MSF-USA: Responding to Violence in Somalia

September 15, 2006
Responding to Violence in Somalia

"We are able to treat most of the gunshot victims, but we do not know how many die of their injuries before they get here."

– Abbas Hassan Warsane, MSF surgeon

The Doctors Without Borders/Médecins Sans Frontières (MSF) project in Somalia's Galgaduud region provides life-saving surgery free of charge. It also provides a worrying glimpse into the level of day-to-day violence in Somalia.

Istarlin Hospital is one of very few health facilities that perform quality surgery in Somalia. Patients with gunshot wounds come from both Galgaduud and other regions for surgery. Some travel up to 200 kilometers to get to the hospital.

MSF took over responsibility for Istarlin Hospital in the town of Guri El in early 2006. Since then, 21 percent of the admissions to the hospital have been violence-related. Many of its beds are occupied by patients with disturbingly similar stories.

Bullet wounds

Ahmed al Faray was traveling on a truck when armed robbers stopped the vehicle and he was shot. He was shot in the left arm. Ahmed has received surgery, and is recovering in the Istarlin hospital, which is run by MSF. Photo © 2006 Espen Rasmussen

Abdinaser Hashi from Beletweyn, 100 kilometers south of Guri El, is lying on his stomach in his bed. He has been in Istarlin for a month, ever since he was shot in the lower back by an unknown man.

"I have no idea why he shot me," Abdinaser says.

Another young man, Ahmed al Faray, explains that he was traveling on a truck when gunmen stopped the vehicle to rob its passengers. Ahmed was shot in the left arm. He has received surgery, and is recovering in the hospital.

Hassan Aden Noor is from the Hiiran region. He has been hospitalized for 20 days. Bandages cover his abdomen.

"I was shot in the stomach by robbers," he says.

"We hear stories like these very often," says MSF surgeon Abbas Hassan Warsane. "We are able to treat most of the gunshot victims, but we do not know how many die of their injuries before they get here."

Fatal trap

One of the first patients at the hospital after MSF arrived in Guri El was a young boy from Abudwaaq, near the border with Ethiopia.

"He came here with a very serious grenade injury," says MSF nurse Bianca Tolboom. He and two friends had been stealing from a shop. The shop owner placed a watch on a piece of cloth, under which she hid a live grenade.

"Both of his friends were killed in the blast," Bianca says. "After two months and three rounds of surgery, we could finally discharge the boy."

Demands attention

Frequent acts of piracy off Somalia's coast have caught the attention of international media, as have death tolls in the hundreds after clashes in the capital Mogadishu. The everyday violence endured by Somalis is perhaps less spectacular, but it is no less serious for those who suffer from it.

"Survival instincts have been brought down to a very brutal level after 15 years of lawlessness and civil war," says MSF Head of Mission David Michalski. "That is the reality people here are forced to live with."

MSF has been working in Somalia since civil war began there in 1991. It currently runs eight medical projects in the country. In 2005, MSF provided more than 350,000 outpatient consultations and admitted more than 10,000 patients to its health facilities.