Amnesty International called on the Somali Federal Government to ensure the rights of people with disabilities are protected in law and in practice.

People with disabilities face greater abuse in Somalia because they are often seen as a burden or as easier targets to attackers, said Gemma Davies, Amnesty International’s Somalia Researcher.

Researchers in February spoke to dozens of people with physical disabilities who spoke of the abuses inflicted on them including rape and beatings, the rights group said in statement. Women and girls with disabilities said they are forced into marriage to older and sometimes abusive men in their families’ bid to rid themselves of the perceived burden of having disabled children, the statement said.

Amnesty researchers spoke to a woman identified only as Hannan, who has been disabled since she was a baby and forcefully married off when she was 13 years old.

“My family decided to give me to this man, I refused and ran away. My family sent strong men after me. They caught me, tied my arms and legs and threw me in a room with the man. He beat me since the beginning,” she said, adding that she was told not to complain. “When I escape and go home, my aunt says that I am disabled and returns me back.”

Somalia is struggling to rebuild itself after decades of conflict and an ongoing insurgency by Islamic militants. The country was plunged into chaos following the 1991 ouster of dictator Siad Barre.

In one shocking case, the convicted killer of two of the agency’s aid workers was mysteriously freed from prison after serving only three months of a 30-year sentence, it said.

Hundreds of thousands of Somalis will be left without humanitarian aid as a result of the sudden withdrawal by the famed relief agency.

The withdrawal was a grim reminder that Somalia remains a dangerously violent and terror-prone country, despite recent fanfare about an “investment boom” in Mogadishu after the retreat of Islamist militants from the capital.

Doctors Without Borders, also known as Médecins Sans Frontières (MSF), announced on Wednesday that it is shutting down its activities in Somalia after a “series of extreme abuses” – including the killing of two staff in Mogadishu and the kidnapping of two other MSF aid workers who were abducted in a Kenyan refugee camp and held hostage in southern Somalia.

With about 1,500 staff in Somalia, the agency is one of the biggest providers of medical care in the war-torn African nation. It helped more than 620,000 patients last year alone in a dozen towns and cities across Somalia.

The closure is “one of the hardest decisions MSF has had to make in its history,” the agency said in a statement.

It is the first time in 22 years that the agency has shut down its medical work in Somalia. But it had already been forced to use armed guards to protect its staff in Somalia – a precaution that it does not take in any other country.

The decision to withdraw from Somalia was not only because of the extreme violence, but also because the attacks were increasingly supported or tolerated by civilian authorities, MSF said.

Civilian leaders in Somalia are playing a role in “the killing, assaulting and abducting of humanitarian aid workers … either through direct involvement or tacit approval,” it said in the statement.

In some cases, it said, the attacks have been supported or condoned by the same armed groups or civilian leaders with which MSF has to negotiate promises of security for its humanitarian work.

“Ultimately, civilians in Somalia will pay the highest cost,” said Unni Karunakara, the international president of MSF, in a statement on Wednesday.

“The armed groups’ targeting of humanitarian aid and civilian leaders’ tolerance of these abuses has effectively taken away what little access to medical care is available to the Somali people.”

He said the “risks and compromises” for MSF staff have become too high for the agency to accept.

“In choosing to kill, attack and abduct humanitarian aid workers, these armed groups and the civilian authorities who tolerate their actions have sealed the fate of countless lives in Somalia.”

Twenty new cases of polio were reported this week in Somalia by the Global Polio Eradication Initiative. That brings the total number of cases in the Horn of Africa to 73. The rest of the world combined has tallied only 59 cases so far this year.

Health workers are worried that the virus could gain a foothold in the Horn of Africa and jeopardize the multibillion-dollar effort to wipe out the virus worldwide.

Until this recent outbreak, global efforts to eradicate polio appeared to be making remarkable progress. Last year the number of children paralyzed by polio hit a record low at 223.

This year it was looking like there were going to be even fewer cases. The last significant pockets of the virus appeared to be isolated in Afghanistan, Pakistan and Nigeria.

Then in May, a 2-year-old girl in Mogadishu became the first confirmed case of polio in Somalia in more than six years.

The number of polio cases in Somalia is increasing by the day, says Dr. Nasir Yusuf, who leads UNICEF’s immunization efforts in eastern and southern Africa.

Part of the problem, he says, is that the majority of children in Somalia have never been immunized against polio. “We have an outbreak in a population that has been quite vulnerable for quite some time,” Yusuf says.

Somalia has the second worst rate of polio vaccination in the world after Equatorial Guinea, according to the World Health Organization.

In response to the current outbreak, there have been five emergency polio immunization campaigns in Somalia since May. The Somali government directs the campaigns, but it doesn’t control or have access to vast swaths of the country. Some of the most recent polio cases have occurred in areas that are considered off limits to vaccination teams.

Underscoring the lack of security in the region even for health workers, two health workers with Doctors Without Borders were freed this week after having been held hostage in Somalia for almost two years. The women had been working in the Dadaab refugee camp in Kenya, where eight new polio cases were reported in May.

The current outbreak is forcing governments throughout the region, including parts of the Middle East, to launch supplemental vaccination drives, Yusuf says, because polio is capable of spreading quickly.

“A week after the virus was reported in south central Somalia, one of the viruses got into the Somali refugee camp in the most eastern part of Kenya,” he says. “So that tells you how fast this virus made it.”

The virus reproduces inside the human gut, and many people carry it but show no symptoms. This give the virus the opportunity to travel long distances inside people and then get shed into the environment through feces.

The World Health Organization traced the poliovirus in Somalia to one in West Africa. Nigeria is the only place there where polio is still endemic.

Before these cases in the Horn of Africa, the end of the multibillion-dollar effort appeared to be in sight.

The Somali outbreak is now forcing UNICEF, the WHO and other international agencies to dedicate vast resources to boost polio vaccination coverage throughout East Africa and parts of the Middle East. Those are resources that can’t be used to attack the virus in Afghanistan, Pakistan and Nigeria — which appeared, until now, to be the last few places where polio had a foothold.

Copyright 2013 NPR. To see more, visit http://www.npr.org/.

The officials say they are struggling to show that the vaccination is safe.

BBC Radio 4′s The Report has found that the discredited former doctor Andrew Wakefield visited some Somali groups in the US.

Health authorities there blame him for the drop-off in MMR vaccinations.

Andrew Wakefield, who now lives in Texas, says Somalis in Minnesota already had fears about autism and MMR before his visit.

Somali Bakita Mohamed Haji lives in north-west London with her 10-year-old daughter, who suffers from autism.

Fears reinforced

She says her daughter’s condition started after she was given the jab.

“My daughter was born normally but when I started the MMR, my daughter changed. Screaming all the time, crying. I went to the hospital and they said it’s autism. I don’t understand it. I’d never heard of it.”

“A number of individuals reached out to the community who planted the seed that there might be concerns about vaccination” Kristen Ehresmann Minnesota department of health

She wishes her daughter had never had the injection, which she believes caused the condition.

Health experts say her fears, and those of other parents, have been reinforced by a common belief in their community that only the children of Somali families that emigrate to the West develop autism, whereas those who stay at home do not.

While there is no solid evidence to confirm this, a small study of immigrants in Stockholm, the Swedish capital, did suggest that families using services for autistic children were more likely than expected to be from West and East Africa.

Discredited study

And separate research in the UK also found there was a higher than average incidence of autism in children born to African mothers – but it did not establish a reason why.

The fears of Somali parents echo those sparked by a study in The Lancet medical journal that linked MMR with autism.

The study was discredited and withdrawn. Andrew Wakefield, the lead author, was struck off by the General Medical Council because of ethical concerns about his methods.

A subsequent raft of research has found no link between the MMR vaccine and autism, and average vaccination rates are back up to 94% in England for five-year-olds receiving the first dose of MMR.

Parents frustrated

But take-up of the vaccine is much lower among Somali children in the UK and in the US.

In Minnesota in the Midwest, the Somali American Autism Foundation has pledged to find out what causes the condition in their children.

Idil Abdul runs the foundation and has a son, 10, who is autistic.

“If your child is sick, the goal is you take them to the doctor and the doctor tells you what’s wrong with the kid and how to make him better. With autism, we go to the doctor and they say, ‘We don’t have a cause, we don’t have a cure, too bad, so sad, you might not get access to early intervention, have a nice day.’”

“It is very difficult to dislodge beliefs from whatever community if they’re dealing with a disease that isn’t adequately explained” Prof David Salisbury Director of immunisation at the Department of Health

She does not believe there is a link between MMR and autism but says parents are frustrated because they do not feel their concerns are being listened to by the authorities.

‘Planted the seed’

Andrew Wakefield visited Minnesota at least three times between 2010 and 2011, promising research to find answers to their questions.

The Minnesota department of health says his visit contributed to a drop-off in MMR uptake among Somalis and says only around 50% of Somali children now receive the vaccine.

Kristen Ehresmann, the state’s director of infectious disease, believes he had an influence on Somali perspectives.

“There were a number of individuals who reached out to the community who planted the seed that there might be concerns about vaccination and what role it could play.

“Since that time we’ve seen vaccination rates drop off accordingly.”

Andrew Wakefield denies his visit caused the drop in Somali children having the MMR jab, claiming the trend was already happening.

‘Vaccination champions’

He said: “The reason that I was invited was to help address the Somalis’ pre-existing fears about developmental regression in their children following MMR immunisation.”

Although there are no official statistics, vaccination rates are also believed to be low among Somali children in London.

Shukri Osman, a parent of an autistic child, estimates that only half the Somali parents she knows have taken up the vaccine.

She lives in Brent in north-west London. The local council said: “There are a number of groups and communities in Brent where uptake rates for immunisation have been low. Low uptake rates in the Somali community has been recognised for a number of years.”

It is currently training up “community vaccination champions” and now has an immunisation team with Somali-speakers.

Engrained perceptions

Prof David Salisbury, the director of immunisation at the Department of Health, said: “We know that there is not an association between MMR and autism, and that I’m sure has been said many times to Somali community leaders.”

But even he admits it will be hard to change what may have become engrained perceptions.

“I think we know it is very difficult to dislodge beliefs from whatever community if they’re dealing with a disease that isn’t adequately explained on the basis of the cause. ”

You can listen again to The Report on BBC Radio 4 via the Radio 4 website or The Report download.

Associated Press:

With more regions of Somalia, including the capital Mogadishu, at peace for the first time in 20 years, health care workers are expanding vaccination programs and can now access 40 percent of south-central Somalia, where the influence of hardline Islamic insurgents is highest. Three years ago, health workers could access only 15 to 20 percent of that territory.

Dr. Hawa Abdi, a beloved Somali doctor known as “Mama Hawa,” has sheltered and treated thousands in Somalia throughout her decades-long career.

The other guests at the swanky downtown Toronto hotel do not realize they have a celebrity in their midst.

It is may be a mark of prejudice that, until recently, the mention of Somalia would, for me, only conjure up images of civil war and famine.

But for some years many Somali people have made Northamptonshire their home and are now keen to reveal a little more about their country’s culinary culture.