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Last Updated: Wednesday, 1 December 2004, 08:05 GMT
Somalia's angels of mercy
By Joseph Winter
BBC News, Mogadishu

An armed security guard sits at the entrance to the Hayat Hospital in the centre of Somalia's capital, Mogadishu, to ensure that no-one takes their weapons inside, turning a place of healing into a place of killing.

Ward in Hayat Hospital
Somalis were in desperate need of medical services
And the doctors and nurses who work inside the hospital are only too well acquainted with the results of Somalia's 13 years of lawlessness.

"Gunshots are one of our most serious problems," says Dr Mohammed Mahmut Hassan.

But there is a sign of hope.

He says that as the attempts to set up a new government have made progress, the number of gunshot victims has fallen.

"We used to have 10 gunshot victims a day. Now, we see just four or five a month," he says.

While Dr Mohammed is keenly waiting for the days when Somalia again has a government, the Hayat Hospital is also a sign of how well Somalis have coped without a central authority.

He and other Somali doctors working abroad got together and in 1998 set up the hospital to try and fill the gap.

"We had to help our people, even though we ourselves were safely living abroad," he said.

Aids threat

In order to meet its running costs, the hospital charges for every visit - nobody is paying any taxes which could be used to provide a free service - but Dr Mohammed says they try to keep charges as low as possible.

Dr Mohammed Mahmut Hassan
We can offer counselling but we cannot distribute condoms
Dr Mohammed Mahmut Hassan
Every Friday, 200 people who cannot afford the $3 fee are treated free of charge and long queues form overnight.

While Hayat, and Mogadishu's four other hospitals, are able to provide a basic medical service, the Aids pandemic highlights the need for a government to tackle the problem at the national level, for example by running public awareness campaigns.

The most recent statistics show that about 1% of Somali adults are HIV positive - low by African standards - but Dr Mohammed believes the numbers are rising quickly.

"We come across about five new positive cases every week," he says.

One reason is the high number of Somalis living in refugee camps in the region, some of whom are now able to go home as fighting subsides.

But Somalia remains a very traditional society, where Islam is strong and Dr Mohammed says that the hospital does not stock condoms - a key part of the fight against Aids - because the people do not accept them.

"We can offer counselling but we cannot distribute condoms," he says.

One hospital working alone will be unable to change such a deeply-entrenched mindset.

Water lifeline

In another sign of the entrepreneurial spirit and self-reliance shown by Somalis, those Mogadishu residents with some form of income are also able to go to school and university and get running water and electricity.

We must think out of the box for Somalia
Western diplomat
These are services not enjoyed by all of those who live in African cities with functioning governments.

Until 2000, Hawo Mohammed Khalid got her water delivered in a barrel carried on a donkey cart. Now, she just has to turn the tap.

"I feel happy now because I have water 24 hours a day. Before I might need water in the middle of the night and I didn't have any," she says.

Hawo, married to one of the few Somalis with a regular job, also enjoys regular electricity - and says there are rarely any power-cuts.

Facts and figures about life in Somalia

Her water and electricity are supplied by Abdoulkadir Hassan Issa, who runs the Isaf Water and Electricity Supply company in Bulo Hubey's south Mogadishu suburb.

"We are doing this to provide a public service until the government comes," he says.

"Then they can provide water and electricity or they might give us a contract and then we could continue. That's what we'd really like."

Wire thieves

Mr Abdoulkadir says they used to use an open well but some customers complained about their water quality, so they dug a bore hole and add chlorine to prevent infection.

It may not taste like mineral water but Hawo is not complaining.

Abdoulkadir Hassan Issa
Mr Abdoulkadir's generators serve 180 families
Generators provide electricity along very precarious-looking wires and Isaf has even hooked up fluorescent lights as makeshift street lamps.

Isaf provides running water to 800 families and electricity to another 180 across a large part of south Mogadishu, he says.

The biggest problem Mr Abdoulkadir faces is that thieves take advantage of the absence of law and order to steal the wires and pipes he used to provide his services.

"But at least the militia which controls this area doesn't ask us for protection money," he says.

'Wait and see'

Nobody says that such services mean that a government is not needed but one western diplomat closely involved with the peace process says they mean "we must think out of the box for Somalia".

When a new government is eventually installed in Mogadishu, it would make no sense for it to take over all these services which are already functioning.

Street lights
Some street lights are better than none - unless there is a short circuit
"It would be a tragedy to fall into the trap of having a massive state sector, which would inevitably fuel corruption as we have seen elsewhere in Africa," he says.

"Maybe the health ministry could set policies and targets for hospitals, which would remain in private hands, for example."

But while arguments continue about how to bring the Kenya-based government back to Somalia, such questions remain academic.

In the meantime, Dr Mohammed is not making any predictions about whether the fall in shootings will continue, or whether the latest attempt to set up a Somali government will fail, like the 13 which have gone before.

"We're just waiting to see, like everyone else," he says.




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