At ‘Place of Bones,’ Somali Doctor Runs an Oasis of Hope

Hawa Abdi Diblawe remembers the worst day she had trying to get food supplies to starving refugees at her hospital and camp.

Just as a convoy of trucks was leaving the capital’s port, a band of militia fighters from one side of Somalia’s civil war arrived to steal the valuable supply of grain. Hawa stood up and told them that the food was for starving Somalis and that she was Somali and was ashamed of them for robbing their own people. This brave speech convinced half of the gang, but not the other. The debate was settled in the current style: a shootout in which, luckily for Hawa, her new supporters won.

“I just ducked within the convoy and waited. Fortunately, the ones who believed me were better shots,” said Dr. Hawa, as she is known.

And she is known widely, because she is one of the few Somalis who have put themselves on the line for other than partisan gain. Having a chance to flee like thousands of other well-off Somalis have done, she stayed on and almost single-handedly maintained a medical oasis for the destitute along a road south of Mogadishu.

Her Lafole Hospital has become virtually a required stop for touring dignitaries visiting stricken Somalia. President Bush visited last week, and on Sunday, U.N. Secretary General Boutros Boutros-Ghali paid a call.

They come because word got around about how Hawa had shown what dogged dedication can accomplish under primitive conditions of violence and deprivation. Her hospital was the only private one in the country before the civil war, and she set it up to service rural folk who had little chance to get medical care for lack of transportation and money. Sixteen beds were for paying patients; 24 were for free. Rich Mogadishans helped support the project.

With the war, Hawa received whole new varieties of patients: people who were afraid to go to Mogadishu hospitals because of intense fighting there (hospitals closed as streets became impassable) and rural residents driven off their land by waves of attacks and counterattacks among warring clans.

“Sometimes people who never heard of us just saw the building and decided to stop by. We had to give them food. That’s how we became a refugee camp,” Hawa said.

The two-story building is surrounded by little domed huts covered with plastic, wood and paper sheeting. Nomadic refugees have set up mini-villages among family members. Food is served from communal vats heated over charcoal fires.

As the war heated up, Hawa received help from the International Committee of the Red Cross and the U.N. Children’s Fund. Food was rarely sufficient, and the refugees kept coming. Hawa recalls how refugees would drop dead on the road outside the hospital just before reaching safety. Some children left parentless are now housed by Hawa in an orphanage. Lafole means “place of bones,” so named because a battle between Somalis and Italian colonists once took place there. The name has taken on a new meaning with the skeletal condition of refugees who lie listlessly in the huts.

The great majority of Somalia’s doctors have fled the country, driven away by the danger of a war in which civilians are tactical targets. Hawa raises her voice slightly when reminded that few Somali doctors remain. “The intellectuals must stay or the country will not survive,” she said and then returned to her more customary soft tone. “Anyway, to flee is no solution for me.”

Hawa, 45, was trained in medicine in the Soviet Union. One of her three children is studying to be a doctor. Her husband is an engineer.

She operates the hospital, popular outpatient clinic and camp with one other physician and six nurses. “I could use another doctor, more nurses, almost any equipment, an operating table, so many things.”

A dispiriting thing about Somalia is that once one problem begins to move toward a solution, that movement seems only to reveal yet another horrendous quandary on the way.

So when food relief supplies began to flow steadily into Lafole Hospital and refugee camp, thanks to security offered by American and other foreign troops at the port in Mogadishu and along the road south, problems that were secondary to starvation blossomed into prominence. In this case, it was tuberculosis, for which the hospital has absolutely no medicines to cure and can only deal with the symptoms. Patients are sent home rather than being kept at the hospital or camp for fear that the disease will spread rapidly among the 5,000 refugees.

“One person can infect 10. We have no facilities for isolation, and we have asked the World Health Organization for medicine, but they have given us nothing. Well, there are so many problems, this will not be the last,” Hawa said.

Food is a problem only partially solved. She receives mostly carbohydrates from the Red Cross; no meats or fruits or milk. She lacks funds to buy on the open market where bananas and mangoes are available.

Hawa is not waiting passively. She has opened some land she owns to refugee farmers whom she will move from the camp to the scrub property and let them grow corn and beans. Later, Hawa hopes to encourage coastal refugees to begin fishing off the nearby shore. “Maybe,” she said, “the people someday will supply this hospital with food and not us, them.”