Somalia is one of the harshest places on the planet, an extreme environment that presents huge challenges to its people just in terms of simple survival. The combination of a hostile, predominantly arid environment, difficult terrain with settlements scattered over vast distances, the legacy of a nomadic way of life and a civil conflict that has shattered social structures and exacerbated poverty add up to mean that a Somali child’s chances of surviving to adulthood are among the lowest of children anywhere in the world. Add to this the fact that the odds of the child’s mother dying during pregnancy or in childbirth are also extremely high. These high death rates stem from the interaction of a number of causes set within a complex socio-political context, but are largely attributable to disease, dehydration, malnutrition, lack of safe water, and poor sanitation.