“That is, in the UN’s terms, a crisis … But because it’s been a similarly awful picture for such a long time, the crisis warning bell no longer produces the fire brigade”, Paul Smith-Lomas , Oxfam GB’s east Africa director.

Somalia presents the single largest humanitarian challenge in the world. “Over 3.6 million people, or half of Somalia’s population, are currently in desperate need of aid. In terms of numbers of people, access to any form of social welfare or livelihood choices, and the apparent intractability of it (the conflict in Somalia), it is the most pressing concern in humanitarian terms that we have globally”, Jane Cocking the humanitarian director for OXFAM GB said.

In the past 21 years, the country has lived through droughts and famines, wars and conflicts, massive population displacements, appalling human rights violations and state orchestrated terror. These conditions continue to devastate the country. Civilians without any other options are pouring into impoverished camps in neighbouring Kenya, Ethiopia and Yemen. In Somalia, 1.3 million persons are living in makeshift camps, without assistance from humanitarian agencies or from the UN

Robbert Van den Berg, Oxfam International’s spokesman for the Horn of Africa, describes the conditions in the refugee camps as “barely fit for humans”. The UN Food Security and Nutrition Analysis Unit for Somalia, issued a report on Tuesday, August 25, 2009 saying Somalia is now in its worst humanitarian crisis for 18 years.

Operation Inshallah

Somali warlords and Islamic insurgents have been powerful enough to drive out foreign troops serving under the United Nations, including Americans, Germans, French and Norwegians. But none of them were strong enough to kill the others.

In a state of total destitution, were its population depends solely on a small amount of international relief aid, the Transitional Federal Government, headed by the previous chairman of the Islamic Courts Union, a former school teacher and once a head wanted by the Bush Administration, President Sheikh Sharif, is now, with support from his old American enemies, planning a major offensive against his old insurgent friends.

Sheik Sharif is a thinking man. He is 45 years old, but today, without his long beard, wearing special tailored blue dresses and expensive diamond engraved watches, he looks younger. After almost being killed during an American air strike in 2006, Sheikh Sharif managed to escape to Kenya and asked for political protection. Almost 3 years later he was invited to meet Mrs Hillary Clinton, the United States Secretary of State, who said “We believe that his government is the best hope we had, for quite sometime, for a return to stability and a possibility for progress in Somalia.” Sheik Sharif had moved back to Mogadishu. He left behind in Kenya the Kalashnikov and the simple clothes he used to wear when he tried to convince the rest of the world that his Islamic courts were not a treat, dismissing any accusation of links with Al Qaeda or any terrorist organisation.

Somalia struggles to rescue its identity from a deleterious war, and Sheik Shari, tried to be more than just a cosmetic treatment in his country´s mutilated face. He promised he would be able to produce profound facial and moral reconstruction. After only one year as president, he has already understood the treatment might be harder than he previously thought.

He lives isolated in Villa Somalia, a fortress constructed during the days of Italian colonial rule. The first entrance is guarded by doubtful soldiers from the new Somali Army. Young men, mostly in their early 20’s or younger, some wearing light brown, oversized military uniforms with sandals, others, in the best Rambo style, with their chests shielded by bullet-belts, ready to feed their rusted Chinese-made Kalashnikovs. They spend the days together, protecting their boney faces from the sulphurous East African sun under an old, improvised tarp shelter. In Mogadishu, soldiers with khat-fuelled values are one hundred dollars a month loyal to anyone and therefore, the president cannot trust to leave his own men to go beyond the first gate. From there, only high-level government officers and African Union soldiers can enter.

The UN sent the African Union Soldiers to Mogadishu (AMISOM) to replace the invading Ethiopian army. They have been in Mogadishu for 3 year with a peacekeeping mandate, but there is no peace to keep and the AU soldiers are constantly in close fighting with insurgents wearing civilian clothes. Their weapons, powerful and destructive, are not engineered to make distinctions in their targets. During its years in Mogadishu, AMISOM has been responsible for the death of many civilians.

Under the same protection but in separate houses, are the president’s three wives living with their respective children. The president is a very busy man administrating an area the size of a small middle class condominium with protocols of a nation. He has little liberty to move around his fortress. Bullets are constantly flying over people´s heads, leaving signs of destruction on almost every wall. His own home is ironically on the top of a hill, less than a kilometer away from Bakara Market, the area controlled by Al Shabaab. From his veranda, if he were allowed to go out, he would be able to see his enemies running and shooting.

Discouraged by the slow or non-existent political or social progress in Mogadishu, some government officials express their frustration with cynicism and refer to the president’s plans to attack his enemies as “Operation Inshallah,” because it will only begin when Allah wants it to. Although the new Somali Army has some 9,000 soldiers, the president can only depend on a few units. Many soldiers desert, because there are no officers and no safe barracks, and all too often, there is no pay. Some sell their weapons to the enemy, while others mow each other down in battles between clans.

New soldiers are being trained, in Kenya, Uganda and Sudan, partly with the help of the Americans and the European Union. But no one knows yet whether they will ever arrive in Mogadishu, or whether they will fight on the president’s side.

People dying like ants stepped on.

Mohammed Yusuf Hassan is the chief physician at the Medina hospital, the best working hospital in Mogadishu thanks to the International Committee of the Red Cross (ICRC) support. We met for the first time almost one year ago on an African Express flight leaving Mogadishu to Nairobi and become good friends. Mohammed is an interesting and somehow inspiring person. He could be living a good life in Europe but decided to come back to Mogadishu and help in any way. Mohammed studied medicine in La Sapienza university of Rome. He is officially retired and could be enjoying life near his grandchildren, but he is not a normal person. ‘I can’t be normal, or else I wouldn’t be here’ he says smiling. The Medina is a complex of pre-fabricated green containers and flat-roofed buildings in a park behind an old gate, where blood red flamboyant trees provide shade.

The shadows produced by those beautiful trees are welcomed by patients with normal diseases like little Mohammed. He is 3 years old and has been diagnosed with leukaemia. Patients like him have to lie underneath the trees, because the corridors inside are full of patients with open bullets wounds that could be infected if the patients were kept outside.

Doctor Mohammed really inspires me. He is 51, but he looks at least 15 years older and is clearly exhausted. “Everything here is bad. We Somalis are all traumatized. You can die any day. We are like ants that are being stepped on, a forgotten people. Darfur is a paradise compared to Mogadishu. But Darfur is new and we are old. The children have always been dying here, and no one sees it anymore.”

“An entire generation has grown up in this war,” he says, “and that several generations will never get it out of their heads. This too explains why there is no end to the suffering.”

Short-lived lives.

I´m invited to film a birth and I feel happy. I imagine a happy birth in my mind and I prepare my camera to capture the moment when the mother meets her baby for the first time. I never ask any question about her. My need to experience a moment of beauty was too strong. She is crying and the labor seens not to start. After a short meeting, the doctors decide to operate on the mother. She is young and after she receives the epidural anesthesia, her words make no sense and her eyes show no more pain. I move from my position to give the doctors better space to work. A young Iraqi doctor is leading the team. I´m impressed, she looks very small and does not want to talk or even tell me her name, but she shows total control over the situation.

Unexpectedly, at least for me, the door opens violently and a group of noisy, anguished young men enter the room pushing a stretcher. They say in Somali something that I cannot understand in words, but that I can feel in volume is call for help. On the stretcher I can see a scrawny body writhing in convulsions. His clothes, pale jeans, sandals and a short-sleeved beige shirt are soaked in a mixture of dark blood and dusty red sand. He is not older than 20 and he was shot in the neck, just bellow his month, his hemorrhagic wound making it impossible for him to breathe. The Iraqi doctor orders two of her Somali assistants to take care of him as she is trying to get through the diverse layers of muscle in the mothers belly and reach the baby´s head. They try to help the man with a tracheotomy. There is no time for anesthesia or proper preparation, and, without a sound, he shows his pain by hitting the wall, the table and the doctors with his feet and weak arms. I feel stressed and I don´t know what to film. The birth or this dying man I know nothing about. Moments later destiny gives me an orientation and he dies. I feel I can concentrate on my first idea of happiness again and I see a very small girl coming out to this world for the first time. She is rapidly moved to another table by a nurse holding the little body head down. I try to see if the mother is ok and go back to the baby. I see another Iraqi doctor trying to stimulate her heart and lungs. I´m not an expert but I find the shape of her head strange. The nurse leaves the little body over the small table, near some surgical tools used by the doctors trying to save the boy. I ask what is happening and a nurse says that the little girl is dead.

I go back to Hassan and try to find the boy´s name. He operates on young men, again and again, and eventually many end up dead. “Sometimes I think that we are just repairing guns here, guns that are reused until they break. And that the man we are operating on today could shoot a child tomorrow.” I start to understand why he says he is not a normal person. If this is a normal day at Medina Hospital, how can a man like Hassan keep his sanity?

The French Prime Minister Georges Clemenceau, said once that “War is a series of catastrophes that results in a victory.”

For 20 years, no one has been strong enough to claim victory in Somalia, and the country´s humanitarian catastrophe will only continue. The UN and African Union officers estimate that about 1,000 people, mostly civilians, die each month in the struggle for Mogadishu in a senseless civil war.