UNDER SIEGE IN WAR-TORN SOMALIA, A DOCTOR HOLDS HER GROUND

[They did not seem to care that Mama Hawa, 63, was one of the only trained doctors for miles around, and that the clinic, school and feeding program she built on her land supported nearly 100,000 people, most of them desperate refugees from the fighting and poverty that has afflicted this nation.]

By MOHAMMED IBRAHIM and JEFFREY GETTLEMAN

MOGADISHU, Somalia, ON May 5, just after sunup, 750 militants surrounded Dr. Hawa Abdi’s hospital. Mama Hawa, as she is known, heard gunshots, looked out the window and saw she was vastly outnumbered.

“Why are you running this hospital?” the gunmen demanded. “You are old. And you are a woman!”

They did not seem to care that Mama Hawa, 63, was one of the only trained doctors for miles around, and that the clinic, school and feeding program she built on her land supported nearly 100,000 people, most of them desperate refugees from the fighting and poverty that has afflicted this nation.

For hours, militia commanders held Dr. Abdi at gunpoint while their underlings — mostly 15- to 16-year-old boys — ransacked the hospital, shooting anesthesia machines, smashing windows and tearing up records.

The gunmen, who belonged to one of Somalia’s most fearsome militant Islamist groups, notorious for chopping off hands and stoning adulterers, put Dr. Abdi under house arrest for the next five days and shut down the hospital, causing two dozen malnourished children to die in the bush after their families fled.

But something extraordinary happened. Hundreds of women from the sprawling refugee camp on Dr. Abdi’s property dared to protest, adding to a flood of condemnation from Somalis abroad that forced the militants to back down. Dr. Abdi even insisted that the gunmen apologize — in writing — which they grudgingly agreed to do.

“I told the gunmen, ‘I’m not leaving my hospital,’ ” Dr. Abdi said. “I told them, ‘If I die, I will die with my people and my dignity.’ I yelled at them, ‘You are young and you are a man, but what have you done for your society?’ ”

Somalia has been at war with itself for 20 years. The health care system, like much of the country, has been demolished. There are very few functioning hospitals left. But for decades — as the government imploded, warlords took over, more warlords came and an Islamist insurgency swept across Somalia — Dr. Abdi has persevered, offering a refuge for thousands of families driven from their homes by relentless street battles.

In a nation where the government controls only a few blocks in this war-torn capital, Dr. Abdi and her daughters, who are also doctors, are essentially running a small, desperate city on their own. But that is not enough, in her estimation. So, on separate patches of land she owns, she is organizing families to run farms and has bought a small fleet of fishing boats to help feed the camp.

HER stubborn commitment has earned her recognition worldwide. After nearly 30 years of Caesarean sections and emergency feedings, Dr. Abdi and her daughters were included in Glamour’s Women of the Year 2010, putting them in the same elite company as Julia Roberts and Queen Rania of Jordan. The magazine described Dr. Abdi as “equal parts Mother Teresa and Rambo.”

Eliza Griswold, who wrote about the compound in her book “The Tenth Parallel,” said, “Mostly out of sheer moxie, Dr. Hawa and her daughters have built a city of healing within the war’s brutal chaos.”

Dr. Abdi’s daughter Amina, who first learned to practice medicine trudging behind her mother during visits to the bush, said her mother needed to rest.

“But she has never rested in 20 years,” Amina laughed.

In fact, Dr. Abdi recently had a benign tumor removed from her brain. She is better, she said, but she is tired. Still the work continues, and Dr. Abdi plans to return in a few months.

“I can’t run away to save myself,” she said.

Dr. Abdi comes from a different generation of Somalis, one with opportunity. At 17, she won a scholarship to study gynecological medicine in Kiev, in what is now Ukraine; she was the only woman among 91 Somali students. Her dream to become a doctor began when she was 12, she said, watching her mother die in childbirth.

“I used to think and dream that one day I, myself, could save lives so no other mother would die helpless,” she said, her eyes bright behind thick glasses.

After Kiev, she returned to Somalia and worked for government hospitals. She married and had three children, two daughters and a boy, though her son was killed in a car accident in 2005. He was 23. Both daughters, Amina and Deqa, became doctors.

In 1983, she opened a one-room private women’s clinic on land her family owned and began persuading nomadic women to deliver their babies with her. Dr. Abdi said Somalia’s president at the time, Mohammed Siad Barre (the last president of a permanent central government in Somalia) personally gave her the permission.

That one-room clinic has steadily grown, almost unrecognizably. Today, Hawa Abdi Hospital has 400 beds, 3 operating theaters (still badly damaged from the attack), 6 doctors, 43 nurses, an 800-student school and an adult-education center that teaches women how to cook nutritious meals and make clothes.

Dr. Abdi has long performed surgical procedures herself, everything from Caesarean sections to tweezing out bullet fragments, though operations have been on hold because of the damage from the assault. Measles, malaria, diarrhea, epilepsy, tuberculosis and especially life-threatening malnutrition in a country constantly teetering on the edge of a full-blown famine are what she confronts on a daily basis, withsome international assistance but far from enough equipment or medicine.

AROUND the two-story hospital, 15 miles down a shelled-out road from Mogadishu, a veritable city has sprung up over the years, 90,000 refugees living in bubble-shaped huts made out of plastic sheeting and sticks, people who have flocked here because it is considered one of the few safe zones in southern Somalia. The medical treatment is free, supported by donations.

The haven comes with some security guards and a few important rules. Among them: no man may beat his wife. The property even has a storeroom that doubles as a jail for offenders.

Hakima Mohamoud, a 50-year-old mother who had just given birth, recently arrived here with a tiny, listless, malnourished baby, who was immediately put on a feeding tube. It seemed to be working, and Mrs. Hakima marveled that her daughter’s life could be saved — for free.

“I’ve never, in my life, seen a free-of-charge hospital serving free medicines,” she said. “I don’t know how I will pay Hawa Abdi Hospital back.”

Many Somalis have essentially given up on their government helping them. So, too, it seems, has Dr. Abdi. When asked if she thought of calling the government forces that day in May, when she was surrounded by hundreds of militants, Dr. Abdi simply laughed.

“Oh no,” she said, “they can’t do nothing. They are only in the state house and they can’t go out.”

She gets excited every time the story comes up and described how the militants, during their brief seizure of her compound, even raised one of their signature black flags.

“As soon as they left, we pulled it down and put up a white one,” Dr. Abdi said.

It was made out of a hospital sheet.

@ The New York Times