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Keeping Hope Alive

One Woman: 90,000 Lives Changed

Grand Central Publishing

CHAPTER 1

A Stranger in My Homeland

My career began in Mogadishu in 1971, in my country's prime and in my own. I was twenty-four years old and had just returned from medical school in Ukraine, where I'd studied on a Soviet Union–sponsored scholarship. When I presented my new diploma to Somalia's Ministry of Health, I immediately received a position at the European-built Digfer hospital. Somalia had only about sixty doctors at the time, and Digfer's 600-bed hospital was run by just thirty-five doctors—thirteen of them were Somali, and just one other was female. The rest of my colleagues were Italian men, for although we were newly independent, we were still emerging from the shadow of our colonial past.

On my first day of work, I put on a new outfit—white trousers and a white blouse, to match my brand-new white coat—and I went directly to the office of Digfer's medical director, Mohamed Ali Nur. Mohamed Ali Nur was also the country's first Somali pediatrician; he was trained in Italy and had returned five or six years ahead of me. Although I respected the work he had done to bring better medical care to the area, when we sat down to discuss my role at the hospital, we clashed immediately.

"You will start with a rotation in pediatrics," he said.

"I want the surgery department," I told him. "I have done rounds for two years, in medical school, and I am already a doctor." From the moment I participated in my first procedures, when I was a medical student in Odessa, I had dreamed of becoming a surgeon. I thought often of the cool-headed precision that I saw in one of my professors when, as a sixth-year student, I assisted him in a procedure to repair a woman's obstructed intestines. I had stood in awe with one of my classmates, holding the professor's instruments and staring down at the incision under the bright lights as he sewed them together with expert sutures. For every move that I could predict, there were at least two that surprised me. I'd decided then that to save a life like this, with such speed and confidence, was the most important thing anyone could do.

I told Mohamed Ali Nur that I loved the long, complicated process of surgery: consulting the patient, learning her history, settling on a diagnosis and a solution, and earning her trust. "Children can't talk with you," I said. "They can't answer questions about where they're feeling pain. They just cry."

"You will talk with the mothers," he said.

The mothers, I told him, were often the problem. Many didn't remember when their children's symptoms began or what food they had given them, so it was hard to know if the children had been poisoned or if they had been infected some other way. "I prefer working with people who I can ask questions, and who will answer me," I said.

"Throughout your career, you will see so many children in the most severe states of disease," he said calmly. "It's required."

"There are plenty of other doctors who want to be pediatricians," I said. "I know you are a pediatrician, but it's not my strength."

Mohamed Ali Nur was a kind man, but he was also very firm. "Protocol is protocol, and as a doctor, you will be required to follow it," he said, folding his hands on his desk and looking at me. "In this country, every doctor must understand how to treat children. If you don't choose to, you can leave." He stood, and in a quiet way forced me to follow him down the hall and into the pediatric ward. While he introduced me to my new colleagues, I thought only of how I would prove to him that I was a gifted surgeon.

Later that afternoon, my younger sister Amina met me at Digfer's gate. As we walked together to the center of town, I felt the sun warm my skin and the frustration leave me. I sighed loudly with relief, swinging my arms and breathing deeply.

Amina laughed to see me relax. "Abayo," she said, using the Somali term of endearment for a sister. "Up until now, you were waiting for your life to begin."

"You're right," I said, laughing at the strange idea of being reborn at age twenty-four. It was true, really. After seven long years in the Soviet Union, I had been delivered home, into the beauty that was five o'clock in Mogadishu—the best time of day, when the sun is lower and the salty breeze from the Indian Ocean feels cool on your skin.

That afternoon, Amina and I met friends for cappuccino at a place called Caffè Nazionale, which was popular on Thursdays and Fridays—our weekend. We went there often; if the Italian restaurant was full, we could also go to Hotel Savoia, a Western-style hotel and restaurant in the middle of the city, or down near the seaside for ice cream. When we headed back home that evening, some of the boys we went to school with stopped us on the street, flirting and joking: "Ah, Hawa, you need a ride? I'll give you a lift." Like the sun on my face, like the sweet Somali bananas and the grapefruit I had missed so much, I enjoyed the attention. Here, every person I saw was my brother, my sister.

In those days, everyone our age was feeling free and optimistic—eager to be a part of a country that was growing as fast and as strong as we ourselves were. All three of my younger sisters were still in school, for by this time, education was free on every level: Our president, Mohamed Siad Barre, had formed a medical school, a law school, and several other colleges in and around Mogadishu, so students came from other parts of the country to continue their studies, rather than going abroad, as I had done. Now, at age nineteen, Amina was pregnant: Our family was anxiously awaiting the birth of a new generation.

Amina had prepared for me a two-room apartment in a neighborhood called Hodan, near both the hospital and the villa that she shared with her husband, Sharif, and with our other sisters, Asha and Khadija. We still spent most nights together, as we had as children. We had grown up since the time when we ate rice from the same dish and slept in a pile together, our mother stretching her warm body around us and shushing us as we poked at one another. But some things had not changed: Amina and Asha still fell asleep easily, while I lay awake, long into the night, wondering about my future. To calm myself, I tried to remember what my mother once told me, on a walk to the seaside: "Listen to your inner voice," she had said. "When it comes time to make a decision, sit quietly until you can hear that voice—only then will you be able to find a solution to your problems." Only through quiet, through planning, through prayer, was I finally able to sleep.

In the region called Lafole, where the sandy roads of Mogadishu meet the soft, brown earth of the Shabelle River basin, my grandmother raised my mother. Together, they raised me. Lafole is Somali for "place of bones"—for the battles our people waged against the Italian colonists, who came to us more than a century ago. Even during the 1930s, when my mother was young, the Italian colonists who controlled the area kept Somali laborers like slaves in an area nearby the river. Those whose backs were not broken while cutting down trees or digging farms were struck down by deadly malaria.

Our mother's name was Dahabo, which means "golden"—describing the most precious of the metals. She was an only child, and as my grandmother was a widow, my mother was everything to her. In Somalia, there is no insurance; children are a family's investment and their retirement benefit. When my mother was a teenager, my grandmother heard that her cousin, a local businessman, wanted to take her to help dig the Italian farms, so she took my mother and walked out of their hut, into the night. They found their way by the half-moon, moving through the fog, and continued south along the curve of the river for 100 kilometers, where they reached a village near the coastal city of Merca.

There they stayed, counting two rainy seasons and the difficult dry times in between. To survive, my mother collected armfuls of firewood and kindling to sell at the market, earning enough coins during each trip to bring home a sack of crushed sesame seeds and a small packet of sugar, which would feed her and my grandmother until she could gather enough wood to try again. When the second dry season came, they packed up their few belongings and came to Mogadishu to start a new life in the Abdul-Aziz district. My father lived there, among the fishing community, the Jaaji. He was a tall man, kind and soft-spoken, with a beautiful smile and a long neck. As is our habit, his first name, Abdi, is my last name now.

The Jaaji were a hardworking, honest people that came from many different clans originally—some from Hawiye, my father's clan; some from Dir, my mother's clan; and from many others. (The claim is that there are four major clans in Somalia—the two that I've just mentioned, as well as the Darod and the Issaq.) But the Italians condemned the fishing group, just as they had the ironworkers, shoemakers, and cotton weavers, as they felt this type of work was low-class. I was once told that the colonists would call the clan chiefs, saying, "Your people are the best—superior in this society. We will help you, but you should stay away from these four groups, which are the lowest." Living among a people who were mistreated for harvesting, selling, and eating the fruits of the sea, my father understood the benefit of living simply and the harm of dividing a society.

My parents' was a rare marriage of love. My father even sang to my mother, using lyrics he wrote himself, as was the way among romantics in our area, in our time: "Sidii dayax iyo daruur u ekeey / Dahabooy ma ku daadaheeyaa." (O you, who is fair as the moon and the clouds / O Dahabo, should I hold your hand / And take a stroll with you?) I am their eldest child, born in 1947 and raised in a house with two rooms, a fence, and a door that closed to the outside world, protecting us. I awoke every morning to brilliant white light and salty air, and in the afternoons our neighbors came to sit around the fire, drinking tea until the sun dipped low.

Each time my mother became pregnant, everyone hoped for a boy. In Somalia, you see, the women cheer for the birth of a son. A boy is king, worth two girls—he increases the family's wealth and has the singular power to protect or to destroy. When I was five years old, I was desperate for a sister—a girl that we would call Amina. You know, sometimes children say something, and God accepts. My Amina was born strong and healthy. I loved her from the start.

In those days, we had no running water; the well filled our jugs, and the entire Indian Ocean was our bath and our Laundromat. We would walk with our mother down the alley behind our house at first light, dodging the stones, stray chickens, and animal waste until we reached the beach. On our journey, my mother would sing or tell stories about the ocean. I freely asked questions about her past or about our family, and just as freely, she declined to answer them. "I don't wish to talk about that," she would say as our feet fell at the same rhythm. When I pressed her, she said only that every woman should have secrets she keeps for herself.

My grandmother, whom we called Ayeyo, left Mogadishu soon after my parents married and returned to her cows and goats in the rural area of Lafole. As I grew, our family began to spend more time with Ayeyo, where the milk and meat were as fresh as the air, and we were free to run through the grass in our bare feet. Ayeyo taught me to make breakfast at four o'clock in the morning, before the cold left the earth and almost two hours before sunrise. I held a match to the firewood our cousins had brought the previous afternoon. When the fire was hot, I rested a pot of water on the wood until the water boiled. I added sugar—the most important ingredient—and a mix of tea, cloves, cinnamon, cardamom, and mint. In another bowl, I mixed sorghum flour, water, and oil into a thin batter, cooking it in a flat pan until it became a pancake—injera—to accompany the tea.

Ayeyo was a philosopher, and those mornings I sat with her, dunking my injera, she helped me understand the order of things. A curse was the worst thing possible, said Ayeyo; these ill wishes follow a man for fifty generations, as damaging as fire. This is an image, you see, that a child can understand: After a fire, you will walk around where the trees and the huts once stood, and you'll hardly be able to imagine anything but ashes. I had seen, after fire, just the bones of animals and small piles of charred sticks—evidence that the world cannot sustain life in the wake of a curse.

Blessing, said Ayeyo, is a heavy rain cloud hanging over a parched village after a season of harsh sun. From the first shower, the land awakens, the soil darkens, and tiny sprouts appear along the edges of the road. From there, greenery will spread, rising with the grasses, the maize, and sesame plants, and stretching up into lemon and mango trees that swell into fruits. From there, life continues, and only good things will come.

I questioned Ayeyo about the other facts of life—I thought I understood love, but marriage was a mystery. I knew only that when my mother was very young, just fourteen years old, she had been married to a different man—her first cousin. Some evenings, Ayeyo spoke into my mother's silences. She had promised my mother's hand, she said, because it was the way of our society, which believed that women who refused marriage were as good as in the grave. The men, who made the rules, could take as many as four wives so long as they provided for each one and for all the children. From the beginning of our history, said Ayeyo, women obeyed without question.

No one could explain to me how my mother could overcome the pain and fear of her first marriage. Her husband had beaten her, knocking out one of her teeth; she was so young when she gave birth to a daughter, Faduma Ali, that she left the child behind and ran back to Ayeyo, where she thought she'd be safe. Although the man who married my mother finally agreed to give her a divorce—something very rare for a Somali man of the time—he insisted on keeping Faduma Ali with his family in the rural area. Eventually, Ayeyo convinced the man's mother that they could raise the child together, which is why I grew up to call Faduma Ali abayo, sister, just as Amina called me.

Why didn't Faduma Ali live with us? "If your mother tells you not to ask, then do not ask," said Ayeyo. A Somali child's role was not to question her parents but simply to obey their wishes. "If you care for your parents," said Ayeyo, "you will get the world."

She also taught that discomfort was a part of life—something to be accepted, not questioned. "When your mother was a child, she never cried," she said by way of example. As I grew, I learned that memory can be short, especially memories of the most difficult times. New urgencies and new enemies arrive, demanding all our attention and intelligence.

The doctors of Digfer hospital were required to attend a physicians' meeting every morning at seven; before we discussed the events of the previous night, we began with a song about scientific socialism, singing that the way gave us prosperity and progress, that every one of us—even the young, the women, and the elders—was ready to support the cause, that President Siad Barre was the father of the Somali society. Only after we sang could the doctor who had been on duty inform us about what had happened the night before and what was now required—further examinations, Cesarean sections, other elective surgeries.
(Continues...)

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Excerpted from Keeping Hope Alive by Hawa Abdi, Sarah J. Robbins. Copyright © 2013 Hawa Abdi Sarah J. Robbins. Excerpted by permission of Grand Central Publishing.
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