FOR IMMEDIATE RELEASE 8 June 1993

RELEASE NO. 93-31

HEALING SOMALIA: A NAVY DOCTOR'S EXPERIENCES

IN OPERATION RESTORE HOPE

By Robert Figueroa

Doctors will tell you that dealing regularly with trauma and tragedy requires a certain professional detachment. Yet even the most case hardened physician will admit to occasions when this psychic shield gives way, when the sheer drama and emotion of a moment bring the suffering painfully home. For Navy Medical Officer Curt Andersen, recently returned from Somalia, there were more than a few such moments among his many unforgettable experiences in that stricken country.

A trim, soft-spoken 32 year-old with thin blond hair and wire-rim glasses, Lt. Andersen, a native of Fresno, practices primary care at NAS Alameda's Branch Medical Clinic. Assigned in December as medical support for the Marines in Operation Restore Hope, Anderson first received a quick course in war-zone survival skills--including the use of a 9 mm automatic pistol he was to carry with him at all times--before flying into Mogadishu on Christmas day.

It was in that port city, not far from where the Marines first landed, that Anderson's unit (part of the First Force Service Support Group) set up shop--a clinic and trauma room in tents on a fenced-in compound. One of the first patients of the Group Aid Station--as it was called--was a Somali man who had been accidentally crushed by the front gate as a truck came through. The man was limp and barely breathing.

"We ran a code on him," Andersen recalls (a set of emergency procedures to stabilize him). "After a while we could see he wasn't going to make it. But we kept on going. We decided he better not die at our facility. We didn't know how the Somalis would react. We thought they might riot against us."

They decided the man had to be moved out of the compound. "So under heavy marine guard--it was at night and we had to go over the green line into what was considered the war zone--we drove him to a Somali hospital."

Conditions at the hospital shocked Andersen. "The hospital's trauma room consisted of a table, a trash can, and a light." Andersen consulted with an Egyptian doctor, and together they pronounced the man dead. "The hospital was unbelievable. There was human feces on the floor, kids running around without diapers on, excreting all over the place." He describes a ward devoted to victims of tetanus, a disease rarely seen now in the U.S. "It's an agonizing disease, and to see people suffer like that...."

There were few Somali doctors, adds Andersen, because virtually everyone with education or money had fled the country during the civil war. Basic medical supplies were scarce or non-existent, and hospitals did not escape the pervasive looting that had stripped the country of anything of value that could be moved. "There was no law, no government at all in Somalia," says Andersen. "The situation was basically chaotic."

He recalls the tension of driving through danger zones, ducking at the staccato bursts of gunfire. On one occasion the shots were so close he could smell the powder. One of his marine escort yelled out, "I'm hit!" (It turned out that in the excitement the Marine had accidentally shot himself in the leg.) Andersen had to administer to the wound in the middle of a firefight.

With the growing military presence, the danger subsided somewhat--though few days passed without the sound of rifle shots or mortar fire ringing somewhere in the distance. Andersen quickly picked up the basics of the language, delighting in starting conversations with surprised natives. He hitched a ride on a plane dropping leaflets over the countryside warning gunmen to turn in their weapons. He traveled inland to Baidoa and down the coast to Kismaayo, met U.N. relief workers, soldiers, and journalists from around the world, as well as Somali refugees from different parts of the country.

But it was primarily through his work as a physician that Andersen came to know the Somali people. Anderson treated hundreds of Somalis from traveling clinics, through a military program called MEDCAP (Medical Civic Action Program). In doing so he made many friends.

One Somali friend was only too eager to teach him the ways of Islam (Somalia is predominately Muslim). When Andersen had repeated a chant satisfactorily, his friend pronounced him a Muslim. "He said I would need a new name," recounts Andersen. "I asked him why. He said that usually everyone is named for the prophet Mohammed. He asked me my father's name. 'Ralph,' I told him. 'Ok,' he said, 'from now on you are Mohammed Ralph.'"

Near the end of his stay another Somali friend beseeched him to remain. "We need you, Dr. Andersen, he said. Stay with us." The man offered Andersen land and a farm by a river. When Anderson told him he had a wife and children in America, the man said, "I will give you two wives." Andersen respectfully declined, and the man raised the offer to four wives.

The warmth and friendliness Andersen met with from the Somalis came even in the face of often desperate and hopeless conditions. If Andersen's work there was some of the most rewarding of his life, it was also heartbreaking.

"After working out in the community for three hours, I'd come back completely drained. From just seeing so many problems, so many heartbreaking things: children dying of tuberculosis and other diseases, gunshot wounds, limb-threatening conditions. But you would also feel like you really contributed."

Andersen recounts going to a Somali pediatric hospital to treat a small boy who had been beaten. "Again, the conditions were appalling, by our standards. But the kids were so excited to see an American, they just mobbed me. They wanted to touch me, hold my hand. When I started speaking to them in Somali they just went wild." Andersen smiles. "That made me feel like everything was worth it." Andersen and his colleagues knew they could treat only a tiny fraction of the thousands of Somalis desperately in need of attention for infected wounds, dysentery, malaria, malnutrition, tuberculosis and other serious ailments. Even many of those he saw he could not help because of a limited supply of manpower, medicines and equipment. Indeed, the fear that MEDCAPs would deplete resources needed for U.S. personnel prompted many military leaders to oppose them in Somalia. Andersen's commander was one of a few to give the go-ahead.

Again and again Andersen found himself deeply touched and disturbed by the Somalis' plight. He remembers a woman's account of being robbed by marauding gunmen of the precious food she'd managed to procure, a man's story of being bound and forced to watch thugs rape his wife and daughters, and of parents telling how they could only sit by helplessly as their children slowly starved.

But there was one incident, occurring just days before he was to return to the U.S., which affected him like no other.

"We got a call that someone had been shot at the front gate. I jumped into the truck and drove out with some Marines." The victim was a teenage boy with a fatal bullet wound to the head.

"There was a crowd gathering, a lot of arguing going on over who shot him--whether it was one of the Arab security forces, or another Somali, or a U.S. Marine. After I pronounced him dead I looked into the crowd, and there was this man trying to get through.

"Somehow I knew the man was the boy's father. I told them to let him through and I brought him over to the boy. When he saw it was his son the man started to weep. He wasn't crying hysterically, he was just weeping. His face was so hard, so rugged. I felt so bad at that moment. It hit me how awful this was. A few years ago my brother was killed in a tree-cutting accident, from massive head trauma like this boy. I'd seen my own father, known what we'd been through. And it all came flooding back to me in that instant."

It was Friday, the Muslim Sabbath, and the father wanted to take the boy and bury him quickly according to Somali custom. The Marine investigators, on the other hand, were equally determined to take the body to be autopsied.

"It was really a tense moment. I took the father aside, took an Army interpreter, and I started to tell him how bad I felt for him, how something like this had happened in my own family. And then I started to choke up. I told him that we wanted to find out who did this. I promised him the boy wouldn't be carved up, and we'd get his son's body back to him that day."

Well aware of military procedure and bureaucracy, Andersen knew what he would be up against in trying to keep that promise. But he was determined. "We got an ambulance, took the father and his brother and the interpreter and drove the boy to the Army hospital." They managed to find the pathologist and get him to come outside to examine the body. "He determined the shot came from an AK-47, not an M-16. So more than likely it was another Somali who shot him."

Finally they drove the boy, his father and brother back to the green line--the edge of the war zone. "It was as far as we could go," explains Andersen. From there the father and the brother carried the boy away.

The incident represented a low point for Andersen, he says. "At that point I just had this overwhelming sense of dashed hopes. I wondered whether all these efforts might be in vain."

What does he think now? Has the U.S. and U.N. involvement ultimately helped Somalia? "It's definitely helped. When I left people were no longer dying from starvation--in fact the feeding centers were starting to scale down. And school had started again, after two and a half years without it."

"But as far as a long term solution, I just don't know how they're going to straighten it out. There are so many different factions, and they all want power and boundaries--it's just one clan against another, with no government. And there's a whole generation of young men who for the past five years have made their living from toting around AK-47s. It's going to be hard to change that mentality."