Maggie Black.

New African, Jan 2004 i425 p36(2) (Feature)

In 1991, Somaliland declared itself an independent republic within the boundaries of the old British protectorate, and has since been an oasis of peace in the troubled region. But three recent murders of expatriates are threatening the peace in the breakaway republic. Maggie Black reports.

In a shady part of the hospital grounds in Borama, Somaliland, a table is set up every day under a particular tree. One of those who takes her turn to sit at the table is the 17-year-old Hibo Ali Daahiz. She brings a card, which specifies her treatment regime, and carries a bottle of water. Hibo has TB.

Every day, the health worker counts out 20 pills of different kinds from the platefuls on the table, and under his supervision she slowly manages to swallow them. Many tablets are large and effort is required.

It is an absolute rule that Hibo must come every day. A relative has stood surety for her regular attendance. If she fails to show up on any day, the health worker will contact her relative to bring her. Treatment must continue for six months until she is cured. If she absconds, the relative will be arrested and jailed.

Hibo is one of hundreds of patients at Borama and in other parts of Somaliland who are following this course of treatment, and if they stick to it, will be cured. If they drop out before six months are up, their TB will recur and is then very likely to be drug-resistant. Hence the strict regime.

This system of treating out-patient TB, is known as DOT--"directly observed therapy". It was pioneered some years ago in northern Kenya by the woman who opened this hospital five years ago, a 60-year-old Italian, Annalena Tonelli. Known throughout Somalia simply as Annalena, she has spent the past 35 years working among Somalis, first in Kenya, then in southern Somalia during the war and famine of 1992-93, more recently in Borama, in the far north. The DOT system for treating TB has been formally recognised by the World Health Organisation (WHO) and is now used all over the world. The Borama Hospital is regarded by WHO as a TB resource centre for all of Africa.

One Sunday evening in early October, under one of the trees in the hospital grounds--maybe that very tree where the patients receive their treatment--a gunman stood waiting. When Annalena passed by, he shot her at point-blank range, twice, in the head.

Her murder horrified the town of Borama, the whole of Somaliland, the government authorities, and the many friends and supporters of this selfless, tireless, and humble person. It has threatened the future of her hospital, and all the programmes run from it.

Two years ago, Annalena received an award from the Pope for her contribution to humanity as a "voluntary worker". In June 2003, she was awarded the Nansen medal by the UNHCR for the assistance she had rendered to Somalis returning to their country from Ethiopia.

Both these awards she accepted not because she welcomed personal celebrity--far from it. She accepted them because she wanted to draw attention to the travails of the country and people that she loved. Somalia and Somaliland were, she felt, ignored.

In a sense, Annalena belonged to the old-fashioned era of heroic missionary endeavour. But she was not a missionary--she came to Africa in 1969 without the backing of any organisation or religious order, although her motivation was to follow the Christian gospel and serve the poor.

She was on her own, both organisationally and in her religion. All her staff were Somali. Everyone she knew and worked with was Muslim. She had excellent relations with the local sheikhs, and she was a thoroughly modern person in all her social work approaches and health care professionalism.

Although best known for her work in TB care and control, Annalena had recently become active in HIV/AIDS as well. The proportion of her TB patients testing positive for HIV had been steadily rising, reaching 15% in mid 2003. The prevalence rate in the country is much lower--around 3%, according to Somaliland health minister, Dr. Xasan Ismail Yusuf.

A strong stigma attaches to HIV infection in Somalia, as it does to any life-threatening infection, including TB. When an ambulance with an HIV-positive mother and child was sent up from Hargeisa, the capital, to the Borama Hospital some months ago, Annalena's house was attacked and her life threatened. The authorities were appalled. The director-general of the Ministry of Family Welfare, Amran Ali, spoke to the culprits and demanded that they apologise to her personally.

When Annalena was killed, it seemed like the work of a lone gunman, angry that an outsider--a gal--championed people suffering from loathed diseases.

But only two weeks later, the British headmaster of Somaliland's top secondary school and his ex-wife, Richard and Enid Eyeington, were similarly murdered.

They were shot as they watched television in their apartment at the school in Sheikh, in another part of the country. No stigma at all attached to what they were doing. On the contrary, their students were some of the best achievers in the country, being given top education to prepare them for leadership at home and abroad.

These three humanitarian professionals were unusual in that they worked for entirely Somali institutions, even though supported by external aid. The handful of other expatriates resident in Somaliland--African, Asian and European--mostly work for organisations such as UNICEF, other UN bodies and international NGOs. No longer does Annalena Tonelli's death seem to be a one-off act by a resentful gunman but part of a pattern both obvious and obscure. People wonder: Who or what is next?

No-one would pretend that security in Somaliland has up to now been guaranteed. But on the whole, bar precautions in home and office compounds and on the road against banditry, the country has been seen as safe.

This is not the South, Somalia proper, where there are many no-go areas for gals and for Somalis not of the local clan. For many years, things have been peaceful in the North and guns hidden. But now these terrible deaths. What can they be about?

One thing they will definitely be about is damage to Somaliland's growing reputation as an enclave of order, peace, and stability within the larger, more violent, Somali "state".

Somaliland's President Dahir Riyale Kahin believes that these murders are part of a deliberate effort to destabilise the country and force it to join the ongoing--and interminable--peace talks in Nairobi, Kenya to resolve inter-Somali conflicts and re-institute a functioning central authority.

So far, Somaliland has refused to participate in these negotiations, at which factions from the rest of Somalia squabble over power carve-ups and repeatedly walk out. The Somaliland leaders have no desire to reintegrate with their neighbours in the chaotic south, however much the international community insists that the country's post-independence boundaries are inviolate.

In 1991, Somaliland declared itself an independent republic within the boundaries of the old British protectorate, under their veteran President Mohamed Ibrahim Egal. Under his guidance, the institutions of government, law, justice, politics and civil society were reintroduced.

There has been a genuine effort to bring about a transition from clan-based power structures to a modern and democratic state--always with the caveat that this is one of the harshest environments on earth and the warrior ways of desert life die hard.

Hospitals and schools have been re-built and re-opened. Women leaders--notably Edna Aden Ismail, ex-wife of President Egal--have been at the forefront of establishing basic services and improving life for women and children.

In the markets in Hargeisa, women stall-holders beam and say: "We are enjoying the peace!"

Over half a million people who fled across the border to Ethiopia during the war have returned and been resettled. In 15 years, there has been a striking recovery. Few Somalilanders wish it to be jeopardised.

Following the death of President Egal in 2002 and the temporary installation of his deputy, presidential elections were held last April. Three parties contested, having agreed in advance on an electoral code of conduct.

In the event, the party of incumbent President Dahir Riyale won by only 80 votes in a ballot of 488,543. Everyone held their breath until the main opposition party publicly accepted the result--an act of statesmanship of major significance in this troubled land.

Edna Aden Ismail was appointed minister of foreign affairs. Somaliland has since renewed its bid for international recognition. But who will listen now?

The deaths of three expatriate humanitarians, all special individuals but noticed now, and in the gunman's sights, because their skins were white, should not be allowed to obscure the efforts made by a large number of Somalis, many as courageous and committed, to build health and education services and bring about an enduring peace.

Their efforts in turn depend to a considerable extent on support from the international organisations--who teeter on a knife-edge of being scared away.

Hibo and other patients and the staff at Annalena's hospital, and students and staff at the Eyeington's school, will feel their deaths most keenly. But it is hard to know where the repercussions will end.

Not only their work, but the entire story of post-1993 social and political progress in Somaliland has been put into jeopardy by those gunmen's bullets.