Somalia's war surgeons learn skills of peace
Wednesday, May 08, 2013
Not yet named but much loved by watchful parents, a newly born baby boy
is a small symbol of change: a birth, not a death for Somalia's key war
After more than two decades of bloody civil war,
Somalia remains a very dangerous place, but security has slowly
improved, with Islamist fighters linked to Al-Qaeda on the back foot
despite launching a deadly bombing campaign.
For the surgeons of
Medina hospital, whose specialised war wound operating theatres were set
up shortly after the collapse of the government in 1991, that gradual
reduction has meant they can start to focus on more everyday health
problems for the first time, and not just bomb blasts or bullet wounds.
"Medina... is the thermometer of the temperature of the security in the city," said hospital director Mohamed Yusuf Hassan.
now are tackling elective surgeries -- scheduled operations, not
emergencies -- and the decrease in war wounds the Mogadishu hospital
treats shows how the "situation has improved", he added.
the war wounded last year made up almost all of the hospital's cases --
95 percent, Hassan estimates -- that has now eased to around
"Step by step security is improving," Hassan
said, adding he hoped that in the year ahead elective surgeries could
rise to as many as half the hospital's cases.
In Somalia, however, improvements are relative.
In the emergency ward, a government soldier rests by the bedside of a colleague, shot in the belly last week.
crowd even the corridor, with more than a dozen people all shot or
wounded in recent attacks by Shebab Islamist extremists, or clashes
between rival groups within the often violent city awash with guns.
in the obstetrics ward, Shurkri Abdi recovers from a Caesarean section
performed to deliver her seventh baby -- and her first child born inside
"I was living in the bush and I didn't expect to
come to the hospital," Abdi said, her still unnamed child sleeping in a
cot beside her. "But I fell down and my baby was in danger so they took
For Nimo Abdi Hassan, the doctor who delivered the child, such cases signal a shift in Somalia's fortunes.
patients only used to be received here," she said. But since the number
of cases involving gunshot wounds or shell injuries has fallen, staff
are treating a greater variety of cases, she explained.
"If peace continues, we could transfer from an emergency hospital to a general hospital for all cases," she said.
-- 'I don't know how long it will take to become a normal city' --
busy, overstretched surgeons rarely had time for cases that emergency
rooms in less-violent cities would tackle, meaning many doctors simply
had to drop procedures that are routine in other parts of the world.
as the cases of war wounds diminish, doctors in Somalia are for the
first time able to start tackling common conditions like appendicitis,
ovarian cysts or hernias.
"We need training... but in terms of
the actual surgical skills, well we have that," Hassan said, adding his
doctors are hugely experienced, even if they are not necessarily up to
date with the latest techniques or know little but basic operating
"They have surgeon's hands... completing surgery after surgery with so much experience," he added.
World Health Organisation is supporting efforts to train doctors in
Somalia in the skills needed to treat these everyday health problems
often ignored during the years of conflict.
But there is still a
long way to go. Even as the hospital director speaks, the sharp rattle
of multiple rounds of rifle fire echoes close by.
Shortly after, a man with gunshot wounds is rushed into the hospital for the surgeons to try to patch up.
when there was fighting close by, stray bullets would even injure
people inside the hospital, bullets coming through the roof," Hassan
said, on a rare break from his work, resting in the shade of a tree in
the grounds of the sprawling hospital compound.
"It's better now, but still, I don't know how long it will take to become a normal city."
those improvements in security have also meant people can reach the
hospital more easily, meaning the doctors in Mogadishu are busier than
In 2011, heavily fortified trenches and sandbag walls cut
the city in two, marking the slow street-by-street progress of the
African Union (AU) and Somali government troops creeping forward to
wrest territory from the Shebab.
Today, those frontlines are gone, after the overnight pull-out of fixed positions by the Shebab in August 2011.
doctors once filled the medical school at Mogadishu University, but the
compound is now overgrown with thick bushes, the buildings in ruins or
inhabited by displaced people, and the main grounds occupied by
sandbagged positions of Burundian troops from the AU force.
much was destroyed in this city during the years of fighting, it will
take a long time to return to what Somalia once was," said Abdi Shuib, a
former history lecturer at the university, now working as a translator
for the Burundians.
In the school's place, AU military doctors provide a clinic for locals in need of healthcare.
have changed in Somalia, but I still dream of the university opening
again, and training returning," Shuib said, on a break between
translating for Somalis receiving medical support in a basic army tent.