, unless the individual is intentionally deprived of healthcare.[13]

In the case of persons living with disabilities, the individual assessment whether the discrimination and mistreatment by society and/or by the family could amount to persecution should take into account the severity and/or repetitiveness of the acts or whether they occur as an accumulation of various measures.

Not all individuals under this profile would face the level of risk required to establish a well-founded fear of persecution. The individual assessment of whether there is a reasonable degree of likelihood for the applicant to face persecution should take into account risk-impacting circumstances, such as: nature and visibility of the mental or physical disability, negative perception by the family/community, existence of support network, etc.

Nexus to a reason for persecution

According to available information, if well-founded fear of persecution could be substantiated in the individual case, such persecution may be for reasons of membership of a particular social group (e.g. persons with noticeable physical disability, due to this innate characteristic and distinct identity linked to their stigmatisation by the surrounding society).



[13] CJEU, M’Bodj, paras. 35-36. See also CJEU, MP v Secretary of State for the Home Department, C-353/16, judgment of 24 April 2018 (MP), paras. 57, 59.