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A doctor bound by humanity

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Times Staff Writer

FROM the second-floor balcony of her modest hospital, Dr. Hawa Abdi scans the wind-swept bluffs that lured her here a quarter of a century ago. The landscape is dotted with thousands of stick huts, draped in bright-colored plastic, leaves and anything else the refugees could scrape together.

Downstairs, the stream of patients never ceases. A dozen malaria cases a day. Bloated babies with diarrhea.

The miscarriages are hardest to bear, says Abdi, a gynecologist. She counted 1,111 in four months early this year, when gunfire and shelling between government troops and insurgents were the heaviest.

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Abdi opened her private clinic for women and children in 1983. But when the government collapsed eight years later, she threw open her doors to all, treating victims of shootings, malnutrition and a string of epidemics.

As word of her generosity spread, the needy flocked here. More than 20,000 people currently live on her land. She offers treatment, clean water and whatever food she can spare. Nowadays, few can pay, but no one is turned away.

Abdi acknowledges that after 25 years, she dreams of escaping this place, of selling everything and joining one of her daughters, who is in Atlanta.

“I’m tired,” she says, sighing. “Sometimes you lose hope, you feel depressed. I’ve been here so long.”

But Abdi, 60, has become a hostage of her own humanity.

“How can I leave now?” she asks, walking past dozens of patients sitting on the ground around the whitewashed building and lining the halls outside her office. “What would I say to the people who have been living here for 16 years? If I could get 20,000 green cards, I’d take everyone to the U.S. But who will take my place?”

Her reputation has spread throughout the nation. Here, Abdi is a nearly mythic figure. The hospital is named after her. Even the surrounding village is called Hawa Abdi.

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“She’s a queen,” says Hamdi Nur Mire, 45, a mother of nine who fled Mogadishu four months ago for this place 12 miles to the west.

MIRE and thousands of others have found security on the 60 acres around Abdi’s hospital. Every day, new families settle on the tree-covered terrain, constructing dome-shaped huts from branches.

Abdi used to try to personally welcome every new family, but that has grown harder now that she oversees one of Somalia’s biggest displacement camps.

“We wouldn’t survive without her,” Mire says. “She is doing what the government should be doing.”

Abdi may feel weary, but she shows no sign of it as she makes her daily rounds. Her purse under one arm, Abdi caresses cheeks and strokes heads with a mother’s tenderness. Patients beam and struggle to sit up as she gently prods and pokes.

Despite limited funds, Abdi tries to keep the compound cheerful. Fresh orange and pink paint decorate the walls. Pots of flowers brighten the halls.

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In contrast with the desperation around her, Abdi, wearing a shimmering green dress and dangling gold earrings, exudes calm and courteousness. A squinty grin rarely leaves her face.

Abdi stops at the makeshift pediatric unit, in a patio covered by flimsy plastic sheeting to keep the rain out. Here some of the sickest babies lie limply in their mothers’ arms. Diarrhea and dehydration are the biggest risks, but Abdi has only a limited supply of IV bags. That sometimes requires painful choices.

She presses her thin fingers against a baby’s stomach.

“This one needs an infusion immediately or he won’t make it,” she tells a nurse.

Sometimes there is little she can offer besides comfort and hope.

A middle-aged patient removes her veil to reveal a cancer that has nearly eaten away her lips. With no access to chemotherapy or radiation, Abdi can give her only a traditional African therapy involving tree bark.

“It’s all I have,” she says.

Born in Mogadishu, Abdi came of age in an era when the seaside capital boasted thriving coffeehouses and ornate Italian-style mansions. Thanks to Somalia’s strategic importance in the Cold War, the economy boomed.

Her father ran the city’s port. Her mother died when she was 12. As the eldest, she might have been forced to raise her siblings and take care of the house.

“But my father was an educated man,” she recalls. He ensured that she pursued her dream of becoming a doctor.

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Abdi received her medical training in Kiev, Ukraine, during the 1960s with the help of a Soviet scholarship. At the time, Somalia was allied with the Soviet Union, while its archrival and neighbor Ethiopia was a partner of the United States. (In an abrupt Cold War reversal, a Marxist regime came to power in Ethiopia in 1974 and Somalian dictator Mohamed Siad Barre switched loyalties to the U.S.)

After completing her studies, Abdi returned and opened her clinic; soon the practice drew clients from all over the country, and even abroad. She was one of Somalia’s first female gynecologists.

She married, raised three children, invested in hundreds of acres of farmland and had enough left over to purchase a beach getaway.

After Siad Barre was toppled in 1991 and Somalia descended into clan-based civil war, Abdi struggled to keep her clinic independent. One day, she says, soldiers with the Darod clan swarmed the facility, looking to kill or capture patients from the Hawiye clan.

“You will have to kill me first,” she recalls telling the armed fighters. They left and never bothered her again.

BY 1993, disease and starvation had crippled the city.

“We got 50 bodies a day,” she says. “They were literally dying in the street. We buried 10,065 that year.”

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She motions to a patch of bougainvillea next to the hospital. “President Bush’s helicopter landed right over there,” she says, referring to the current president’s father, who visited

in January 1993 before he left office. He tried to comfort her

patients, she says, assuring them that everything would be OK.

But any hope was short-lived.

Later that year, President Clinton withdrew U.S. troops after 18 American soldiers were killed in a battle when two Black Hawk helicopters were shot down during a mission in Mogadishu. The bodies of two soldiers were dragged through the streets. United Nations peacekeepers left shortly after.

Warlords divided the capital but left Abdi and her rapidly growing displacement camp alone. Assistance occasionally came from international aid groups. The International Committee of the Red Cross donated an operating table. Doctors Without Borders provided drugs. A Christian relief group built a second story to the hospital, which now has 100 beds. But most groups abandoned the dangerous Horn of Africa country.

And with no functioning government, there has been no public funding to help with the costs. Abdi pays from her own pocket -- from her savings or occasional payments by patients.

Drugs and medical equipment are in short supply. The hospital has no X-ray or ultrasound machines, and just one overburdened generator.

In 2000, Somalian leaders met in neighboring Djibouti in an effort to reestablish a national government. Abdi gave a speech about unity that was so well-received she was appointed vice minister of labor.

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But the brush with government service didn’t last long. Neither did the government. She quit after less than a year, frustrated that those in top positions were expatriates or warlords seeking to profit. The fledgling government fell apart without really taking power.

Her commitment to her work, and Somalia’s instability, contributed to the breakup of her marriage, she says. Her husband left years ago, starting a new family in northern Somalia. But all three of her children followed their mother into medicine. Her daughter in Atlanta is studying to become a doctor, while another helps run the clinic here. Her son was killed last year in an unsolved shooting.

When an Islamist militia seized control of Mogadishu last year, Abdi wondered what it might make of an outspoken, strong-willed woman who wore a red-checkered African-style head scarf rather than a veil.

“As a woman, of course I was worried,” she says. “I stayed away from Mogadishu.”

Islamist rule also proved short-lived. But after Ethiopian-led troops helped the transitional government take back control of Mogadishu in December, the fighting continued, nearly forcing Abdi to shut down in the spring. The number of displaced on her land soared from 500 families to 3,500.

“April was the hardest time,” she says. “I wanted to give up.”

Her daughter Amina Aden Mohammed, 28, helped her get through the rough period.

“My whole life I have watched my mother helping other people,” the daughter says. “I will stay here forever, like my mom.”

Upon hearing this, Abdi shakes her head. Nothing has made her prouder than watching her girls take up medicine, she says.

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She has no regrets about the sacrifices she made to help those who came to her land. But she doesn’t want to see her daughter do the same.

“No,” Abdi says. “I won’t let her do it.”

edmund.sanders@latimes.com

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