Somalia: Practising medicine in the middle of violence, displacement and deprivation

NAIROBI, 9 May 2007 (IRIN) - In the midst of Somalia's chaos and violence, mostly in and around the capital, Mogadishu, one woman has vowed to make a positive contribution. Hawa Abdi is a gynaecologist with a practice in a 26-hectare compound that has become a camp for thousands of displaced Mogadishu residents fleeing the fighting between Ethiopian-backed government forces and insurgents.

Abdi was one of the few female professors in the Medical School of the University of Somalia, before the collapse of the Somali state in 1990. She attributes her achievements to her father. "I was blessed with a very progressive father who put a lot of emphasis on education," she says.

Abdi opened her practice - 20km south of Mogadishu - in the 1980s with in-patient and out-patient facilities. The civil war began in the 1990s and with it the crumbling of her successful practice. "Back then [before the civil war] every one of my patients could afford to pay for the services. Now it is a different story," says Abdi. "I even worked normal hours and had time for rest and relaxation."

She now cares for thousands of internally displaced people who cannot afford to pay for her services and need constant care. "Most of the people in my compound could not afford to pay for their lunch, so how can I ask them to pay for my service?

"Most days, I work 15 hours and sometimes more, but I am thankful that my daughter [also a doctor] is with me and has been by my side through it all.

Abdi has another daughter who is also a doctor but lives abroad. Her son, who was studying medicine, was killed in 2005.

Abdi says running the practice and helping people has been satisfying both "personally and professionally".

She says her compound has not been targeted and is "respected by all sides throughout the civil war as a neutral zone where anyone can seek help".

The main challenge remains finding supplies, "whether it is medicines, food or water. It is a constant struggle to provide the basics, even for my staff."

Abdi says the compound has a staff of 72 - mostly volunteers. "Sometimes they are lucky if they are paid once a week."

Aid agencies have helped but they had to increase their activities, she says. The United Nations Refugee Agency, UNHCR, and the UN World Food Programme (WFP) have assisted the displaced, but "we need the agencies to scale up much more seriously - and soon".

She says children are the most affected and they should concentrate on them.

Despite enjoying her work, Abdi says she is growing physically and mentally tired and is losing hope of the situation improving.

"When you are hopeful that things will improve, you can go on but when you lose hope then you cannot go on.

"I see nothing but hopelessness in the faces of the people in the compound."

Abdi says she is not optimistic that peace will ever come to Somalia. "I am not very optimistic. It is almost as if peace is getting farther and farther away from us."