SAHA – Somalilander-American Health Association

Point of Care Ultrasound (POCUS) Training Debrief for SAHA Members

March 26 – April 29, 2022
SAHA conducted a Point of Care Ultrasound (POCUS) training for six junior doctors from the six major regions of Somaliland. Dr. Max Fraden and I worked six days a week (6 hours a day) for three weeks with the six doctors from Hargeisa, Berbera, Burao, Las Anod, Erigabo, and Borama. The training site was inside the Hargeisa General Hospital – a national referral hospital with over a 400-bed capacity.

The trainees learned the following ultrasonographic modalities:



To evaluate the pneumothorax, alveolar/interstitial syndrome, lung consolidation, and pleural effusions as
the cause of respiratory distress.


Focused Cardiac

Focused cardiac ultrasonography to evaluate the left and right ventricular function, right a trial pressure,
pericardial effusion, and tamponade, among other pathologies.


Abdominal Ultrasonography

Abdominal ultrasonography to evaluate ascites, hemoperitoneum, hydronephrosis, acute pyelonephritis,
and gallstones and confirm Foley catheter placement.


Point-Of-Care Compression

Point-of-care compression ultrasonography to rapidly detect deep venous thrombosis with high accuracy.

We also engaged with the Ministry of Healthcare Development (MOHD) leadership during our time there. We agreed to explore and pilot non-communicable diseases (NCD) clinics at the district and community levels, so, patients do not have long travel distances for chronic management.

NCDs are emerging as a significant contributor to preventable morbidity and mortality in Somaliland. Treating these disease entities (heart failure, hypertension, COPD / asthma, diabetes mellitus, chronic kidney disease,
cancer, and mental health) requires coordinated acute and chronic care management across the hospital, outpatient, and community settings.

At the end of the POCUS training, we established two pilot sites run voluntarily by two participating trainees to diagnose, manage and follow up heart failure patients at the Borama and Erigabo Regional Hospitals. If successful, this initiative would lay the foundation for the devolution of heart failure management to the district and community levels throughout Somaliland. The successful launch of this project will also motivate the implementation of similar clinics targeting a broader range of NCD pathologies.

Of note, this model of NCD clinics draws heavily from Rwanda’s public healthcare sector experience over the last decade.

“NCDs are emerging as a significant contributor to preventable morbidity and mortality in Somaliland.”