MALARIA and TUBERCULOSIS: 'My life as a Somali doctor'

Somali Dr Hafsa Abdurrahman Mohamed, 26, describes what it is like working at a hospital in Marere, a town in the southern Islamist-controlled part of the country. She was one of the 20 student doctors to graduate from a medical school in the capital, Mogadishu, in December 2008 - the first to do so for nearly two decades.
The best thing about my work is when the baby is born and together with the mother, they are both safe; the moment when the baby cries out.
All the women are so welcoming. Especially the pregnant women - they are very happy to have a female doctor

I want to help Somali women.
It was difficult studying in Mogadishu. Sometimes it was difficult to travel to the university because of the fighting. And then if you made it to the class but there was fighting near the university, you would worry how you would get home.
That is past now and I am very happy that I have reached my aim which was to be a doctor.
I had never been to Marere before I came to work here but I chose to take this job here in Marere because it is peaceful.

Comfortable
The journey to Marere from Mogadishu should take one day of driving by car but the roads are very bad so it took three days.
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I was worried I would not be accepted but I had no need - the people were very friendly and welcoming to me and I was made to feel comfortable. It is a small town and the people are farmers. Livestock cannot survive here - they die from disease. Because of this there are no animals in Marere. Meat has to come from the next town called Jilib. Farmers grow maize, mangoes and other fruits. There are some small shops but there's not much trade.

Enough beds
There are about 200 beds at the hospital where I work, which was built by Medecins Sans Frontieres.
There is one other doctor - a man - who has been there three months longer than I have. There are also two midwives but they also do normal nursing.
We have a ward for children and one for adults and there are normally enough beds for the number of patients we have. Mostly, it is OK.

I begin my working day at 0800 hours, visiting the in-patients at their beds to check how they are and then I go to the ante-natal consultation unit. If a mother comes to give birth and if she can give birth naturally then the midwife helps but if she cannot, then I do a caesarean. I do sometimes one operation a week. I actually live at the hospital but it is not like I am always on call. I don't get a lot of calls unless there are complications which is quite rare.
Welcoming women
There are no machines in the hospital - we don't have ultrasound nor x-ray, so we only know what is wrong with people from symptoms. That is how diagnosis is done.

 This baby was named Hafsa in her honour
We have a generator so the hospital has electricity and we have internet. Wells provide clean water. The most common complaints are malaria, TB, cholera and bilharzia. At first the male patients are so surprised to have a woman doctor but then they are welcoming. There is no problem. All the women are so welcoming. Especially the pregnant women - they are very happy to have a female doctor. On average, about 70 expecting mothers come to the hospital for check-ups which is a lot. But for the whole of last month, only 10 babies were born in the hospital. It is because the women don't know when they are due and so end up giving birth at their homes in the villages using traditional midwives. It is because no-one has vehicles to carry and bring them to the hospital when they are in labour and so if there's any complication, the mother and the baby can die.
The hospital has a normal car that is used as an ambulance but if their family doesn't call, then no-one knows to go and collect and help. I educate the expecting mothers on food and nutrition, dangers like high blood pressure and the importance of breast-feeding but if they came to the hospital to give birth, it would be much better. Many mothers and babies would not die then. I work six days a week. On my day off, I study because I want to specialise in gynaecology and obstetrics.
http://news.bbc.co.uk/2/hi/africa/8280415.stm