Over time this small operation evolved into one of the largest camps and medical facilities for internally displaced people in the war-torn country.
Today the camp houses 90,000 people, mostly women and children. She works alongside her two daughters, also doctors, under perilous conditions.
In 2010 Islamist militants invaded her camp and held her hostage for several days.
“I am Somali, I am a mother, I am a doctor, and I deserve to be respected. I care for so many people around you—this was a tragedy you could have prevented.
I ignored their call, so they came to my gate unannounced: six members of the Somali insurgent group Hizbul Islam, with a request to speak with me in person. Their militia had controlled our area for the past year—the latest in an endless line of transitional leaders, warlords, and regimes I’d seen since the collapse of Somalia’s government. I was examining a severely malnourished child, who hadn’t eaten for at least four days, when I heard the news; I was not willing to abandon my patient for a conversation with people whose only clear goals were to rob, to take over, or to kill.
As hard as it may be to imagine, Somalia was peaceful when I moved here. But now, after more than 20 years of a civil war caused by interclan fighting, the small clinic I started is a 400-bed hospital. The land behind it, once fertile, now utterly parched, offers refuge to more than 90,000 internally displaced people—a fraction of the nearly half--million who now live along that main road, which stretches northwest from our destroyed capital city. (About 1.5 million Somalis have been displaced by the violence.) The need in our area is unimaginable, but my mission as a doctor is the same. I rise long before dawn with a singular focus: to meet my patients’ needs.
One of my fellow doctors tried to reason bravely with the Hizbul Islam soldiers, jittery, aggressive young men with -henna-dyed beards, wearing red-and-white checkered scarves, their index fingers forever on the triggers of their guns. He told them that in our area, we are known as a refuge; we treat all victims of the conflict equally, no matter what side they’re on.
The six men refused to leave, so I assembled my committee of elders and welcomed them to lunch.
They finished my food and began the conversation with an insult: “You have to hand over the authority of the hospital and the management of your camp to us,” one gunman told me.
“This is my property,” I said. “I am the doctor here, and I have the knowledge for it. On what legal basis should I hand over a hospital to you?”
“You are a woman,” said another, with naked contempt. “You are not allowed to shoulder any responsibility and authority.”
According to their version of Islam, a woman is an object that is denied basic human rights. Her role is to support men by staying in the home, cooking and cleaning for them. My Islam sees women as valued members of society—as equals.
The elders quietly reminded me that the men could shoot me at a moment’s notice, but I refused to back down.
“So they’ll shoot me!” I told them. “At least I will die with dignity.”
They did not shoot me; they pushed back their chairs and left. Although none of us doubted Hizbul Islam’s words, and their threats, we had no time to worry or wonder. We returned to our work.
In 1971 I began my practice in Mogadishu’s biggest hospital, as one of Somalia’s first female gynecologists. Since most women lacked the resources for a hospital birth, I decided to open my own clinic next to our family’s home in a rural area, 15 miles from the capital. Within a few months, I was seeing 100 patients a day.
When our government collapsed 20 years later, the clinic and my home next door transformed into a triage center; our land became temporary housing for hundreds, then -thousands—mostly women and children. With limited resources, I gave away what I had, but our farm’s stores soon ran out. Warlords blockaded the ports and created countless checkpoints along our already lethal road, attacking aid groups, intercepting the food, and selling it for arms.
During those dark days of 1992, starvation set in and I sold my family’s gold to buy enough food to sustain the vulnerable children and give the grave diggers enough strength to work. Even when we were burying 50 people per day, I was still able to provide free land, security, and medical treatment. We clung to one another and we survived, but the fighting continued. Now, again, we see famine—not caused by drought alone, but by the conflict that continues to ravage Somalia.
A week after my meeting with the Hizbul Islam militants, I awoke to the sound of gunfire. The phone rang as I was rushing to dress: they had sent 750 men to surround us, and to take my camp by force.
The invaders hung their black flag in our emergency ward and brutally beat our guards and our elders, clubbing them with gun-butts. As their mortar shells slammed into the cement walls and aluminum roofs of our hospital, I called my daughters, who were both out of the country at the time. They prayed for my safety and began alerting the media.
When a BBC producer called me during some of the heaviest shelling, I told him that the militiamen’s targets were the maternity and surgical wards, and the pediatric malnutrition section. One woman recovering from a C-section I’d performed earlier that day had stood up to run, her wound opening as she disappeared toward Mogadishu.
Terrified mothers had detached feeding tubes and IV lines from their dehydrated children’s noses and arms to flee into the woods, away from the indiscriminate shooting. We knew that they would not survive. “Pray for us,” were my last words before hanging up. “Pray for us.”
A round of bullets hit my front door, shaking the entire house; a group of militiamen stormed into my room. “You’ve spoken to the radio, haven’t you?” shouted one. Six of my nurses surrounded me—“We have to be present when she is killed,” they said—and another militant ordered us to hand over our mobile phones and forced us outside to a waiting bus, which drove us to their headquarters, about 4 miles away.
They held us in an empty room where the nurses and I sat together on a stack of mattresses. At one point I heard my own terrified voice from the next room: the militia was listening to a rebroadcast of the BBC interview.
Some time later, a gunman entered and handed me his mobile phone. “You have many supporters,” he said, ordering me to send a message that I was alive and unharmed. I talked and talked, reaching out first to my daughters and then to the hospital’s staff, urging them to speak out. Hizbul Islam, I said, didn’t have an ounce of humanity. They’d done things far worse to others than what they’d done to me.
After 10 hours the militiamen hustled us back into the bus and returned us to the camp, which was dark, silent and ravaged. Without my daily order to start the generators, there was no electricity and no power for the water pumps. (I later learned that militia in the camp had taunted the residents by shouting, “No Hawa, no water.”) Armed men led me into my ransacked house, guns slung over their shoulders.
They’d destroyed every one of my family pictures, shredded my documents, shattered our CDs. My mattress was ripped open, my furniture slashed in a fruitless search for hidden money; though they went after my safe with a sledgehammer, they’d failed to open it. They’d even stomped on my daughters’ framed college photos, saying that their association with their male classmates proved they were infidels.
At dawn I looked out the window to a sea of people gathered around the house. When they saw me, they began shouting, “We want to see Dr. Hawa!” Hizbul Islam’s guards had no choice but to turn to me for advice; I told them that to maintain order, they had to let people in, about 400 at a time.
As I welcomed visitors between the hours of 6 a.m. and 1 p.m., I put on a brave face. But I could not stop thinking about the two men who had died in the initial gun battle, and the people suffering without medical care. I gave a local reporter a short interview, telling him that Hizbul Islam had entered my private property, and that the needy women and children they’d attacked were my guests. The area’s safety, I said, depended on the intruders’ removing their black flag and leaving.
The next day a militiaman entered my room, flanked by two 18-year-olds carrying machine guns. “Dr. Hawa, you are stubborn,” said the man, reiterating that I was not to give an outside interview.
“You are an old woman,” he said. “You need to sit.”
“I do something for my people and my country,” I said. “You are young and active. What have you done for your people and your country?”
I could see fear registering in the faces of the nurses surrounding me. “You are men,” I said calmly. “You need to give something to these people in need.”
They removed most of their gunmen, but the hospital, the school, and the sanitation departments remained at a standstill, the camp’s wreckage a reminder of Hizbul Islam’s unimaginable cruelty. In the back of my head I can still feel the pain of every hour, every minute that hospital stood still.
After a week of paralysis, five armed men returned to my room with a different demand: “We told the media that the place is open,” they said. “You need to open it.”
I knew that if I accepted their request to open my facilities today, they’d have the power to return tomorrow, to tell me to close them. I had to show them the consequences of their actions, for their own survival: they are the husbands and the sons of the women I treat, the brothers of the other wounded men in the hospital.
“I’m not going to open it until you write me a letter of apology,” I said.
Seven days later, their second-in-command came to me with a signed letter written in both Somali and English. The letter apologized first to me, then to the nongovernmental organizations helping in the camp, the camp’s staff, and the Somali people around the area who lost loved ones.
“I am Somali,” I told him. “I am a mother, I am a doctor, and I deserve to be respected. I care for so many people around you—this was a tragedy you could have prevented.”
Thanks to the generosity of donors, we’ve rebuilt the hospital bit by bit, and we’re expanding our maternal and child health services and our education programs. But the attack had a lasting effect on our work: since then, all of the international organizations working within our borders, including the U.N.’s World Food Program and Doctors Without Borders, have left. The situation is too dangerous.
The drought in our area has led to the worst starvation I have ever seen—worse even than what we saw in 1992. Without any other option they are walking to us from as far as Baidoa, more than 150 miles west, deprived of food and water for four, five, even seven days. Many—too many—are falling down and dying along the way; their families have no choice but to bury them alongside the road. Those who make it stand in line by the hundreds at our hospital—mostly desperate mothers holding children dying of severe malnutrition.
While we’ve run out of space to house them, we give what we can—free water and free health care. We’ve taken the money we’ve raised to open a series of emergency feeding centers that will serve, for now, about 12,000 people per day, but it is not enough. We need the investment of the international community to guarantee that we survive this difficult time and return to strength.
Adapted from the forthcoming Human Rights Watch book The Unfinished Revolution: Voices From the Frontline in the Global Fight for Women’s Rights (Seven Stories Press, March 2012). Abdi’s autobiography, co-written with Sarah J. Robbins, will be issued by Grand Central Publishing in 2013.