Tag: Angela Berry

In Memoriam: Mohamed Warsame Dualeh

May 3, 2026         Dr. Mohamed Warsame Dualeh, a Somali physician, refugee-health leader, humanitarian official, and later diplomat, died on April 25, 2026 in Germany.  He is survived by his wife, Marie Therese Lenz, and children, Amalie, Issa, and Edna.  Among the positions he held during his distinguished career were Head of Operations in Darfur for UNHCR and Director of the Somalia Refugee Health Unit.

Over a career that spanned public health, refugee operations, and international diplomacy, he served vulnerable communities across Somalia, the Horn of Africa, Sudan, and beyond.  He retired in 2014 and became adviser to the President’s office in Somaliland, working hard to get the new nation organized in public health and soliciting international recognition and support.  He continued to offer his services to the UN into 2025.

He was born on April 14, 1954.  He graduated from the Benadir Medical School in Mogadishu and the University of Sydney where he obtained a Master’s degree in Public Health, writing his thesis on maternal and community health worker care for diarrheal diseases of children in rural Somalia.   As Dr. Ahmed Magan remembers: “Dr. Warsame was my medical school classmate and graduated with distinction. He was a pioneer in Somalia, recognizing early on that public health and Primary Health Care (PHC) were the most effective ways to serve a community with limited resources and a high disease burden.”

His formative experience was with the Refugee Health Unit in Mogadishu, which coordinated care for Ethiopian refugees who had fled to Somalia.  That early work grounded the rest of his career:  he belonged to the generation of Somali doctors whose medical service quickly became inseparable from conflict, displacement, and the survival of uprooted families.  The RHU oversaw up to 35 camps of Ethiopian refugees.  Dr. Dualeh wrote: “It is extremely important to take health care to the refugees – to have an outreach program.”

Mike Toole recalls: “I worked with Mohamed Warsame Dualeh in Somalia in 1981 and 1982 when I was the senior medical adviser in the Refugee Health Unit (RHU) within the Somali Ministry of Health. The RHU coordinated the health programs within … camps for one million ethnic Somali refugees from Ethiopia scattered throughout the country…Mohamed eventually became the RHU director, based in Mogadishu. He was a major force in establishing the RHU as a unique national unit that based the Refugee Health program on epidemiological evidence, primary health care, community participation, standard treatment protocols, and prevention. …He was a trailblazer in Refugee Health …[in] a stellar career in the UNHCR.”

Beverly Snell explains about the RHU: “It was the first …primary health care (PHC), community-based approach to refugee camp health management…. Traditionally refugee health care had been very top down and often dependent on foreign professionals. …it was the leadership of people like Mohamed Warsame that made it work.  So much so that the host population was complaining that refugees had better health care than they did.  And that led to starting the PHC approach in the host population to, (a harbinger for the policy adopted by the Sphere Handbook).  Mohamed Warsame’s contribution in the leadership of both RHU and national PHC made a huge impact.”

Kate Burns remembers: “He was always Warsame to me.  Great guy.  Very easy to get along with…we met again when I joined UNHCR’s Health Unit in 1995/6 in Geneva…a really lovely man.  I loved greeting him in the few Somali words I remembered.  ‘Nabad, Suba Wanagsan, Nabad Geleyo’.”

With the RHU, Dr. Warsame oversaw an historically important model refugee health team, a model that merited being replicated around the world.  It was an all-star team of experts who created standards such as serial surveys of malnutrition among children in the camps to identify changes in the rates of malnutrition, knowledge of breastfeeding and oral rehydration, and other life-saving measures.

Surveillance in the camps in the early-80s revealed an outbreak of scurvy, a vitamin C deficiency disease, caused by a lack of camel’s milk in the refugees’ diet, an overdependence on standard rations provided by donors, and an accompanying lack of access to local markets where they might have bartered for fresh vegetables such as tomatoes and onions.

Dr. Jama Gulaid recalls:  “I will remember Mohamed for his devotion to the health and welfare of refugees. I travelled hundreds of miles with him while doing refugee work. Our challenges were many — heat, dust, and poor accommodation and food — but still immensely better than those facing refugees. Mohamed was undaunted, his energy undiminished, a spark in his eyes as he engaged vulnerable people as warmly as a physician in a comfortable office in a developed country.”

In a 1994 UNHCR paper about refugee family health, Dr. Warsame argued for a practical and humane principle that seems to capture his whole approach: “It is extremely important to take health care to the refugees – to have an outreach program. It has to be easily accessible.”  In the same piece, he recalled conditions in Hartisheik, of Somalis in Ethiopia, this is incomplete in 1988, where mortality among children under age five was exceptionally high in part due to inadequate food rations, and inadequate provision of water and sanitation compounded the crisis. He advocated for training refugees as health workers and birth attendants, and bringing care closer to families instead of forcing desperate mothers to travel long distances for help.

He served in multiple roles for the United Nations High Commissioner for Refugees (UNHCR), including as its focal point for HIV/AIDS and chair of IAAG, serving in the Programme and Technical Support Section in Geneva.

CDC’s Brent Burkholder remembers “I remember him as being a kind, quiet person but very committed to refugee health”

UNHCR Nutritionist Angela Berry Koch remembers: “He was always with a great sense of humor. Very warm and amiable. He had strong humanitarian instincts and argued against the limitations of institutions when they were less than humane. In that sense he showed a subtle kind of leadership   was astute politically, knowing when to push and when to fall back on diplomacy. Very smart guy.”

In the RHU and at UNHCR, he cared about refugee access to health care, distances to clinics, camp layout, and the daily burdens placed on women and children.

Angela Berry:  “Mohamed came with extensive field experience in primary health care… he was always willing to support our field colleagues, always cheerful and joking. He had a very warm personality. He was very tolerant of everyone from whatever background or culture. He was extremely generous and selfless, highly dedicated in all his endeavors.  He never hesitated in being placed in the worst type of conditions while expertly negotiating and spearheading the repatriation program… often found in isolated areas with landmine risks. He showed great courage and flexibility in his work. Always highly intelligent… loved field work. He always had a jovial spirit and a twinkle in his eye.”

Ron Waldman: “I first met Warsame when he was a young, recent medical graduate working for the Somali Refugee Health Unit in refugee camps in what is now Somaliland.  He rose rapidly up the ranks to become the Director of the RHU and went on from there to have a long career at UNHCR.  Throughout he was modest, spoke softly, but had a major impact.  He was a quick learner and what he learned early in his career was the importance of community-oriented primary health care.  Having seen the success of this approach during his RHU years, he continued to advocate for it on behalf of all of the vulnerable and marginalized populations he worked with in East Africa for the following decades.  He was always a pleasure to work with, a great listener who asked insightful questions and then questioned the answers he received.  And always with that quizzical smile and a twinkle in his eye.    He was an important figure in the development of the way we think about refugee and humanitarian health today.”

Rita Bhatia met him in Ethiopia and served a decade with him in Geneva at UNHCR:  “I admired Mohamed’s humility, simplicity & warmth and respect for people…[he] will be deeply missed, but never forgotten. Om shanti.”

In later years, he also moved into diplomacy and public advocacy. He served as Special Envoy of the Republic of Somaliland to the United Nations and other international organizations, while remaining a trustee of AHA.   Matt Bryden says he “will miss his great warmth, humor and intelligence.”

Looking back, Dr. Warsame said “Africa, as a whole, is a great continent welcoming refugees.”

He also said, “Sudan is in my heart. I dream of the great days and friends that I met in Kassala, Khartoum and Al Fasher.”

Dr. Magan reflects: “As a close friend for many decades, I remember Mohamed as a down-to-earth, exceptionally kind, and selfless person. He had a remarkable ability to connect with people and maintained a wide circle of friends globally. He was wonderful company, and whenever he was present, the room was always filled with laughter and jokes.”

He was a doctor shaped by the Horn of Africa, committed to refugees, and convinced that humanitarian work had to begin with dignity, proximity, and respect for the lives people were actually living. His career joined clinic and camp, epidemiology and diplomacy, Somalia and the wider refugee world. He appears to have been one of those indispensable officials whose name was not widely known outside professional circles, but whose work touched thousands of lives.

 

 

The Use of Food as a Weapon: Reflections Working with Khmer Refugees

Field Experience on the Thai–Cambodian Border, 1979

The year was 1979.  In October, I braved the streets of Bangkok, Thailand at five o’clock in the morning to get on a volunteer bus bound for the Thai–Cambodian border. Our destination was Sakeo, a newly established refugee camp sheltering 30,000 sick and dying Cambodian displaced people.

The camp sprawled across a large rice field.  Because it was the rainy season, there was thick mud everywhere and rows of blue tarpaulins stamped with UNHCR logos.  A so-called “hospital” occupied one corner of the encampment, made up of several large tents hastily erected by volunteer organizations.  There were few trained staff or expatriate presence.  The  stench of excrement, death, and human suffering overwhelmed me.

I was only 23 years old, utterly unprepared for what lay ahead. Yet every time I reached a breaking point, I found renewed motivation in the urgency and desperation of those I was trying to help.

In the beginning, I volunteered in the tuberculosis ward, which was just a large tent attached to the International Rescue Committee. I had the honor of being trained over a few days by the Medical Missionary Sisters, a group of nuns from the United States.

My training consisted of rudimentary nursing skills: giving injections, carrying water, applying medical bandages, and setting up IVs. For about a month, this became my daily work.

Early on, a UN reufgee camp coordinator suggested I return to Bangkok to sign up formally with the International Rescue Committee, an NGO.  I did so and was hired on the spot, returning quickly to the Sakheo camp.

Addressing Deficiency Diseases

At one point, someone learned that I had training in nutrition. They approached me because there was an apparent outbreak of a thiamine (vitamin B1) deficiency disease in the camp.  This was unsurprising: the population arriving from Khmer Rouge–controlled areas inside Cambodia had endured prolonged malnutrition and starvation under Pol Pot, and the food rations at Sakeo were grossly inadequate.

I examined the food being distributed and discovered it lacked sufficient protein and particularly B vitamins, causing deficiencies that were manifesting as disease.  I recommended adding mung beans to the rations. Once implemented, with such a simple intervention, we saw a rapid improvement in the health of many refugees, and several deficiency syndromes began to disappear.

Discovering Food Distribution Inequities

What this article  explores formed the basis of my later master’s thesis, “The Use of Food as a Weapon.”

Through my translator, I began receiving complaints from refugees across the camp that they were not receiving their proper food rations at the distribution points. To investigate, I brought scales, set up a table, and—together with translators—began weighing the food voluntarily as refugees exited the distribution site.

Each person was supposed to receive specific gram amounts of rice, meat, mung beans, and vegetables. But after a week or two, it became clear that there were major discrepancies: some people were receiving more than the allotted amount, and some much less.

Naively, as a 23-year-old, just fresh out of my university in the U.S., I set up public weighing stations and posted the expected ration amounts on a board, so people could check whether their distribution matched the standard.

Uncovering Coercion by the Khmer Rouge

I soon learned that my actions had unintentionally disrupted a covert power structure within the camp. The Khmer Rouge, still active among the refugees, were manipulating food distribution to coerce people to return to Cambodia and submit to Pol Pot’s authority. Those who complied received extra food; those who resisted received less or none.

Rumors of this circulated quickly. Not long after, I was summoned by the UN head of the camp to attend a meeting with the “refugee leadership”—in reality, Khmer Rouge operatives and former enforcers. The topic was this “major food distribution problem.”

As I walked to the meeting, my knees were shaking. I remember thinking, “Oh my God… what have I done?”

The Confrontation

As I walked into the tent, I saw a group of four or five men, the head of the UN office seated at the front, and a few others gathered around. I took a seat and immediately noticed the serious expression on the UN head’s face. It was clear that the situation was grave.

The Khmer Rouge representatives expressed their displeasure at the UN’s control over the food distribution points. They wanted to regain authority over the rationing system. Fortunately for me—and for the refugees—the head of the UNHCR office was exceptionally firm.  He declared that control over food distribution would not be relinquished, as the food was provided by UNHCR and must be distributed equitably.

During the meeting, they asked about what was my role. I sat there uncomfortably, only to hear the UNHCR leader announce that I was now “in charge” of food distribution.  Well, this was news to me, but apparently, my job had just changed.

Unexpected Negotiation

After the meeting, the Khmer Rouge representatives approached me. My heart sank andI thought, “This is it — I won’t survive this new role.”

But to my surprise, they asked for extra rice for weddings, explaining that many young people were marrying after years of prohibition under the Khmer Rouge. Relieved, I agreed to arrange extra rice allocations for wedding celebrations, which helped defuse tensions and built a tenuous rapport.

Scaling Up the System

The next phase was to expand the weighing stations across all food distribution points. We posted clear boards showing exact ration weights per person, enabling refugees to verify whether they were receiving their proper share.

A few months later, when the camp was preparing to move, the Khmer Rouge leadership could only coerce less than one-third of the population to return to the border. By shifting control to transparent, neutral distribution mechanisms, we had undermined their power and protected the majority of refugees who remained.

This simple innovation became a systematic new process adopted by the UN in the 16 refugee camps across Thailand in 1980.  We replicated the weighing stations and ration boards, giving people the right to know their entitlements and receive adequate food.  Then, I was hired by the UN, and we expanded this practice to refugee camps all over the world.  I had the honor of working with UNHCR for thirty years in numerous countries afterward, helping develop guidelines and manuals to institutionalize equitable food distribution systems globally.

Entitlement & Moral Responsibility

I share this story, learned nearly 50 years ago, because today we are again facing a dangerous trend of using food as a tool of coercion. In several contexts, food aid is being blocked or manipulated to control civilian populations, undermining the principles of human rights that humanitarian actors fought to establish decades ago.

The concept of entitlement is central to any aid program. Food and health care are not favors—they are human rights essential to survival. When entitlement is stripped away by those in power—whether through guns or the lingering trauma of past violence—a profound moral disequilibrium is created. Our failure to uphold these principles represents a corrosion of obvious ethical standards.

Over the years, the UN — especially the World Food Programme — developed extensive tools, kits, and guidelines to uphold these principles. Yet too often, these manuals gather dust on shelves while oversight and neutrality waver on the ground.

Ultimately, the neutrality of humanitarian agencies and their ability to ”hold power—not yield it to armed actors—“ remains the cornerstone of equitable food distribution. In recent years, we’ve witnessed how corrupted access to food can become when neutrality erodes.

We often say, “Let’s learn from our past mistakes.”   This story is a reminder that transparency, entitlement, and moral clarity in humanitarian aid are not abstract ideals—they are lifesaving practices.

  •      –  Angela Berry-Koch, Former UNHCR Senior Nutrition Adviser, currently faculty at Psychiatry Redefined and contributor to Hunger Notes, 12 Oct. 2025