Mary Robinson went to Somalia as Ireland's president in October 1992. She went again in July this year. It wasn't good in 1992. "What struck me this time," she told me, "is that on every count, things were worse."

In 1992, she says, she spoke to two of the warlords about letting food get into the feeding stations - but "it's impossible to have any constructive conversation with Al-Shabaab, with their links to Al-Qaida," she said. In October 1992 there was some prospect the rains would come. In July 2011, the UN had already declared famine in two regions.



To me, that is horrific because it means the death of thousands, particularly children. They estimated while we were there that about 28,000 children had starved to death. It's really awful indictment of all of us in the 21st century. To put a woman at her ease, one of the questions you tend to ask is how many children do you have? Of the women I asked, there wasn't a single mother who said to me fewer than six. The average is seven or eight. You could see how they live their lives. They have many children so that at least one or two might survive.



She asked whether there was any attempt to provide reproductive health and family planning advice, but it was clear it was neither culturally easy nor a priority. The priority was to weigh and stabilise starving children by feeding them plumpy'nut - the peanut-based paste given to babies with severe malnutrition. Older children and even the mothers were so hungry that they were sucking on it, too.



That's a backdrop that is really extraordinarily difficult, particularly for the women, that they simply have no security and they have no sense - because of the lack of healthcare – that their children will survive.

She is chair of the global leaders' council for reproductive health at the Aspen Institute. She and her colleagues believe the absence of family planning in Somalia, where just 1% of married women have access to contraception and where the birthrate is one of the highest in the world, is a contributory factor to the country's misery. Robinson talks of the failure to learn the lessons of the famine of 1992, and the failure of the donor community to prioritise the health of women and children.

Trying to turn our backs on Somalia in recent years, she says, has been a disaster.

The tragedy of Somalia is that because of the lack of effective governance over the last 19 years, there has been too little emphasis on building up healthcare and education. Once Al-Shabaab was linked with Al-Qaida as a band of terrorists, a grey curtain of 'too difficult, no-go area' came about. Last year Al-Shabaab expelled a number of humanitarian aid workers, and that made life even more difficult. But we cannot afford in the 21st century to have failed states. It's not conscionable anyway for those who live there – the women and children, elderly and men – anybody. Today no country is isolated from a very inter-connected world. We've seen the realities of piracy, we've seen Kenya, Somalia's neighbour, having to go in militarily. There is a lesson to be learned: we need to re-engage right across the board with Somalia at all levels and try to strengthen the access to education and to healthcare, and include in that access to reproductive health and family planning.

She thinks there is a real need to engage with Somalia's women, who are not as hidden or powerless as some might assume. They control the market in khat, for instance, and on the political front Asha Haji Elmi founded the "sixth clan" to get a seat at the table in the peace process. But women are still excluded from being decision makers or being involved in the solution, she says. Changing that would be significant.

Humanitarian aid must be linked to development, she says.