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Last Updated: Wednesday, 26 May, 2004, 14:43 GMT 15:43 UK
Mogadishu doctor defends his actions
SOS hospital
The hospital's gates remain closed
A Somali doctor whose suspension triggered a strike and the closure of Mogadishu's only free hospital has defended his actions.

The SOS hospital in the capital was shut after gunmen threatened Dr Bashir Sheikh, who had carried out an operation to remove the womb of a woman in order to save her life.

The other doctors have refused to work in support of Dr Bashir. They allege the woman's family, who argue they did not give consent for the operation, sent the gunmen.

Somalia has had no central government since 1991 and is divided into areas controlled by rival warlords.

Dr Bashir told BBC World Service's Outlook programme that the woman, Fatuma Abdulle Elmi, had been carrying a dead baby, and her life was in danger unless her womb was removed.

"Her situation was very serious," he added.

"Upon commencing surgery, I discovered that the foetus had been dead for at least 48 hours, and had already started to decompose."

Disputed consent

Dr Bashir said that Ms Elmi's uterus was torn apart and bleeding, and that she was in a state of shock, suffering low blood pressure and having difficulty breathing.

Her blood was flooding other organs, her stomach and her digestive system.

Women with sick children
The closure has sparked protests from people with sick children
"We had consent from her husband to do whatever was necessary to save her life, and that is how we began the operation - which thanks to God was successful," he stressed.

"We had to remove the uterus to save her life. If we hadn't done the operation, she would have died."

However, this consent has become the sticking point in the dispute.

Ms Elmi's family argue that while they agreed an operation should have taken place, they should have been consulted before her womb was removed.

Her husband, Noor, disputes that he gave the necessary consent.

He did, however, admit he signed his name on the back of a piece of prescription paper - but says this was to allow the removal of the baby, not the removal of the womb.

"I knew that this hospital was for women having babies. If they do not deliver their babies normally, then doctors can perform operations," he said.

"The issue is not where the operations should take place or not, it's about the removal of the uterus, which we feel was wrong to do on the part of Dr Bashir.

"All we want now is for Dr Bashir to convince us that he had the right to do this without consulting us."

No legal procedures

He added that he was aware that the hospital is currently closed, and had heard that doctors were threatened, but said his family "don't intend to harm anyone".

"We have nothing against any doctors in this hospital," he added.

Ms Elmi's brother Ali Abdulle said that he wanted the issue settled "according to Islamic law." The family have demanded 50 camels, the traditional Somali compensation offered for the death of a woman, arguing she is as good as dead because she can no longer bear children.

Families outside the SOS hospital
Many families cannot afford treatment in private hospitals
Dr Bashir said that he had accepted this demand, and that religious scholars had been brought in. However their belief that "the doctor had done the right thing" has not convinced the family.

However, Ali Elmi protested that his family has not threatened anyone.

"No-one went to the hospital with guns," he added.

"Dr Bashir himself is my witness. It is not us who are responsible for the closure of the hospital."

The closure of the hospital has sparked mass protests in Mogadishu, with the medical doctors appearing to have the support of the community.

There is, however, no proper legal procedure for dealing with the dispute. It is likely that traditional elders and religious scholars will intervene.

But the doctors are not likely to work again until the gunmen go away.

"The problem is, one has to be safe," Dr Bashir stressed.

"This is surgery. One has to be calm, and have the stability and peace of mind to carry out the operations. If there is fear at the back of your mind that someone will sue you because of the operation, it is impossible to work... that's what prompted us to suspend operations."

Somalis march over shut hospital
19 May 04  |  Africa
Militiamen shut Somalia hospital
17 May 04  |  Africa

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