MOGADISHU, SOMALIA – The whirring fan in the middle of the container-turned-hospital blows constantly, but does not tame the sweltering Somali heat. The faint noise of the fan competes with wailing children and grandmothers’ prayers.
“Welcome to Mogadishu. We are now in the African Union’s Mission for Somalia’s (AMISOM) field hospital,” says Dr. Lopez Mukuye, a military capital working at the hospital.
The small room is crowded. In the corner, a little girl sobs uncontrollably. “Her name is Hawo Muhidin. She is six years old. A bomb hit her house at night and all her siblings died.” says Juliet Arinkunda, a nurse, as she cleans what is left of her little limbs.
Arinkunda, 23, is from neighboring Uganda. She is a nurse with the African Union in Somalia on a nine-month tour.
For the last five months she has spent day and night in this container, cleaning up wounded children, calming their insistent cries and giving hope to hopeless relatives.
“This place is empty now,” she says, pointing to the still overcrowded container. “During Ramadan, the place was full. We had children lying on the floor. We did not rest,” she says. “Some had broken limbs. Others had bullets lodged in their bodies; others [had] bomb shrapnel. We managed to treat all of them, nobody was turned away,” she says proudly as she finishes to dressing Hawo’s torn limbs.
During Ramadan, a holy month on the Islamic calendar that lasted from August 11 through mid-September, Al Shabab, the armed group at war with Somalia’s transitional federal government, stepped up its onslaught on the African Union forces and civilians here.
And as is the case with many wars, women and children are frequent victims in the battle for Somalia. According to the United Nations Children’s Fund, UNICEF, Somalia has devastating rates of infant mortality as the war here nears the 20-year mark. In the capital, Mogadishu, and in the countryside, thousands of children are nursing gunshot wounds, amputated and fractured limbs, and countless other injuries thanks to the civil war that has been going on since 1991. Last year, the Somali government declared a state of emergency and requested international support.
Of the more than 7,000 African Union troops called to Somalia, just 122 are women. Somalia remains on of world’s most dangerous countries and those on the front lines, including the doctors and nurses who tend to thousands of patients each week, are helping to keep the United Nations-backed government in place.
Last month, Al Shabab declared a “massive war” against the African Union and any other international troops aiding the Somali effort. In August, Al Shabab claimed responsibility for an attack on a hotel that killed 35 people, including eight members of parliament.
There has not been a central government here since the ouster of president Mohammed Siad Barre, in 1991. The current government, the Transitional Federal government, controls the capital with the assistance of the African Union forces from Burundi and Uganda, supported by the international community and the United Nations.
The collapse of the central government has meant that public services and institutions are scarce. Hospitals and clinics operate on a shoestring budget maintained mostly by international donors.
For Arinkunda, the politics are not important. She says her life is about the people who did not choose war.
“They come everyday, the children hit by stray bullets, mortars. Others lose all their parents and are brought here by their grandparents or neighbors, but many more never live to get here,” she says.
At 23, Arinkunda has seen her fair share of suffering. “All these women are looking to me to save their children,” she says as she points to a line of mothers and grandmothers.
Arinkunda says she has questioned whether or not she would have the strength to complete her nine-month assignment many times. But with just over three months left, she says she will finish her assignment.
“These too are Africans. If we leave, many will die,” she says as she moves on to the next child — this time a boy whose face has been torn off by a stray bullet.
In the next tent, Mukuye leads the way into an area he calls one of AMISOM’s success stories. In this tent, a group of women who Mukuye says have “all lost their babies and have been divorced,” sit shyly. “No man will agree to stay with a woman who is leaking urine and stool,” he whispers.
“He is talking about Fistula,” says Sister Mary Ochieng, interrupting. Ochieng is a lieutenant in charge of the female ward where hundreds of women suffering from fistula are admitted ever year.
Obstetric fistula is condition defined by a hole in the birth canal caused by prolonged labor. Many women who suffer from the disease leak urine and stools, causing them to be socially isolated from their families and communities. This makeshift hospital is the only place where women can come in search of a surgical cure.
“Unfortunately, here in Mogadishu, we have so many ladies getting married at an early age, from 14. So they end up getting complications [that] lead to leaking urine and stool,” Ochieng says.
Inside the tent, the smell of urine and feces is choking. Here, more than 300 women are awaiting the simple, but rare and expensive surgery that can restore their lives. Ochieng walks with ease inside the ward, stopping to cover those who are already asleep and sharing hearty laughter with those who shy away from the camera.
“The majority [do] not fit in the community because they smell [of] urine. Because of that smell, psychologically, they undergo a lot of torture,” she says.
The surgery can normally repair the injury at an average cost $300 USD. But most women with the condition do not know the treatment is available, or they cannot afford it. Women have flocked here in hopes of receiving treatment.
Ochieng is here on her second tour. She was among the first officers to be deployed in Mogadishu last year. In her first deployment, she says she watched as some of her colleagues died on the frontline.
Today, there is still gunfire in the air. As visitors duck for cover, Ochieng walks calmly and begins to tend to her patients.
“These women have seen it all,” Ochieng says, gesturing to one woman at the back of the container. “She told us she is 50, but we think she is older than that. She told us she has had [fistula] for 22 years,” she says.
Ochieng, like many other military officers, will reveal little about herself. She says she left her family back home in Uganda where peace now reigns. For now, Mogadishu is her home.
