Out of Somalia’s Civil War Rises a Disability Center Turning Lives Around
The year was 1991, and Ali Jama Hassan was exhausted, famished, and fleeing civil war in Somalia. Then about 23 years old, he was traveling in an armed convoy with more than 1,000 other university students. Earlier, the group had been so desperate, they had been reduced to eating leaves “like goats,” says Hassan—who, now in his late 40s, recounts the story with a soft laugh to TakePart.
“Then we start to see the first Ethiopian border guard,” he recalls. “[In] my life, it was the first time to see an Ethiopian. Because Somalia and Ethiopia were historical enemies, when we are at school—‘They are monsters, they are not normal people’—that’s what we were taught.”
While Somalia and Ethiopia have violently clashed over border disputes since the 1960s, they called a détente in recent years. Hassan explained what went through his mind as they came upon the guard: “Then, I said ‘Ah! An Ethiopian is a human, really.’ That is in my brain. In fact, they were so nice. They welcomed us.”
Civil war has raged in Somalia for more than 20 years. While it stemmed from resistance to military dictator Siad Barre in the 1980s, Barre was overthrown, and since then, clan-based armed factions have competed for influence and power, eventually leading to the total collapse of the state in 1991. Amid the overthrow of the government, the former British protectorate declared its independence on May 18, 1991. It has since established a separate government and currency but is unrecognized as a country by the international community.
Somaliland’s mother country, Somalia, continues to stumble. After a decade of feeble and failed attempts at establishing a center, a U.N.-backed government was created in 2012. It is still at war today, now fighting the al-Qaida affiliate al-Shabaab. Around 500,000 people are estimated to have died since the start of the conflict in 1991.
Hassan’s encounter at the border—seeing the humanity in what was only depicted with enmity—has been a motivating factor in keeping him in Hargeisa, the capital city of Somaliland, the self-declared independent state of Somalia. Here, Hassan heads the Disability Action Network, a locally run NGO that supports disabled children and adults, specifically those injured in the civil war, or refugees or internally displaced persons with disabilities. In the fourth-poorest economy on earth, DAN is the main referral center for disabled patients living not only in Somaliland but also across Somalia proper and in parts of Ethiopia.
DAN, where Hassan has been for more than 20 years, operates in five centers across Somaliland and runs on a modest annual budget of approximately $120,000. This figure covers everything from equipment, prosthetics, and wheelchairs to salaries for physicians, maintenance crew, and security guards.
Founded by Handicap International in 1992, DAN originally served adults and children injured by land mines, gunshots, and war-related trauma. These days, the organization operates independently from any international NGO. In addition to physiotherapy, DAN also focuses on mainstreaming patients into school and employment, including prosthetic and wheelchair production; for the past three years, the Somaliland government has contracted with DAN to make wheelchairs. “This is a precondition for inclusion,” Hassan says. “Kids can’t go to school without wheelchairs, people can’t go to work without them.”
The organization is also fighting the current law in Somaliland that denies people with physical or psychological disabilities the right to run for office.
Even though patients these days aren’t often directly injured in conflict, Hassan says, DAN exists because of Somalia’s brutal civil war, which tore apart the functioning health care system that was in place before the fighting broke out.
Inside the sun-filled, colorful children’s physiotherapy room, toddlers at different stages of development can be seen cooing while they practice exercises to help them roll over or control their head. Cerebral palsy is widespread in Somaliland because of poor maternal health care—another result of the destroyed system—and DAN estimates that at least 10 percent of children in Somaliland have some form of disability. Hassan has encountered numerous families that have more than one child with cerebral palsy.
Suleekha Mohammed, a 25-year-old mother of eight, thought her youngest child was stillborn when she gave birth to him nine months ago in a rural village in Ethiopia; he didn’t move a muscle. The family rushed the infant to the nearest doctor, where he was misdiagnosed and given a tetanus shot. When his condition didn’t improve, they drove him to Hargeisa, where he was diagnosed with cerebral palsy and went to DAN for physiotherapy. Mohammed and her baby boy have since stayed in the city so he can receive regular therapy at DAN. This is common: Families from out of town will stay with relatives or rent a house in order for their children to get the help they need.
Zahira Yassin is almost two years old, and she also has cerebral palsy. Her mother, 35-year-old Amina, jingles interactive toys in front of her eyes to keep Zahira focused on a central object while she struggles to keep her head upright and steady. The “corner seat” chair supports children with cerebral palsy, helping them correct their posture and better control their head. This is the second stage of development, with the first being rolling over, the third crowning, and the fourth standing. As Hassan explains, “If we succeed at one stage it’s good, otherwise the child will lay on the bed without moving.”
Progress encourages Hassan to continue his work—a job that came to him from the very conflict he was fleeing.
“Every child that comes here is a victim of the war in a direct or indirect way,” he says.