by Hawa Abdi
I did not talk publicly about my patients, but I also didn’t work in secret, which is a dangerous habit for any doctor. One day, when I walked out of the outpatient clinic to get some air, a man approached me. “Dr. Hawa,” he said, “I want to tell you something.”
Since he had been there all day, I had assumed that he had been waiting for one of the women inside. I asked him to take a walk with me around the back of the clinic, toward the bush. “You’re being watched,” he said. “The police know that you are using this traditional medicine.” He looked very serious, pressing his lips together in between sentences. “Your situation is in danger.”
Unsure of what to say to the man, I told him that I followed all government protocol in my work. Then I said, “Thank you,” and he left.
The next morning, before my lecture at the university, I stopped in the office of the head pharmacist, shut the door behind me, and began to shout. “I’m using these trees, in the way that you’re encouraging, and someone came to me and told me I was in danger,” I said. “What is this supposed to mean?”
The pharmacist had also been educated in the Soviet Union; he understood the implications of what I was saying, but still, he was passionate about his work. “You continue your job,” he told me. “Let them accuse us—we know how to defend ourselves.” I thought he was right. This research, these discoveries, gave me confidence. I began to document my work, dreaming of a new treatment for cancer out of those very trees.
A few months later, I was doing rounds in Banadir hospital when I examined a woman who had a dangerous-looking growth on her vulva. When the biopsy came back, we saw that it was cancer, already in the second stage. Oh, I was sorry to deliver that news. A few weeks later, she came to me in the clinic, searching for some small hope. “We have a good treatment for you here,” I told her. That woman stayed with us for three months, and every day, I applied a bit more of the mixture to the infected area. With her permission, I took photos as her situation progressed, and slowly by slowly, the growth began to reduce in size.
Aden’s friend invited our family to camp under the stars near a big meteorite, which was a major attraction in the area. By then, Faduma Duale had enough experience to take care of the clinic in my absence, and to call on one of my colleagues in Mogadishu in case of an emergency. For three days, our family was together, laughing and playing. Amina delighted in cooking over an open fire, while Deqo sulked to be the oldest, left with most of the hard work. “I can understand,” I told her gently, “but this is your job.”
When we returned on Saturday, I went immediately to the clinic to check on the patients. But the woman I’d been treating was gone. “I didn’t see her leave,” said Faduma Duale. We relied on our patients to check themselves in and out; it was easy for something to happen without being noticed.
“She wasn’t finished with her treatment,” I said.
We never found out what happened to that woman, but that day I stopped all use of traditional medicine. Its benefits were not worth the danger that I was bringing to myself, or to my patients.
CHAPTER TEN
My Sisters Return
One afternoon when the clinic was slow, I sat on our veranda and saw in the distance two veiled women walking toward me. Behind them followed a line of children, going by three by three by two. Assuming they had come for medical help, I stood up to return to work. As they got closer, though, I could see that it was Asha and Khadija. Behind them ran their children, and my sister Amina’s, who all ran to hug their long lost Mama Hawa.
“Hello!” shouted Asha.
Aden heard the noise and came out; so did Deqo and Amina, who carried Ahmed in a sling on her back. My sisters had come from Mogadishu, walking from the bus stop along the Afgoye Road, about fifty meters away. “Please, brother, we have nothing to eat, no place to go,” Asha told Aden. As we talked, we learned what had happened in the time since we’d spoken: Asha had divorced, and Khadija was alone. A few months earlier, Sharif had gone on hajj, the pilgrimage to Mecca, after a popular sheikh. He was still there, somehow, so they hadn’t paid their rent.
There were some among us who, for generations, believed that sheikhs had extra powers—that they could support you with health and riches and send you to paradise when you die. Sharif had been running after the same family of sheikhs for as long as I’d known him. A few times a year, he and his friends would go to the rural areas, where the sheikh held big meetings in honor of the birth of the Prophet Muhammad or some other prominent sheikh. Families would travel from far and wide, bringing camels, goats, and cows, rice, oil, and sugar, money, or gold to offer the man, as a way to get closer to God.
“Hawa, you have to believe in this sheikh,” Sharif had told me years ago. “He will bless you, and you will get everything in this world!”
“How?” I’d asked. It was as difficult for me to accept that this man was a small god as it had been to believe the Gypsies we used to see as students, who said that reading our palms would tell our fortunes. But Sharif believed; even Aden, who had been in the Soviet Union with me, seemed to accept it.
The children ran after Deqo and Amina to see the television inside, and I kept quiet for a few minutes, listening to Aden and Khadija talk. Then I shouted to one of the boys working with us, asking him to call the woman who helped with the cooking and cleaning. “These are my sisters,” I said to the boy. “Clean the extra apartment; it will be for them.” I excused myself and walked into the kitchen to instruct the woman working there to prepare an additional ten portions—eight children and two adults.
I returned to Asha and Khadija and pointed to the other building. “We’ll prepare dinner and bring you a carpet to sleep on,” I said. “In the morning, we will talk.”
That night, as Aden slept, I lay awake, wondering if they knew how much they’d hurt me. Raalli gelin, they’d told me—“I apologize.” I had given up so much of my life for them, putting their needs ahead of my own. After our mother died, I began a competition with my mother’s friends and neighbors, who had daughters that were around our age. Whatever their daughters did, my sisters had to be at the same level—with education, with behavior. I had succeeded, with the help of my sister Amina. But after we lost our beloved Amina, Asha and Khadija had left me while my pillow was still wet with tears.
Like so many women, my sisters had believed in their husbands above all else. I had seen so many women make this mistake, throwing away their fathers and mothers, their brothers; in the end, there was no way for them to go back. Seeing my sisters return to me with no money, no hope, I grieved again for my mother, my father, and for Amina, who were no longer there to help me find a solution. One part of me did not believe that my sisters could change. But the other part thought of their children—the eight voices that crowded into our sitting room, cousins that my children barely knew. Maybe they will be good people, I thought. As it was almost dawn, I stood up to begin the day, having made my decision. I found the energy to raise their children as my own. We had everything to offer them—a well-running farm with many cows and chickens, a big area in which to play, and a family that would finally be together.
The arrival of more adults who thought they could act as boss was not an easy thing for the farm and hospital staff, or for my children. Our home became more crowded, and more complicated. One day Deqo ran to me while I was in the clinic. “Mama! I don’t want the workers to leave us!”
“Why? What has happened?” I asked.
“Mama Asha told them to,” said Deqo. I asked her to tell whoever was upset to wait for me, and when I finally came out I saw a group of my staff standing there, furious and insulted.
“She told us, ‘This is my sister’s place, so I am also the owner,’ ” said one of the men. “She said, ‘I don’t like the way you address me, so you must go.’ ”
Asha didn’t understand that if you are leading a group of people, you have to administer instructions, and punishments, equally.
One night, when one o
f Aden’s relatives’ boys started some trouble among the camp’s children, one of the youngest got caught in the scuffle and began to cry. Asha came out of her room and said to Deqo in an angry voice, “Did you hurt this little boy?”
“No, Mama Asha,” said Deqo, but Asha didn’t believe her. The fighting escalated between Deqo and Asha until I ran out and got between them.
“You stupids!” I said, raising my voice against my sister for the first time in a long time. The little boy ran into the bush. “You are paranoid,” I said to Asha, while holding Deqo’s shoulder still. “You’re starting trouble with my daughter, while I’m protecting you? Don’t do these things again.”
Khadija needed some medical treatment, so we paid her way to Saudi Arabia, to stay with one of our cousins, who lived in the city of Riyadh. She hoped to reunite with Sharif there. Asha decided that she wanted to go to Saudi Arabia as well; she came to me one day and asked me for 60,000 Somali shillings, so she could follow the sheikh.
Politicians, doctors, businessmen—they all believed in the power of these men: Oh, Sheikh so-and-so says that! We have to go! We have to pay!
“These people are lying to you, Asha,” I said. “They are cheating people—God will punish them.”
“You are Russian now,” she said, accusing me of being without religion. “You cannot understand how powerful they are.”
“So take it,” I said when I returned with a handful of bills. “Then, when you get all your power, you can divide it and give me some.” She went but returned soon after, horrified by the way that Saudi men touched her and propositioned her. “Do you know why so many people come back from Saudi Arabia so rich?” she said. “They are practicing prostitution, and I don’t want that.”
The children all remained with us, eating well and growing to be good friends, chasing one another outside all afternoon. They came into my room one day to tell me that they all wanted to be doctors—Deqo a gynecologist; my sister Amina’s eldest girl, Su’ado, a pediatrician; and her youngest son, Abdi Karim, a surgeon.
“What kind of doctor will you be?” I asked my Amina.
“Any kind I want,” she said.
I dug a new garden near the clinic; the plants sprouted quickly, just like my practice, which had grown from a single room with twenty-three beds into a building that could house sixty-two and accommodate surgical procedures. With further help from Church World Service, we had built a second floor above the clinic and replaced our iron roof with a concrete one. Now with our new operating room, we had the ability to perform Cesarean sections on our own. While I could now save so many girls and women who could not deliver normally, I still had the challenge of explaining why surgery was necessary.
“To just cut open her stomach like that,” said one woman’s mother, “are you sure she will be alive?”
“Yes!” I insisted. “The biggest way that we doctors show we care is to take a knife and cut someone open.”
I worked with two other well-qualified doctors in those days. Our surgeries were elective, and since we didn’t have an anesthetist on staff, we often had to wait for one to arrive so we could perform an operation. There were times, of course, when I wanted to intervene immediately, but as was the case in the Mogadishu hospitals, we had the rule that no doctor should operate alone. I’m grateful, for there have been times over the years when I’ve fainted or have had to leave a surgery unexpectedly. But never, in all forty years of being a doctor, have I ever lost a patient on my operating table.
Our brand-new surgical suite, the first of its kind outside Mogadishu, was for me an oasis, free of the politics and the oversight that had held me back. I could not foresee at the time, of course, how important the room would be in twenty years, when the city’s hospitals would be overrun by squatters and militiamen. Then, some of the senior doctors who had challenged me in Digfer would come to my place. “Hawa,” they would say, “we need someplace to operate, someplace to admit our patients.”
“Okay,” I would say. “You are welcome.”
During the first few weeks others would use our operating room, I’d hear of tragic mistakes—first one patient died on the table, and then two. Finally, I would tell them to stop: “This is my hospital, and we will be damaged if people begin talking and hearing, ‘We brought her to Hawa Abdi hospital, and she died there.’ ”
Somali people say that life is like a day—in the early morning, you see a dark shadow falling on one side of the tree. But then the situation changes; by the late afternoon, the shadow is on the opposite side. Today you are powerful, and maybe tomorrow you will become weak. Your responsibility is to try to do right by everyone.
In those days, we made international phone calls at the Mogadishu post office. One afternoon I received a message from one of Sharif’s friends, so I went to place a call to him in Saudi Arabia. As I stood waiting, I feared that something had happened to Khadija. She’d been searching for Sharif for weeks, hoping that the sheikh could help make peace between them.
After several tries, the connection came through. “How are you?” I asked Sharif’s friend.
“We found Sharif dead in his hotel room,” he said. “He was in Riyadh.”
I held my breath while, in an even tone, he explained how such a thing had happened. Sharif accompanied the sheikh back from hajj, but when they tried to enter Riyadh, the military did not allow the sheikh to enter. I don’t know why: Perhaps they had a problem, or perhaps he tried to enter in a wrong way. Thinking only that his sheikh was sacred, Sharif argued with the soldiers, striking one. They turned around and beat him well.
Soldiers, you know, are well trained in violent tactics; they know how to beat someone so that the trouble in their body grows slowly, doing lasting damage. Sharif got up from the fight and walked back to his hotel, but his friends did not hear from him for days. The hotel staff finally called the police, who broke down the door to find Sharif lying on the bed, with blood in his nose, his mouth, and his ears.
My cousin arranged a phone call with Khadija, who was shocked. “I’m going there to see if it’s true,” she told me. She later called me from Riyadh, where authorities had put his body in refrigeration. She’d insisted on seeing her husband, and although the hospital officials at first refused, they finally agreed to let her into the morgue. When they brought his body, she ran away. “I could not see his face,” she cried to me. “I only saw his hair.”
Khadija had hoped they would reunite in Saudi Arabia. “Sharif, he ran away when I was in Somalia,” she cried into the phone, “and when I came to Saudi Arabia, he left me here.” The authorities listed the cause of death as a heart problem, and they buried him in Riyadh.
I tried to console her, although I didn’t know the words she needed. “That is God’s decision,” I said. “We cannot change anything. You are strong and well now. You need to come back to your children.”
When a Somali person dies, his family slaughters some animals for the guests who will come. Since Khadija was still in Saudi Arabia, I took a big bull from among our forty cows to give to Sharif’s mother. “Kahiye,” I said to his oldest son, the child of my beloved Amina. “You will sit in the front of the pickup, with the driver, and bring it to your grandma.”
Kahiye, by this time, had grown into a strong, handsome boy. While he tried to remain calm, I could tell he was crying. He needs his father, I thought, as I hugged him. His mother was dead, and even his stepmother, Khadija, was still in Saudi Arabia. What could we do to protect him?
“Ayeyo, this is my cow,” he told his grandmother when we arrived. “I want to help you to bury my father. This is a little thing that I can do.” They slaughtered the animal, she blessed him, and together, Kahiye, Asha, and I came back to our farm.
CHAPTER ELEVEN
Necessity Is the Mother of Invention
In 1988, government forces sent airplanes to the north of Somalia to attack the Somali National Movement rebel group, dropping bombs around the city of Hargeisa, killing as many as 5,0
00 people. It was a massacre. The terror and outrage spread across the country as government troops rounded up members of Aden’s clan, the Issaq—officers, professors, lawyers—beating them and killing them. Another strong clan to the south, the Hawiye, formed their own resistance group, the United Somali Congress, and they, too, became government targets. Countless men were under suspicion, targets of the military police, which monitored people’s conversations and often came into homes at night, terrorizing everyone inside. At one point, a group of prominent Somali people signed a petition that called for elections and for human rights. To Siad Barre, the message could not have been clearer: The society doesn’t want you. But those people were threatened with death.
Some of the tension exploded into clashes on the city streets, while government soldiers—stern, young men—stood at the gates of Mogadishu at so-called checkpoints, holding Russian machine guns and interrogating every person trying to flee. “What is your clan?” they would ask. If they heard what they considered to be the wrong response, or even the wrong tone, they would shoot. Some people died immediately; others, wounded, staggered down the Afgoye Road in search of help.
Necessity, they say, is the mother of invention. We had studied emergency medicine in the Soviet Union, learning from veterans of World Wars I and II, who told us what would happen if a bullet went into an abdomen and how to treat a stab wound to prevent internal bleeding. The Soviet Union was peaceful at that time, however; so we never had a case to treat. Now, we had to do what we could with what we had, and we also had to work in secret—if government soldiers saw that their victims were being treated by us, they could shell or shoot up the hospital. When wounded people came to us, I often administered first aid quickly and sent them into the bush to recover.