The 'Angel of Mogadishu' who raised a hospital from the ruins of war

As fighting was at its fiercest, doctor Aisha Omar Ahmed returned to her homeland to salvage the wreckage on the front line

Mogadishu

Reopening the San Martino hospital in the Somali capital Mogadishu has been a largely thankless task for Dr Aisha Omar Ahmed. Instead of earning a tidy living as a consultant obstetrician in Europe, the hospital director has been working mostly unpaid and in appalling conditions.

Since quitting her medical career in Rome to return home to a city and country at war, the 44-year-old has been threatened, beaten and shot at. So far she has chosen to stay.

"I was watching Somalia for 20 years in the headlines. I saw the [wounded] children brought to Italy for treatment. I was always thinking about this country," she says.

The San Martino is barely recognisable as a hospital. A cluster of wind-blown Italianate ruins overlooking the Indian Ocean near the old port, it has long since been overrun by squatters fleeing the destruction elsewhere in the capital. The wards and operating theatres, laundry and clinic have been variously shelled, occupied or looted. The new residents at the facility did not welcome the arrival three years ago of a young doctor with big plans for restoring their adopted home.

In her small office dusted with crumbling plaster she sits behind a spartan desk and makes light of her circumstances: "As you can see I am very poor." There is only one ward with 30 beds. The rest of the complex is a camp for IDPs – internally displaced people – who have resisted eviction.

The hospital's patients, many of whom have gunshot wounds, have only Dr Ahmed and a handful of nurses to care for them. The rusted metal beds are in a ward with a collapsed ceiling where the sea breeze blows through holes in the wall. The floor is scattered with cardboard prayer mats.

Not everyone supports her efforts. Some of the squatters have day jobs as police or soldiers, she explains, which means that rows at the hospital can involve facing down men with guns. In the yellowing corridor outside her office she points to bullet holes punched through the rotten wood of the ceiling as evidence of past tussles.

While admitting she has thought of giving up, Dr Ahmed insists that San Martino must become a hospital again. "I am a Mogadishu person. I was born here. My mother was born in this hospital. This is our place."

Her family wonders whether she has lost her mind. She is the daughter of a wealthy Somali family – Dr Ahmed's father was minister of finance under the socialist dictator Siad Barre, the last time Somalia had a functioning central government before war broke out in 1991. He died during the civil war that followed. Today, most of her relatives live in London and think she is crazy to risk her life in a notoriously dangerous city.

"My brother is telling me that I'm mad," she says. "My mother can't believe I'm here in the hospital where she was born."

When the Somali medical student put her studies on hold to return to her home city for the first time in 2006 the trip was traumatic. The port and airport were closed due to heavy fighting, which meant landing 100km outside the city. At the time Mogadishu was under the control of the Islamic Courts Union (ICU), an Islamist alliance which drove out the warlords who had fought over the Somali capital since the early 1990s. Dr Ahmed chose to live and work at the foreign-funded SOS hospital in the city and was on hand to witness the death of an Italian nun, which prompted the evacuation of all foreign aid workers. The suffering she witnessed stayed with her after her return to Italy and when she finished her PhD in Rome she decided to go back.

Dr Ahmed returned just as the fighting was getting to its worst in 2009. By then, the battle for the city was being waged between African Union peacekeepers protecting the UN-backed transitional government and al-Shabaab, an extremist offshoot from the Islamic Courts. The radical militia had won popular support in Somalia when Ethiopia invaded in 2006 with US support to topple the ICU. The Ethiopian occupation was fiercely resented in Somalia, radicalising what had been a moderate country.

The San Martino was so close to the front line of the fight against al-Shabaab that the hospital director had to be taken to work in an armoured convoy. When asked what equipment the hospital has, the answer is "zero" or next to zero. There are two ultrasound machines, both of which Dr Ahmed brought from Italy. For medicine, food and fuel she gets by on hand-outs from the African Union mission, Amisom. The doctor says her motivation for continuing the struggle to re-establish San Martino has been the plight of her country's women.

The destruction of Somalia's health infrastructure combined with the widespread practice of female genital mutilation has left the country with the highest maternal mortality rate in the world. In rural areas all girls are cut between the ages of three and seven, often leading to complications during childbirth. The doctor estimates that one in five mothers suffer from obstetric fistula – a tearing of the passageway between the bladder and the vagina normally resulting from birth complications.

Her reward comes in the form of a dozen young women sitting in a makeshift classroom near her office. Known as "traditional birth attendants" the ladies often act as midwives and FGM cutters in their home communities. They are now the first graduates of a scheme that the director hopes can help to change conditions for women. They have been schooled in basic hygiene, given a stern lecture on the ills of FGM and dispatched with some sterile gloves and the offer of $10 per referral to the capital – paid for by a local mobile phone operator.

The overawed women sit in silence as she tells them they are expected to "go back to make a difference in their village". The San Martino's director is a tough woman to argue with.

News
Brand said he
people
Sport
Adam Lallana, Juan Cala, Andy Carroll and Cameron Jerome
sportThe latest news and scores
Voices
Actor Zac Efron
voicesTopless men? It's as bad as Page 3, says Howard Jacobson
Life & Style
Sampling wine in Turin
food + drink...and abstaining may be worse than drinking too much, says scientist
VIDEO
Have you tried new the Independent Digital Edition iPad app?
Arts & Entertainment
tvGrace Dent on TV
Arts & Entertainment
The monster rears its head as it roars into the sky
film
Voices
For the Love of God (2007) The diamond-encrusted skull that divided the art world failed to sell for
its $100m asking price. It was eventually bought by a consortium
which included the artist himself.
voicesYou can shove it, Mr Webb – I'll be having fun until the day I die, says Janet Street-Porter
Sport
Mercedes driver Lewis Hamilton of Britain drives in the rain during the qualifying session of the Chinese Formula One Grand Prix in Shanghai
sport
Extras
indybestFake it with 10 best self-tanners
Arts & Entertainment
Madonna in her music video for 'Like A Virgin'
music... and other misheard song lyrics
News
Much of the colleges’ land is off-limits to locals in Cambridge, with tight security
educationAnd has the Cambridge I knew turned its back on me?
Sport
Steven Gerrard had to be talked into adopting a deeper role by his manager, Brendan Rodgers
sportThe city’s fight for justice after Hillsborough is embodied in Steven Gerrard, who's poised to lead his club to a remarkable triumph
News
peopleOrlando Bloom the pin-up hero is making a fresh start
News
Who makes you happy?
happy listSend your nominations now for the Independent on Sunday Happy List
Life & Style
The North Korean TV advert for Taedonggang beer, that became a YouTube hit
food + drinkAnd what did it take to set up a taste test back in Wiltshire?
Arts & Entertainment
filmLife for Leslie Mann's can be challenging sometimes
Voices
For music lovers: John Cusack with his vinyl collection in 'High Fidelity'
voices...but don't forget rest of the year
Independent
Travel Shop
the manor
Up to 70% off luxury travel
on city breaks Find out more
santorini
Up to 70% off luxury travel
on chic beach resorts Find out more
sardina foodie
Up to 70% off luxury travel
on country retreats Find out more
Have you tried new the Independent Digital Edition iPad app?
Independent Dating
and  

By clicking 'Search' you
are agreeing to our
Terms of Use.

iJobs Job Widget
iJobs General

Apprentice IT Technician

£150.00 per week: QA Apprenticeships: This company is a company that specializ...

1st Line Technical Service Desk Analyst IT Apprentice

£153.75 per week: QA Apprenticeships: This company is an innovative outsourcin...

1st Line Helpdesk Engineer Apprentice

£150.00 per week: QA Apprenticeships: This company has been providing on site ...

Sales Associate Apprentice

£150.00 per week: QA Apprenticeships: We've been supplying best of breed peopl...

Day In a Page

How I brokered a peace deal with Robert Mugabe: Roy Agyemang reveals the delicate diplomacy needed to get Zimbabwe’s President to sit down with the BBC

How I brokered a peace deal with Robert Mugabe

Roy Agyemang reveals the delicate diplomacy needed to get Zimbabwe’s President to sit down with the BBC
Video of British Muslims dancing to Pharrell Williams's hit Happy attacked as 'sinful'

British Muslims's Happy video attacked as 'sinful'

The four-minute clip by Honesty Policy has had more than 300,000 hits on YouTube
Church of England-raised Michael Williams describes the unexpected joys in learning about his family's Jewish faith

Michael Williams: Do as I do, not as I pray

Church of England-raised Williams describes the unexpected joys in learning about his family's Jewish faith
A History of the First World War in 100 moments: A visit to the Front Line by the Prime Minister's wife

A History of the First World War in 100 moments

A visit to the Front Line by the Prime Minister's wife
Comedian Jenny Collier: 'Sexism I experienced on stand-up circuit should be extinct'

Jenny Collier: 'Sexism on stand-up circuit should be extinct'

The comedian's appearance at a show on the eve of International Women's Day was cancelled because they had "too many women" on the bill
Cannes Film Festival: Ken Loach and Mike Leigh to fight it out for the Palme d'Or

Cannes Film Festival

Ken Loach and Mike Leigh to fight it out for the Palme d'Or
The concept album makes surprise top ten return with neolithic opus from Jethro Tull's Ian Anderson

The concept album makes surprise top ten return

Neolithic opus from Jethro Tull's Ian Anderson is unexpected success
Lichen is the surprise new ingredient on fine-dining menus, thanks to our love of Scandinavian and Indian cuisines

Lichen is surprise new ingredient on fine-dining menus

Emily Jupp discovers how it can give a unique, smoky flavour to our cooking
10 best baking books

10 best baking books

Planning a spot of baking this bank holiday weekend? From old favourites to new releases, here’s ten cookbooks for you
Jury still out on Manchester City boss Manuel Pellegrini

Jury still out on Pellegrini

Draw with Sunderland raises questions over Manchester City manager's ability to motivate and unify his players
Ben Stokes: 'Punching lockers isn't way forward'

Ben Stokes: 'Punching lockers isn't way forward'

The all-rounder has been hailed as future star after Ashes debut but incident in Caribbean added to doubts about discipline. Jon Culley meets a man looking to control his emotions
Mark Johnston: First £1 million jackpot spurs him on

Mark Johnston: First £1 million jackpot spurs him on

The most prize money ever at an All-Weather race day is up for grabs at Lingfield on Friday, and the record-breaking trainer tells Jon Freeman how times have changed
Ricky Gervais: 'People are waiting for me to fail. If you think it's awful, then just don't watch it'

Ricky Gervais: 'People are waiting for me to fail'

As the second series of his divisive sitcom 'Derek' hits screens, the comedian tells James Rampton why he'll never bow to the critics who habitually circle his work
Mad Men series 7, TV review: The suits are still sharp, but Don Draper has lost his edge

Mad Men returns for a final fling

The suits are still sharp, but Don Draper has lost his edge
Google finds a lift into space will never get off the ground as there is no material strong enough for a cable from Earth into orbit

Google finds a lift into space will never get off the ground

Technology giant’s scientists say there is no material strong enough for a cable from Earth into orbit