Stigmatised patients, victims of rape find refuge in Dadaab hospital

Dahabo Omar has for the past decade been a soldier fighting two wars. The first war, for her life, and the other for her daughter’s well being.

“It can be a difficult life. But Insh’Allah, we shall make it,” says Ms Omar.

She sits pensively under the hot November sun outside her mud and stick house in Ifo 2 camp within the Dadaab Refugee Camp complex.

Here, there are no chairs. The dirt outside her house has been swept smooth with a twig broom. Visitors are offered 20-litre plastic jerry cans to sit on. Chairs remain a luxury.

“But at least, I can get good healthcare for my daughter. I do not know what could have happened had we remained in Somalia,” she says.

As she speaks, she tears up. At the back of her mind the possible outcomes of her not risking her life to bring her daughter across the border play out. Among them is her and her daughter being outcasts of the society. And even death.

At 43, and just three years after she came to Ifo 2, she says life finally stopped giving her lemonade.

Outcast

“My daughter started getting the treatment she required,” she says.

In February last year, the Kenya Red Cross Society opened a Level Five hospital at the camp. And with this, everything became better, says Omar.

She moved from being an outcast because of having a disabled baby, to being accepted and accessing the kind of medical care that her daughter needed.

Ifo 2 has an estimated population of more than 54,000 individuals made from slightly over 12,000 households in a 10km squared area. For the 25 years that Dadaab has been in existence, refugees and members of the host communities have been forced to travel long distanced to access healthcare.

And for the stateless such as Omar, it was worse since they could not access facilities outside their camps. For them, treatment was reduced to the basics.

“Specialised healthcare was impossible to access,” Dr Hasan Ronow, of the hospital told The Standard on Sunday.

“Many treatable diseases and manageable conditions unfairly claimed lives. But now, the refugees and the community hosting them have proper medical care.”

The 18-month-old hospital has a capacity of 100 beds complete with a maternity, adult and paediatrics wing as well as two operational theatres.

“The only thing we do not have is a radio unit, but we are putting it up,” Dr Ronow said. For Omar and many more, the best part would probably be that all services are provided for at no charge. “Everything here is done for free,” Dr Winfred Wanjiru says.

The hospital not only serves the tens of thousands hosted at Ifo 2, but also individuals from other neighbouring camps. Ifo 2 is one of the newest refugee camps in Dadaab opened in July 2011 to decongest Ifo and Dagahaley camps. It is divided into two sub-camps, Ifo 2 East and Ifo 2 West, and demarcated into 18 sections comprising four to nine blocks each.

Apart from the Level Five hospital, there exists three other health posts serving this section of the population. Every so often, specialist clinics are held at the hospital to bring the services closer to the people.

“We know that some of the people in need of our services cannot travel the long distances required to access our services. So we come closer to them,” Dr Peter Ochung’o, a consultant head and neck surgeon, said at the camp.

Since its establishment, the hospital’s impact on the refugee community has been immense.

“We have brought about some services that the locals never had before,” Dr Ronow says. Among these are Sex and Gender Based Violence programmes.

“Somalis are a very close knit and deeply religious society. When we began this programme many of them would not come to us to report what was going on in their lives,”

Mahadho Biriya, a psycho social counselor at the hotel, said: “Bit by bit, they began to understand that what we were doing was for their benefit. Then they started opening up.”

However, this was not easy. “We had to go through the area’s religious leaders who are more respected than the professionals,” Ms Biriya says.

Her small office at one end of the hospital has been the scene of some painful memories. Every day and every time she hears a faint knock on her door, a  little joy escapes her and her heart sinks further. “We see all forms of sexual abuse. But the most common is the sexual abuse of children as young as three. Mostly by people they trust. Uncles.

Cousins. Grandfathers,” she says. “We do our best to counsel them and help them pursue legal recourse.”

But many times, these avenues are not pursued. Culture, like has often happened, stands in the way of progress.

“Many families prefer maslah. To them, this is justice enough for any ill that might have visited their daughter or son,” Biriya says. Her name means ‘thankful’.

Maslah is a form of retributive justice where the aggressor and the aggrieved agree on a suitable recourse for the crime committed without the involvement of existing laws.

“Many times, the two parties agree on a price and we do not come to know of these incidences,” Biriya says. “Sometimes such cases come to us because the aggressors fail to agree to the agreed terms of the maslah,” she says.

Mental healthcare

But by this time, it may be too late for anything apart from general counselling to be done.” In spite of this, she remains among those trying to bring mental healthcare to a community that seldom seeks help. “It has not been easy. Now at least we are making headway,” she says. “Gradually, the religious leaders are coming to our side. They are the law and people listen to them. As long as this...” A faint knock on her door cuts her short. Someone has come for a counselling session. She looks no older than 13 years old.

“Would you mind...” We leave before the patient changes her mind. Sexual offences are not often openly spoken about. But when they are, Biriya, behind a honest smile, is ready and willing to lend an ear.

Away from the hospital, Omar prepares her child for a hospital visit. But as she does this, the air of uncertainty among refugees settles on her too. The mention of repatriation—voluntary or otherwise—touches a raw nerve. “Where will I get treatment,” she asks.

Many of those employed within the hospital are refugees from Omar’s homeland of Somalia. “It is hoped that when peace returns to Somalia, some of those trained in this hospital will go back and start initiatives such as this one,” Ronow says.

But before the war drums stop beating across the border and calm returns Ifo 2, Kenya Red Cross Level Five Hospital provides an important pause in the lives of the stateless.