MOGADISHU, Somalia – On his way to his dental clinic every day, Dr Abdulkadir Abdirahman Adan was appalled by an all too common sight: seriously injured and dead Somalis being transported to hospitals in wooden handcarts or wheelbarrows.
It was 2006 in the Somali capital, Mogadishu, when government troops, reinforced by Ethiopian forces, were engaged in a brutal war with Islamist fighters that left thousands dead and many maimed in the violence.
Dr Adan, who had just returned to the city after studying abroad and opened his dental practice in the city’s largest open-air market, felt powerless to stop the bloodshed . But he believed he could do something to help victims who were still alive get treatment more quickly and ensure the dead were treated with dignity.
“I asked myself, ‘How can I help my people?’ “, said Dr. Adan recently during an interview at his office.
His first step was modest: he hired a minibus, painted blue and white in the colors of the Somali flag, and paid its owners a few dollars a day to transport the wounded to safety. People were calling Dr. Adan or bus owners on their cell phones to direct them to those who needed help.
But this approach could only help a handful of victims each day, and the violence in the city only escalated.
“I thought the situation would get better, but it just got worse and worse,” he said.
So, within months, Dr. Adan had spent all of his savings – around $2,400 – on buying a van, with additional funding coming from a campaign he ran to urge university students to donate. $1 to save a life.
This is how Aamin Ambulance began: the first and still the only free ambulance service operating in the capital of over three million people.
Sixteen years later, Aamin Ambulance – “Aamin” means “trust” in Somali – now has a fleet of 22 ambulances and a team of 48 drivers, nurses, paramedics, radio operators and security guards.
“Anyone who needs an ambulance, 24/7, we’re here,” said Dr Adan, 48. “And it’s free.”
Since the establishment of Aamin Ambulance, there have been few periods of prolonged peace in Mogadishu, with Al Shabab, the Al-Qaeda-affiliated Somali terrorist group, continuing to carry out frequent attacks. While its deadliest came in 2017 – a double truck bombing that killed 587 people – the group remains a constant threat. Just this week, President Biden authorized the deployment of hundreds of American troops to the country as part of a counterterrorism mission.
Aamin Ambulance workers are often among the first to arrive at the scene of an attack, often just minutes after a bomb has exploded.
“We almost always arrive before the police arrive,” Dr Adan said.
This means Dr. Adan and his team are often the first call for reporters looking to verify casualty figures and help verify what happened at the scene of the attack.
But that speed also puts the team at risk: the Shabab will sometimes detonate a second bomb in the area of an attack, specifically intended to target those arriving to help.
Abdulkadir Abdullahi, a medic from Aamin, experienced this type of explosion while evacuating injured people, with the windows of the ambulance he was in shattering due to an explosion as he prepared to leave. leave the premises. “Just when you think it’s safe, it turns out it’s not,” Mr Abdullahi said.
Responding to terrorist attacks is not the service’s only mission. It also transports sick children, mothers in labour, accident victims and anyone else in need of urgent care. Thanks to its 999 hotline, the team responds to a minimum of three dozen calls a day.
It also engages in public health campaigns, including educating people about Covid-19 and providing first aid training.
Despite recent progress on some fronts, the health sector remains weak in Somalia. There are few public hospitals and receiving treatment in private facilities is expensive and out of reach for many.
The coronavirus pandemic has underscored just how vulnerable Somalia’s health infrastructure is, with medical staff facing long working hours and lacking protective equipment.
Mogadishu is particularly vulnerable to infectious diseases, with many residents living in cramped quarters with unsanitary conditions. Tens of thousands of displaced people, many with unvaccinated and malnourished children, continue to stream into the city, presenting a growing health challenge for authorities, who must depend on private groups to provide the services the government does not. can not provide.
“That’s why the work of Aamin Ambulance is indispensable,” said Mohamed Adow, director of health at the regional administration of Benadir, which oversees Mogadishu. “We need more.”
Dr. Adan is not alone in his civic engagement. His work is one of many citizen initiatives that have sprung up across Somalia since the disintegration of its central government in 1991.
For decades, this Horn of Africa nation has been caught between factional warfare and terrorism, with successive weak governments unable to fully secure the country or deliver key services. But through it all, Somalis have cobbled together some basic services: building schools and universities, establishing thriving telecommunications and banking services, garbage collection, building streets and even rehabilitating of child soldiers.
“These are the people who have made their own development, their own progress,” Dr. Adan said.
While Dr. Adan and his team have been exposed to the gruesome consequences of numerous attacks, the twin truck explosions on October 14, 2017, at a busy road junction in Mogadishu, still stand out, with nearly 600 killed and 316 injured.
“It was something not good to remember,” Dr Adan said.
That afternoon, he was about five minutes away from the bombardment and immediately rushed there to meet his team. “A lot of people were crying, dying, bleeding,” he recalls. “It was very disastrous. It’s still like a nightmare in our minds.
But the horrific attack brought much-needed recognition to the ambulance service, both among Somalis and international donors.
Nimo Mohamed was one of many Somalis who rushed to the scene of the blast that day to help. What she saw – burned body parts, mangled vehicles, collapsed buildings – shocked her, but also made her determined to do what she could to improve life in the capital.
She soon volunteered with Aamin and went on to study nursing and midwifery.
“Our people need help,” said Ms Mohamed, now an Aamin-trained nurse and paramedic.
In the days following the attack, a crowdfunding campaign for Aamin attracted contributions from Somali model Iman and British rock band cold game. Abdi Addow, a Somali-born Swede, said he helped launch the campaign because he was both moved and surprised that Aamin was providing such a public service for free.
In Somalia, he said, “everyone is focusing on their own advantage, to take advantage of poverty and chaotic systems”. But with Aamin Ambulance, he added, “They are the ones who always have the courage to help others.”
Dr Adan said he inherited the spirit of volunteerism and generosity to others from his grandfather, a religious scholar. Dr. Adan’s father taught the Quran and other religious subjects, and his mother ran a small shop.
Years after finishing high school in the capital, he left Somalia at the turn of the century to study dentistry at Peshawar Medical College in Pakistan. While there, he said, he was inspired by the example of Abdul Sattar Edhi, who had started Pakistan’s largest ambulance service.
Dr Adan’s work has not brought him the universal goodwill of the country’s authorities, with some wondering if the speed with which his team arrives at attack scenes means they had advance warning. Other officials have expressed suspicions about how he can afford to run the service.
Dr Adan dismissed the idea of receiving early attack warnings and said he was funding the ambulances with income from his own dental practice, as well as support from local businesses, the United Nations and other non-governmental organizations.
Aamin workers are harassed and even beaten by security forces, who regularly deny them access to cross roadblocks when transporting injured people.
“Security forces have put a gun in your mouth and are threatening you,” said Ali Mohamed, a paramedic at Aamin for 14 years. In its decade and a half of operation, three Aamin staff members have died on the job as a result of gunshots or accidents.
So far, the service has not received any threats from the Shabab, Dr Adan said.
Its future ambitions are to offer a free palliative and mortuary care service in Mogadishu and to expand the ambulance service beyond the capital, eventually serving the whole country.
“Somalia and Somalis deserve better,” he said.