Fieldset
The climate up here

The plane journey is as always shockingly early but relatively painless. It is an eight-seated Cessna filled with colleagues from the various MSF project sites, either going into Somalia and peering out with great anticipation, or finishing missions and heading out to Nairobi.

The plane journey is as always shockingly early but relatively painless. It is an eight-seated Cessna filled with colleagues from the various MSF project sites, either going into Somalia and peering out with great anticipation, or finishing missions and heading out to Nairobi. We stop in the Galcayo project site and pick up two colleagues and I feel a little bad as we drop them on the runway in neighbouring Johar, which is 80km from Mogadishu. Due to the security situation in Mogadishu we can’t take in transit passengers, so we leave them in the hot sun on the dusty landing strip, with the pilots promise he will back for them soon.

Last time I entered Mogadishu was a year ago and by car and in today's security climate that would not be an option. Last time I saw the abandoned buildings riddled with bullet holes, and that’s what I had expected from Mogadishu. But flying and landing into Mogadishu is quite striking, from this height the city looks quite impressive, a sprawling metropolis. No sign of the bullets, rocket and mortar damage from the most recent 10 months of fighting. The whole place is capped by ocean, which makes you think that this must have been something else in its day, when there was peace.

My colleague Jelle, the project coordinator, and doctor Fuad are seasoned at this and I follow them as we glide through the regular airport admin. It is a well-oiled machine, with all the people we need to assist us for a safe drive from the airport to the clinic in place. Listening to my colleague and all the arrangements he has done, it reminds me that you don’t take this short 15-minute car ride from the airport to the clinic for granted in a place like Mogadishu.

The clinic and our accommodation are literally a stone throw away from each other, but we drive it, walking just isn’t an option at this point. It is about a 20 to 30 second drive. We drop by the clinic to meet the team who are all waiting. Jelle does a quick introduction of the new face (me); I am always aware that my role does not always make sense to our teams. I am not a doctor or a nurse or a midwife, so we start with a brief chat about my work. We are careful not to keep people too long as it gets both difficult and dangerous the later it gets for them to get home.

In the midst of the conversation a man asks: “Someone who has been affected by the civil war in many ways, who can’t access our clinic, how can you help them?” I am struck by the frankness of his question and wish I had a clear answer, but that is what we are trying to work out and trying to achieve.

We sit over dinner and talk through the realities of how MSF wants to get things done here and what we want to do. We think about access to the clinic for the internally displaced (that’s people who had to flee or move because of the fighting, they are referred to as IDPs) and discuss ways to overcome the difficulties; we are feeling positive and float the idea of possibly seeing if we could quickly visit one of the nearby camps where we are planning mobile clinics. But this discussion comes to a grinding halt as we hear gunshots start, there are often shots in Somalia but these are close and followed by some bigger booms that we suspect are mortars. They start again as I write.

We had an hour of fighting earlier in the evening and moved into what we refer to as the ‘safe room’, a room with solid walls and few windows. We stay there for an hour, and have long conversations to try and work out what is being fired and what the impact must be. Its vague attempt to try and understand what is happening if this lands in the neighbourhood. When a slightly louder bang distracts us, it is clear to us it was close; my colleague Jelle listens to each sound trying to work out what it is and where it landed. Mobile phones beep and ring as information on what is happening comes in. It is not just us though, all of Mogadishu with a mobile is doing the same: trying to work out what’s going on and where your loved ones are I guess, we can’t get through as the network is jammed.

As we sit here, we think out loud about how MSF can operate on a day-to-day basis in this sort of environment.