I'm going to hazard a guess. If I mention Somalia, you'll think of warlords and pirates. Because that's what the media headlines have highlighted. What's garnered less attention, however, is the impact that the Somali crisis is having on the wider region of East Africa and neighboring Kenya in particular.
Kenya is now home to more than 320,000 refugees. These individuals have fled conflict or persecution in around a dozen different countries, but it's safe to say that the overwhelming majority are from war-torn Somalia next-door.
Dadaab camp in eastern Kenya alone currently houses more than a quarter of a million refugees. Virtually all are Somali. Even though the official Kenyan-Somali border is closed, more than 60,000 Somalis crossed into Kenya last year and the influx has continued apace in 2009.
The refugees are fleeing vicious fighting between the government and Islamic insurgents, severe food shortages and recurrent drought that has decimated livestock. In Dadaab, they find relative safety and humanitarian aid, but they also find overcrowding, water shortages and increased exposure to contagious diseases such as cholera and measles.
Dadaab's camps were built for an initial population of 90,000. They now house almost three times that number. In Hagadera camp, Dadaab, the hospital and four health clinics operated by the International Rescue Committee (IRC) have been working hard to contain a recent outbreak of cholera - a highly contagious disease that can kill in a matter of hours.
"To date, the number of cases in Hagadera has been small - just 26 - and we have managed to contain the outbreak, but resources in the camps remain massively overstretched and provide ideal conditions for diseases like cholera to keep coming back," says Dr Vincent Kahi, the IRC's health coordinator in Kenya. "All agencies in Dadaab are doing their best, but the sheer number of people in such a small space and in an area with water scarcity is a recipe for future problems."
Drawn-out discussions between the Government of Kenya and the United Nations High Commissioner for Refugees (UNHCR) have yet to find a solution. There's talk of a fourth site in Dadaab being opened to ease the overcrowding, as well as moving tens of thousands of refugees west to Kakuma - a camp formerly established for Sudan's Lost Boys in the early 1990s. But this latter option would be massively expensive and would take a mammoth coordination effort as it's a three-day trip over some pretty atrocious roads from east to west.
So while the talks continue, so does life in Kenya's camps. Aid agencies in Kakuma have been working with the Ministry of Health and the UN to vaccinate children against polio, after the potentially-paralyzing disease reared its head again in the region after decades of dormancy. In Dadaab, a similar campaign to vaccinate children against measles is ongoing.
The UN has estimated that it will need around US$91 million this year to improve conditions for existing refugees in Dadaab and provide aid to new arrivals. It's a daunting task ahead and one that won't get any easier until an agreed solution to Dadaab's dreadful congestion is found.
Check out the International Rescue Committee here.