MOGADISHU, Somalia – On the way to and from his dental clinic every day, Dr. Abdulkadir Abdirahman Adan shocked by an all-too-general sight of seriously injured and dead Somalis being transported to hospitals in wooden handcarts or wheelbarrows.
This was in 2006 in Somalia’s capital, Mogadishu, when government forces, supported by Ethiopian troops, engaged in a brutal war with Islamist fighters, killing thousands and maiming many more in the violence.
dr. Having just returned to the city from studying abroad and opening his dental practice in the city’s largest open-air market, Adan felt powerless to end the bloodshed. But he thought he could do something to speed up treatment of living victims and ensure that the dead were treated with dignity.
“I asked myself, ‘How can I help my people?'” said Dr. Adan recently in an interview at his office.
His first step was modest: he rented a minibus, painted blue and white in the color of the flag of Somalia, and paid the owners a few dollars a day to take the injured to safety. People called Dr. Adan or the bus owners on their cell phones to refer them to people who needed help.
But this approach could only help a handful of victims a day, and the violence in the city only increased.
“I thought the situation would get better, but it kept getting worse,” he said.
So within months, Dr. Adan put all his savings — about $2,400 — into buying a van, with some extra money coming from a campaign he ran to encourage college students to donate $1 to save a life.
And so began Aamin Ambulance: the first and still the only free ambulance service in the capital of more than 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 officers.
“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 Somali terrorist group affiliated with Al Qaeda, continuing to carry out frequent attacks. Although the deadliest happened 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 US troops to the country on a counter-terrorism mission.
Aamin ambulance workers are often the first to arrive at the scene of an attack, often just minutes after a bomb attack.
“We almost always reach before the police come,” said Dr. adan.
This has led to Dr. Adan and his team are often the first call-up for journalists who want to verify the number of victims and help verify what happened at the scene of the attack.
But this speed also puts the team at risk: the Shabab will sometimes detonate a second bomb in the area of an attack, specifically designed to target those arriving to help.
Abdulkadir Abdullahi, a nurse at Aamin, has experienced explosions like this while evacuating victims, with the windows of the ambulance he once was in being shattered by an explosion as he prepared to leave a scene. “Just when you think it’s safe, it turns out it isn’t,” said Mr. Abdullah.
Responding to terrorist attacks is not the agency’s only mission. It also transports sick children, mothers giving birth, accident victims and anyone in need of urgent care. The team handles at least three dozen calls a day through the 999 hotline.
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. Public hospitals are few, and treatment in private institutions is expensive and out of reach for many.
The coronavirus pandemic underlined how fragile Somalia’s health infrastructure is, with medical workers working long hours and lacking protective equipment.
Mogadishu is particularly vulnerable to infectious diseases, as many residents live in cramped settlements with unsanitary conditions. Tens of thousands of displaced persons, many of them with unvaccinated and malnourished children, continue to flock to the city, posing a growing health challenge for authorities, who rely on private groups to provide services that the government cannot.
“That’s why the work that Aamin Ambulance is doing is indispensable,” said Mohamed Adow, the health director of Benadir’s regional administration, which oversees Mogadishu. “We need more.”
dr. Adan is not alone in his social commitment. His work is among the many civic initiatives that have sprung up across Somalia since the collapse of the central government in 1991.
For decades, this country in the Horn of Africa has been caught between factional wars and terrorism, with successive weak governments unable to fully secure the country or provide important services. But through it all, Somalis have cobbled together a number of basic services: building schools and universities, establishing thriving telecommunications and banking services, collecting waste, building streets and even rehabilitating child soldiers.
“People were the ones who made their own development, their own progress,” said Dr. adan.
While Dr. Adan and his team have been exposed to the horrific aftermath of many attacks, the double truck explosions on October 14, 2017 at a busy intersection in Mogadishu, still stand out, leaving nearly 600 dead and 316 injured.
“It was something that’s not good to remember,” said Dr. adan.
That afternoon he was about five minutes away from the bombing and immediately rushed there to meet his team. “A lot of people cried, died, bled,” he recalled. “It was very disastrous. It’s still like a nightmare in our minds.”
But the horrific attack brought much-needed recognition from the ambulance service, both among Somalis and international donors.
Nimo Mohamed was one of many Somalis who rushed to the site of the explosion that day to help. What she saw – burnt body parts, mutilated vehicles, collapsed buildings – shocked her, but also made her determined to do what she could to improve life in the capital.
She soon applied to Aamin and pursued a degree in Nursing and Midwifery.
“Our people need help,” said Ms Mohamed, now a nurse and trained ambulance driver at Aamin.
In the days following the attack, a crowdfunding campaign for Aamin saw contributions from Somali supermodel Iman and British rock band cold play† Abdi Addow, a Somali-Swedish, 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 focused on their own benefit, making money from poverty and the chaotic systems.” But with Aamin Ambulance, he added: “They are the ones who always have the courage to help other people.”
dr. Adan said he picked up the spirit of volunteerism and generosity toward others from his grandfather, a religious scholar. dr. Adan’s father taught the Qur’an and other religious subjects, and his mother owned a small shop.
Years after graduating from high school in the capital, he left Somalia at the turn of the century to study dentistry at the 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.
The work of Dr. Adan has not earned him the universal goodwill of the country’s authorities, with some doubting the speed with which his team arrives at the attack scenes means they were tipped off ahead of time. Other officials have expressed suspicions about how he can afford to run the service.
dr. Adan rejected the idea of getting early warnings of seizures and said he funds the ambulances with revenue from his own dental practice, along with support from local businesses, the United Nations and other non-governmental organizations.
Aamin’s employees are harassed and even beaten by security forces, who regularly bar them from roadblocks when transporting injured people.
“The security forces put a gun in your mouth and threaten you,” said Ali Mohamed, Aamin ambulance driver for 14 years. In the year and a half they have been in operation, three Aamin employees have died on the job due to gunfire or accidents.
So far, the agency has not received any threats from the Shabab, said Dr. adan.
His ambitions for the future are to provide a free hospice and mortuary in Mogadishu and to expand the ambulance service beyond the capital, eventually covering the entire country.
“Somalia and Somalis deserve better,” he said.