by Hawa Abdi
Faduma was still sleeping when I came back; when we all awoke the next morning, her fever had returned, her small breaths shallow. I rubbed her back and gave her my breast, but she wouldn’t take it. I asked Amina to tell our cousin that something was wrong. “Can we call my father?” I asked him when he came. “My daughter is sick—we need a doctor.”
“This child is going to die,” he said sternly, “so you must keep quiet.”
We didn’t believe him, but as we sent a young neighbor boy to tell my father, we waited and prayed.
Death has a different plan for each of us. When my mother passed away, it felt like death took years; her soul fought so hard as her body became weaker and weaker. But for the old and the young, for Ayeyo and for my Faduma, God had a different idea. My cousin was right—she was gone in just a few hours, although I sat holding her until my father came, at about three that afternoon. He turned her tiny face toward him, and I saw tears in his eyes. By then, my cousin had already dug a tiny grave near Ayeyo’s, so we prepared the body, washing and dressing it in a tiny karfan and then reading those familiar passages of the Holy Qu’ran.
When my mother died, I lost my identity; now, without Ayeyo and Faduma, I had lost my past and my future. I was restless for three days, unable to sleep or to eat. When my father prepared to leave, I told him that my sisters and I would follow.
“No,” he said, “you must go back to your husband.”
“I can’t just relax by myself, knowing how you are suffering,” I told my father, but I could not disobey him. On the bus back to Beledweyne, as I thought about my sisters alone, I tried to listen to my mother’s advice, to silence the voices of others, to listen to my inner voice in order to reach a solution. “I cannot leave my sisters,” I told Mohamed Hussein when I arrived. “If you don’t want my sisters, then I don’t want you.”
“You belong to me, Hawa,” said Mohamed Hussein. “I love you. I am not contrary to raise your sisters, but my father doesn’t accept that.”
“I asked you to help, and you won’t, so we have to stop,” I said. “You are just a police officer, with a small salary. You should find a girl who doesn’t have heavy problems like mine.” Our relations never should have happened, and now, I wanted to go back.
“You have suffered a hard loss,” he said, but he agreed to let me return to Mogadishu, to school and to the home that my sisters and my father shared.
And so I did. Around that time, Somali radio was talking about liberation day and night. On June 26, 1960, the northern region of Somalia got their independence from the British; less than a week later, the Italian part would get their freedom as well. A neighbor gave our family a message that Mohamed Hussein was called to Mogadishu for a twenty-day security patrol, but I didn’t even think of him.
I came home from school one afternoon and was surprised to see Mohamed Hussein in our home, drinking tea with my father, as any other visiting neighbor might. I didn’t feel anything when I saw him. When he saw me, he stood, wished my father well, and said good-bye.
“Mohamed told me, ‘I don’t want to disturb Hawa, and she has told me many bad things,’ ” my father said, his shoulders stooped forward. “He said, ‘Here is her paper. I divorce her.’ ”
He showed it to me: There was no going back. I began to cry, because I was still a child maybe, or because I felt Ayeyo would have disapproved. “Don’t be upset, my child,” said my father, and I felt his hand on my head. “I bless you, and your mother and your grandmother blessed you. You will find everything you want.” Though I slept that night with a numb mind and a tired body, when I awoke, I, too, was free.
CHAPTER NINE
Building My Practice
For three months, I set aside as much of my salary as I could for materials—mostly cement and iron sheets, which, as our engineer friend and I discussed, would become a one-room clinic that could hold twenty-three beds. I assembled a small staff as well. One of my relatives brought me a midwife who still works with me, and from a new women’s and children’s hospital called Banadir, which was started by the Chinese government in 1977, I hired two nurses and a very nice cleaner. The cleaner, I knew, had the most important job—in a delivery room, there is a lot of blood, and a lot of bedding to wash.
At the same time, Aden and I built up the farm. We went together to the development bank, bringing with us our deeds in order to guarantee a loan, and then Aden went to the Department of Agriculture, returning with a tractor. It was hard work, but we were rewarded: The crops were growing well, and each morning at sunrise my cousin drove our loaded pickup truck to Mogadishu’s main market, Bakara. He’d return with our money and the meat and sugar and tea I’d requested, and then he’d get his breakfast with our family and drive Deqo to school.
In May, I gave birth to a strong baby boy, Ahmed, who had a long neck, just like my father’s. Faduma Ali helped to care for me, as did my young daughters, and I regained my strength walking among our crops. We opened the clinic’s doors later that year, on August 15, 1983.
In the beginning, we had very few patients—sometimes five, sometimes ten. But since we were on the main road, and since news spreads quickly, I soon found lines of women awaiting me when I returned from work in Mogadishu. Most of my patients who delivered without any complications stayed with us for only one night. In exchange, they would pay the equivalent of about 35 cents—a low amount, but not unheard of at the time. This was not true for people who had the means; when I treated businessmen’s wives or the wives of Siad Barre’s cabinet ministers in my clinic, they paid more. If I knew someone couldn’t afford treatment, I worked for free.
If you think such a thing seems generous, you must understand that when Somali people want something, they will persist. Even if you go out, they won’t leave you; they’ll follow, saying, “We pray for you! We don’t want to curse you! Please, treat our daughter!” I couldn’t resist seeing someone in pain—I had to do something! If someone had a severe complication and needed to be referred to a hospital, I sent her to a group of Chinese doctors I’d befriended at Banadir—an OB/GYN, a general surgeon, an internist, and a pediatrician. When they weren’t working, they drove out to our farm to get fresh fruits and vegetables.
One afternoon, I came back from a lecture to find a woman sitting on the bench in our waiting area. “Hello,” I said. “Are you sick?”
“No,” she said. “My cousin brought me here. I want a job.” Her name was Faduma Duale, and her only experience was a Red Cross and Red Crescent emergency first-aid course. I told her to return at four o’clock, and as soon as I’d looked after our most urgent cases, I explained how to welcome the patients, to show them the toilet, to register them. She began working immediately, and from then on, Faduma Duale was my right hand.
By the time the clinic had been open for about two months, we were receiving about a hundred patients each day, and the line of women sitting with their parents or their children stretched long past the corridor we built. In order to finish around 10 p.m., I tried to visit each patient for about ten minutes—just long enough to examine her, to say that all was okay or to make a diagnosis, and if necessary, to give some kind of prescription or topical treatment. Over time we learned that while patients in the rural area were often less informed about health and basic hygiene than my patients at the hospital, they also hadn’t built up the same type of resistance to certain antibiotics and other medications. That meant that they often returned to health more quickly.
But despite my independence and growing confidence at my clinic, I still needed approval to perform any kind of surgery in Mogadishu—even in the most urgent situations. The power struggles there continued, for as people struggled for prestige, they used science and knowledge as weapons. I remember one prominent doctor who was so eager to publish new research that he sometimes would try a high dose of medicine or give an unnecessary injection, as an experiment. Some of the midwives and I talked together, worrying about what would happen when those patients left u
s. Even if the mother seemed okay while in the hospital, you never knew what would happen to the child.
As my rural practice grew, and referring my patients to other doctors became more difficult, I began to dream of my own operating room. A surgery department turned a practice into a hospital, however; Siad Barre had given us permission only to open and run small clinics. I stored away more and more materials nonetheless, talking with the engineer about my idea and about other new additions. “Hawa, when will you stop?” said Aden, “Do you want to build from here to Mogadishu?”
Amina was still just a child, but Deqo could understand and support me. “Mama, you have to build!” she said.
In those days I treated Siad Barre’s personal secretary, Halawe, who supported my plans to expand the clinic. One day, a man came to me in Digfer while I was making rounds with the students. “Tonight at eleven,” he said, “you will meet with the president.”
“Tonight?” I asked, surprised.
“Go to the gates of the State House. His secretary will meet you there.”
I was not surprised that Siad Barre would have me at his office so late. He received visitors from around 11 p.m. until 3 a.m., subsisting on black coffee, and then slept from 4 a.m. to 11 a.m. I returned home that afternoon, did my rounds in the clinic, and changed my clothes—not to be very formal, but enough to show respect. The car came to our place and drove quickly down the Afgoye Road, while I wondered if the president would refuse my request.
Halawe hugged me when she met me at the gate, and she led me through the courtyard, lit up by beautiful colored lights that stretched along the big driveway and up to the building itself. About thirty guards stood outside, while around them other people, in uniform and in plain clothes, sat, talking in small groups and drinking coffee and tea. As we walked into the office, we passed the president himself, playing Ping-Pong in the open air. He looked happy, like he felt young; he didn’t look up as we continued on. We passed through a dimly lit hallway into his office, where I sat down in an easy chair. Halawe brought me a bottle of orange Fanta to drink as I waited.
I sat there like that for more than forty-five minutes, while Siad Barre met with one of his wives. Finally Halawe came out and said, “Come with me.”
The first thing I noticed about the president was his face—I could tell by his skin that he lived well, and his eyes were lively, smiling at me from the top of his light khaki-colored uniform. “Sir, Mr. President, thank you for receiving me, for allowing me to meet with you,” I said. He motioned for me to sit, and I did so, straightening my trousers and crossing one leg over the other. “My name is Dr. Hawa Abdi Diblawe. I am living between Mogadishu and Afgoye, in a rural place. There are many people who are suffering, and they don’t have the transportation to come to our hospitals in Mogadishu.”
“You want to build a hospital,” he said.
“Yes,” I said.
“Do you know how difficult it is to build a hospital?” he asked. He listed many complications of building and the need to maintain high standards of cleanliness and to follow the national protocols. “This isn’t an easy thing,” he said.
“Sir, Mr. President, I want to make this hospital,” I said. “The women are suffering.”
He interrupted to tell me his position on the rights of women, whom he called the backbone of Somali society. When he finished talking, he dismissed me. “Maybe you will go back and have a meeting with the Minister of Health,” he said. Since I hadn’t expected an answer, I simply thanked him for his time and left. In the car, I tried to remind myself of the good the president had brought to our country—even if it felt like all of Somalia hated him, there were certain things that I did agree with.
The next time Halawe came to me, she was carrying a pink envelope from the president’s office, which contained a letter that authorized me to build a surgical ward and another twenty beds: Hawa Abdi hospital. An international organization called Church World Service sent an American company to do an assessment on the project. They gave us enough concrete for a good roof and strong pillars to support it, and we set aside the leftovers for future building. Meanwhile Aden assembled more and more farm equipment, including a big East German–made engine to power a water pump that would serve our house, the farm, and eventually the clinic.
We built and built, only stopping if the money was not there or on Fridays, when no one worked. Then we would take our pickup truck and drive to the edge of the farm, where the breeze was the best. We would pack a big picnic lunch—camel meat, pasta, rice, sugar—and prepare it under the trees, inviting our staff to come. Amina loved to look at the young bananas, still green and beautiful on the trees.
Years later, my son Ahmed would tell me that he remembered those days as some of the happiest in his life. Memory is complicated. I can’t go back to the past—to a day in 1986, when I walked out onto our veranda and saw a sea of green in the distance. Sometimes I wonder how I would have felt if I could see into the future. But that is as impossible as the idea that I can step onto that same veranda today and picture young Deqo running fearlessly out to the farm to find Aden.
I thrived on my routine: Leave early for Mogadishu, come back to rest, go to the clinic, come back to sleep. Our children grew strong and healthy, eating the freshest food and running in the bush. A cousin brought us one of the first Panasonic televisions that had a videocassette recorder. The television programming, which came from Kuwait, ran from 6 p.m. to 10 p.m. on the weekdays, and on Thursday afternoons, Aden took the children to rent videos. They brought home three each week: a Bollywood film, a Western, and a martial arts film—movies that Aden knew didn’t have a threat of a sex scene. While the television was not allowed during the day, Deqo figured out how to rig up the small generator, so they could watch even more before Aden and I came home. Eventually we caught on, and Aden started bringing one of the connecting cables to work each day.
Aden and I had little time alone together; we began to disagree from time to time. The Somali way, as you know, is for the man to work and give orders, and the woman to raise the children and obey him. Since I had bought the land and built the home, I made many of the household decisions, even if Aden disapproved. The stress of the political situation and the growing tension at Aden’s office did not help matters. Ah, some days I remember that Ayeyo blessed me for a happy life; she didn’t say anything about a happy marriage.
Our disagreements became arguments, and I insisted that we speak in low voices so long as the children were awake. Sometimes, by the time I came home after my rounds, he was already out of the house—in Mogadishu on business, or out on the farm with the workers, to ensure that the irrigation system wouldn’t flood our fields overnight. I thought, in those moments, of the advice that my sister Amina gave me, a week before Aden and I married. “You know, Abayo, there is something I learned about love,” she said. “After marriage, fifteen percent of love, it goes out.”
One night while Aden and I were watching the ten o’clock news, we saw a friend of ours—the husband of one of Siad Barre’s daughters. He was near Hargeisa, the biggest city in the north, which was a base for the Somali National Movement, an opposition group founded by the members of the Issaq clan. As the camera pulled back, it showed him next to a dead body, burned beyond recognition. To our shock, our friend looked directly into the camera, into our own eyes, his left hand pointed down to the body. “Anyone who is contrary to the blessed revolution, we will make like this,” he said.
As Aden was Issaq, we feared for his safety; all we could do was continue to live our lives in the right way. That meant, for Aden, saying nothing when he saw colleagues stealing government money or cars. We took solace in our own immobile capital—big land, a clinic, a farm—but we still had to smile and sing for a government that was killing its own people.
In May 1986, Siad Barre was seriously wounded in a car accident and sent to Saudi Arabia for medical treatment. While many people hoped that a new leader would emerge, we kept quiet,
as we had since the earliest days. He returned to health, running, unopposed, in a rigged presidential election that December. “What is another seven years?” sighed the husband of one of my patients.
In those days, Somalia’s head pharmacist was a very wise man, who helped bridge the gap between modern and traditional medicines. Under his leadership, Somali researchers traveled to the rural area to collect samples, hoping to investigate the remedies that had long been contained in the leaves, flowers, and roots. Unfortunately, we didn’t have the right laboratory equipment to conduct many of the experiments, so the material was sent to Italy. I visited his office regularly, hoping for news of the latest research results.
When I was in the rural area on my days off, I began talking with the traditional healers, some of whom had been elders of their small villages for as many as fifty years. While they were surprised that a young, Soviet-educated doctor would want to learn from them, they were generous with their stories, opening their work to me.
The first treatment I witnessed was for a man who had a big, swollen sore filled with pus on his foot—something that, in our hospital, we would puncture and drain. The healer brought a mixture of leaves and spread it on the foot. I was doubtful, but after a few hours, the sore opened and drained on its own. I noted the leaves in my book with disbelief, asking too many questions as he showed me a combination of seven different types of plants—two from the sea, and five from the bush—known to treat major infections.
From then on, whenever I had patients suffering from difficult problems, I would stay up at night to make notes about their cases. Then, on Fridays, when I went to talk with the healers, I would ask their opinion.
One young woman came to my clinic from the bush, feeling deep pain. Though I didn’t have the resources for a biopsy, I guessed, from her symptoms, that it was cervical cancer. I explained what that meant, and what she could do, but she did not want to go to the hospital, which her family feared. So I admitted her and followed the advice of the traditional healers, mixing together a combination of plants and applying the paste to the affected area, bit by bit, week after week. Over the next three months, the affected area shrank, until it became the size of the head of a pin.