Letter: Hospital con tricks in Somalia

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Independent Voices
Sir: James Roberts's vivid report on Digfer hospital ('Mogadishu's theatre of death', 27 August) is an accurate snapshot of what he saw during a brief tour but, as is common among the myriad newly arrived journalists in Somalia, his sketch is an inadequate representation of a more complex and frightening picture.

Mr Roberts quotes one of the Digfer patients as highly critical of doctors and nurses working for the International Medical Corps (IMC). While all patients are entitled to their opinions, and we do not claim to be perfect, the patient, Kamilo Mohammed, is the victim of an elaborate and commonplace confidence trick.

Traditionally, amputation, the correct treatment for the savage wound to his leg under the present terrible circumstances, is taboo. But he can, and does, pay surgeons to try to save the limb by fitting a plate to the gap made by a bullet that took a large chunk of his leg with it as it passed through. Such surgery requires a high degree of sterilisation, which is impossible in Digfer. Mr Mohammed's leg will eventually have to be amputated to save his life because of infection.

This sort of confusion is typical and is an indication of how difficult it is to work in a Somali hospital, where expatriate and local staff are constantly threatened with guns and are working with very inadequate supplies.

Furthermore, it is not our policy to insist that the Somali doctors and nurses do everything 'our way' - if we did, it would be both insulting and put our staff at great risk of assassination. It is not true that the International Committee of the Red Cross has cut medical supplies to Digfer, though it has reduced its contributions by half.

The Somali doctors cannot be blamed for taking money for operations: they have not been paid for 20 months and receive very irregular supplies of food for working long hours in dangerous and depressing circumstances. As a result, many are leaving to work overseas. There is a crying need for experienced expatriate nurses and doctors in Somalia's hospitals - only then will the sort of medical horrors described by Mr Roberts come near to an end.

I remain, Sir,

Your obedient servant,

STEPHEN TOMLIN

Field Director

International Medical Corps

Mogadishu, Somalia

30 August

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