Skip to main content

3.15. Persons with disabilities or severe medical issues

Last update: 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

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. [KSEI 2021, 1.3.4., p.37]

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 [KSEI 2021, 1.3.4., p.38]. 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 [KSEI 2021, 1.3.4., p. 40, 3.3.4., p. 85]

While healthcare in Somalia is generally not free of charge, services in public hospitals are mostly cheaper than in the private healthcare sector [KSEI 2021, 1.3.4., p. 38].

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 [KSEI 2021, 1.4.2., p. 50]. For people living with disabilities almost no provisions exist regarding housing. Therefore, they are generally entirely reliant on family members for support [KSEI 2021,, p. 33].

Furthermore, girls and women with disabilities face a heightened risk of SGBV. [Targeting, 2.2., p. 31].

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. [KSEI 2021,, p. 51]


Conclusions and guidance 

   Do the acts qualify as persecution under Article 9 QD?   

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.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.

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.


   What is the level of risk of persecution (well-founded fear)?   

The individual assessment of whether there is a reasonable degree of likelihood for the applicant to face persecution in the whole of Somalia, including South-Central Somalia, Puntland and Somaliland, 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.

   Are the reasons for persecution falling within Article 10 QD (nexus)?   

Where well-founded fear of persecution is substantiated, available information indicates that persecution of this profile 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).