Giving Shelter: How Dr. Hawa Abdi Created a Medical Sanctuary in a Time of Civil War.

In the mid 2000s, a small patch of ground in the middle of a country torn apart by the marauding violence of warring clans and religions held ninety thousand souls, in search of peace and protection. In nearby Mogadishu, the capital city of Somalia, the buildings had long since been stripped of anything saleable, and competing warlords regularly seized whatever emergency resources the world sent the nation’s way, creating conditions of scarcity that led to skyrocketing prices for essentials, all dominated by a thick blanket of fear created by squadrons of young males driving machine-gun mounted trucks through the streets, murdering and raping with absolute impunity.

Individuals and families streamed out of the capital city, along the Afgooye Corridor, to that patch of land, soon to become famous the world over as Hope Village, where they knew that one individual had, against all possible odds, established a haven that offered medical services, food, and even education, in open defiance of the succession of warlords who had attempted and failed to intimidate her into closing down. She was Dr. Hawa Abdi (1947-2020), and by the time she was facing down Islamicist radical warlords in the 2000s, she had already been through enough personal strife to make their screams of rage seem like the agitated squeaking of so many pompous mice.

In many ways, her youth was like that of many Somali girls growing up within the environs of Mogadishu in the 1950s. She was taught by her mother to rise well before the arrival of dawn, and to cook the day’s meals, and she experienced the mental and physical scarring of female genital mutilation at an early age. Her mother died when she was twelve years old, and her father shortly after married her off to a police officer, who wasted no time in consummating the marriage against her will, so that she gave birth to her first child at the age of 13, an experience rendered all the more painful from the obstructions created by the scar tissue of her earlier mutilation. That child, a daughter, died soon thereafter.

Photo by Kuni Takahashi

Mercifully, at this point several deviations from the standard tale emerge. Abdi’s husband, unusually, perceived the misery of his child wife and granted her a divorce that freed her to pursue a life path of her own making. She was also the beneficiary of Cold War tensions, as the Soviet Union, in an attempt to exert its influence in Africa, established educational institutions in Somalia which Abdi took advantage of to fill the gaps in her secondary education, picking up Russian in the process, which allowed her to apply for a scholarship to study medicine in the Soviet Union. She worked hard and impressed her teachers, who subsequently supported her scholarship application, which she was awarded in 1964. 

Thereupon started one of the unambiguously satisfying stretches of Abdi’s life. Her Soviet instructors drove her hard, but the atmosphere of high expectations in the service of medicine, the anti-racist ethos of Soviet social life, and the lack of clan strife produced a climate in which Abdi shone, and in that environment she found the man who would become her husband, for better and ultimately worse, Aden Mohammed. The one great dark cloud of these years was the death of her father, which was not only a personal loss, but meant that the defense of the family fell onto her shoulders, and managing the drama regularly created by her sisters and their spouses would come to be a persistent strain the rest of her life.

Returning to Somalia in 1971, Abdi took up work at Mogadishu’s Digfer hospital, where she intended to start her career in the surgery department, but was informed that she would begin instead in pediatrics, a posting she rebelled against, but which provided ample and important lessons in dealing with the unique challenges of family dynamics as they impact medical practice, and the development of a doctor’s skills in interpersonal diplomacy. These were the years of Siad Barre’s dictatorship, which would extend until 1991. Regular readers of the Archive might remember the struggles that Edna Adan detailed with Barre’s regime during her time practicing medicine in Somaliland, but Abdi’s experience appears to have been, on the whole, positive. Her memoirs show disappointment at the acts of political violence during his regime, and poke fun at the pretensions of the cult of personality he attempted to build around himself, but express genuine appreciation of the efforts he made to improve the lot of women in Somalia, from which she, as a practicing woman doctor, benefitted. Of course, this overall positive view was helped by the fact that she was based in Mogadishu, not Hargeisa, where Barre’s iron fist use of clan-based violence was far more extensively felt.

Photo by Seamus Murphy

 Abdi married Aden in 1973, and the first of their children was born two years after that, but the pace of their Mogadishu-based life concerned her. She remembered the best days of her youth in the countryside, eating good food fresh from the farm, running around in open spaces, and experiencing connection with her wider family, and found, against that standard, that her children were living a sort of withered urban half-life. She took the money she had saved up and bought enough land for a farm in the Lafole region, close enough to get to work in Mogadishu, but far enough away to escape the city’s bustle and crowding. 

It was on this patch of land that, in 1983, she established the one-room medical clinic to serve the needs of the surrounding countryside, which would over time grow to a four hundred room hospital, and eventually to a place of refuge for tens of thousands fleeing the indiscriminate violence of national civil war. As she built up the staff and services offered by her clinic, she also established it as a place where people could go to receive medical aid, regardless of their clan or religious affiliation, an aspect of her work that would prove of paramount importance during the hard times of the 1990s and 2000s. With the toppling of the Barre regime in 1991, and the subsequent fracturing of the nation into a state of warlord conflict, Abdi’s hospital would become more important to more people than she could ever have imagined. 

Political chaos disrupted crucial supplies of medicine and food throughout the nation, as warlords either fired upon incoming relief cargo ships, or confiscated those resources to sell at a massive profit on the black market to fund the purchase of more weaponry. Abdi had to deftly navigate the constantly shifting political space to ensure that her patients, and the growing population of refugees living on her land, had the medicine and food they needed to survive. Her reputation for providing aid to all people, regardless of clan, though it brought armed guards to her door on more than one occasion, seeking victims from whatever clan was out of favor at that time, also gave her a reputation for fairness. Everybody knew somebody whose bullet wounds had been stitched up, or whose wives were saved during a dangerous childbirth, by Abdi and her team, and she leveraged that to keep her services functioning even during the depths of radical religious violence that swept the nation in the 2000s. 

As families started descending en masse on Hope Village during the 1990s and particularly the 2000s, fleeing famine and persecution, Abdi established rules for her growing community. There was to be no clan-based discrimination in the village - the basic principle was that “We are all Somalis” and any other identification was to be left behind when you walked through the door. There was to be no violence against women, and anybody who attempted to control the lives of their wives or daughters through violence would be ejected from the refuge. The village was divided into several sub-groups, run by elders who sat in regular council with Abdi about the population’s concerns and how to deal with them. She formed connections with Medicins Sans Frontieres, who for a time had a unit working out of her hospital until they were compelled to leave by the mounting violence against foreigners in Somalia, and who served as a connection with the wider world, which Abdi used to apply political pressure whenever a warlord attempted to use their military muscle to invade the hospital and surrounding village. 

Women particularly flocked to Abdi’s sanctuary as perhaps the only location within several days’ travel of Mogadishu where they could escape the omnipresent threat of rape that had become part of everyday life for Somalian women. During the worst of the violence, the village’s girls were placed under lock and key in rooms at the center of the village, to keep them from getting seized by roving armed males and raped in the fields. 

These were hard, grinding times, and Abdi spared herself no efforts on behalf of her population, even as her husband abandoned her to follow the path of a charlatan who declared himself a sheik and promised riches to all who followed him, and her only son died in an automobile accident while visiting that same father after his abandonment of the family. She worked from before the rising of the sun until deep in the night, anxious that, no matter how much she gave of herself, it could never be enough to meet the towering need of all around her. 

Usually, her connections, reputation, and personal charisma and integrity were enough to keep the wolves from invading the sanctuary, as in 2011 when armed thugs from the Islamicist insurgency surrounded the premises and demanded her surrender, only to end up having to deliver a public apology when her situation became known throughout Somalia and the world and her allies applied pressure. In 2012, however, her luck ran out, the village was invaded, and forced to close operations for some time until, as ever in Somalia, the political winds shifted and the compound could resume normal services again.

At that point, Hope Village was officially in the hands of Abdi’s two daughters, Deqo and Amina, who had followed in their mother’s footsteps and trained as physicians, and under whose care the Dr. Hawa Abdi Foundation continues its work to this day, devoting resources to the expansion of medical care in Somalia, and the creation of services to help the population weather the impact of climate shocks (such as the 2011 drought) without the widespread famines and shutdown of medical care that had happened in the past. 

Dr. Hawa Abdi passed away on the 5th of August, 2020, at the age of 73. She had survived a litany of personal tragedies, stood up to armed brutes who killed with impunity but lost their nerve in the face of her integrity, and led her community safely through two of the worst decades in her nation’s history, providing medical services that not only equalled, but often surpassed, those offered in the national capital during its best decades. Her efforts and her outreach brought national attention to the medical plight of Somalia, and her organizational sense allowed her to bypass the worst depredations of the warlords and get resources to the people who needed them. Families stayed together, babies were born, wounds were healed, and women escaped personal violence, because Hawa Abdi walked this Earth, and though we can’t ever sum in words the magnitude of her presence, we can regularly remind ourselves of it, and guide our actions on this small, violence-prone orb, by its example.

FURTHER READING:

Hawa Abdi’s book, Keeping Hope Alive, is a fascinating memoir about survival during a time of rampant, unhinged political, ethnic, and religious violence compounded by environmental catastrophe. The only issue I have is that the narrative structure hops around quite a bit, so finding the part of her life you are looking for at any given moment is something of a tricky proposition. It is a textbook in standing up to political tyranny, and a reassuring voice that, even in the midst of utter darkness, communities can still be built and maintained, preserving the past in the name of a future that one can only hope against hope will come some day.