By Violet Ikong
Yahye Osman hates to think about the events of October 14, 2017. On that day, at 2:30 p.m., he had joined his friends at the Safari Hotel in Mogadishu, Somalia’s capital, to watch a football match between Liverpool, his club, and Manchester United. He is an avid fan, and boasted cheerfully to his friends that Liverpool was sure to win that afternoon. But the mood changed 40 minutes later, when a suicide bomber detonated a truck bomb at the entrance to the hotel, and parts of the building collapsed, including the area where Osman and his friends were watching the match.
Al Shabaab, an Islamist extremist group, claimed responsibility for the bomb explosion, which killed about 588 people, including some of Osman’s friends. Osman himself was injured, and so were 315 other people. He was rendered unconscious, and woke up to an atmosphere filled with “tragic scenes and darkness.”
“It was a tragic day, not just for me, but for all of Somalia. There were dead bodies around me. People were badly injured and crying for help. Cars were burning. That was the worst day of my life, and I don’t like to talk about it,” a sad Osman said, trying to maintain composure.
The bomb explosion of October 14, 2017, was definitely not the first in Somalia, but it remains one of the most fatal. Although Osman and other severely injured victims weren’t sure they would survive that day, they remained hopeful that an ambulance would get them to a hospital.
Aamin saves the day
Just as Osman and other victims hoped, Aamin Ambulance arrived at the scene of the explosion about 12 minutes after it took place. The ambulance service rescued over 300 victims – including Osman – through back-and-forth rescue operations, using 11 ambulances.
“The first ambulance that arrived there [at the explosion scene] was Aamin. The ambulance’s paramedics rescued me and the other victims. They also administered first aid while transporting us to a hospital. If it wasn’t for the promptness of their ambulance service, I believe I would have died that day because I was severely injured,” Osman, 30, said.
Aamin Ambulance is a 24-hour Somali free ambulance service founded in 2006 to provide pre-hospital services to vulnerable populations and communities in Somalia. Aamin’s founder, Abdulkadir Adan, is a Pakistan-trained dentist who returned to Somalia in 2006, and witnessed widespread violence in the country, largely due to clashes between Ethiopian troops on a peacekeeping mission, and a militant group, the Islamic Courts Union (ICU).
Somalia is battling one of the oldest conflicts in Africa, lasting over 30 years. The conflict, which stems from religious, political, and economic factors, has killed between 350,000 and one million people since 1991, according to Genocide Watch. Different extremist groups have been key actors in the conflict, including the ICU and Al Shabaab extremists, who seek to create an Islamic state in Somalia. Although Somalia is a country where 99% of the population are Muslims, the extremist group seeks to take over power from the government and enforce a strict form of Islam in the country.
Adan saw firsthand the lack of ambulances in Somalia. “People were using wheelbarrows and boxes to take injured people to the hospital, and to evacuate the few dead bodies they could. There were no ambulances,” he said.
Decades of war and political instability have made Somalia one of the poorest countries in the world, and this has affected the country’s healthcare system and the government’s ability to provide free ambulance services to Somalis.
“The entire health infrastructure is in disarray. The private sector and nonprofits primarily run the healthcare system in Somalia. It is fragmented in a way that people in the interior of the country, the rural areas, and villages do not have access to primary healthcare services, let alone secondary healthcare services,” said Eliud Kimutai, Programs Manager at Aamin Ambulance.
Adan decided to do what he could to increase access by starting a free ambulance service. “I asked myself how I could help my people, so I spent all my savings to buy a minibus. That was how I started the free ambulance service,” he said.
Funding support from individuals and organizations, as well as the Somali community in the diaspora, and the United Nations, has helped Aamin increase its number of ambulances to 28, now primarily serving internally displaced persons (IDPs), refugees, and people living with disabilities. After over three decades of conflict, Somalia has 3.9 million IDPs, according to the United Nations Refugee Agency (UNHCR). Despite its own internal conflict, the country also hosts over 16,000 refugees and over 19,000 asylum seekers, mostly from Ethiopia, Yemen, and Syria (Syrian Arab Republic).
The ambulance service operates a toll-free number, 999, and responds to emergencies such as accidents, pregnancy-related complications, and casualties from explosions like the one in which Osman was a victim. Aamin has served over 89,000 Somalis since its inception.
Managing security risks
Aamin Ambulance operates in Mogadishu as well as three Somali states: Hirshabelle, Galmudug, and South West. The ambulance service has 98 staff, including drivers, paramedics, volunteers, and a management team, who work together to ensure their ambulance service gets to those who need it. But doing this comes with security threats and risks.
“Working in a conflict area is risky, but the most important thing to us is saving human lives,” said Adan. “Since we started the ambulance service, we have suffered security threats from different angles, including the Ethiopian Army, Islamist extremists, and the government.”
Aamin has lost two drivers and a nurse to gunfire and accidents while on different rescue missions. “In terms of security, the security of Somalia is very precarious, and you can’t predict what will come next. We train our paramedics to know how to assess an environment before they go in there to rescue victims because if our paramedics are injured, we can’t save lives,” Kimutai said.
During a twin-bomb explosion in Mogadishu in October 2022, one of Aamin’s drivers was severely injured when an ambulance narrowly escaped a bomb that exploded at the gate of a hospital where it was headed.
But Aamin keeps working to prevent such occurrences. “We collaborate with local authorities to ensure no shootouts target our paramedics and our patients. We also make warring parties understand that we are humanitarians and that our job is simply to save lives; we mean no harm to any of them, and we don’t take sides,” Kimutai said.
Handling staff mental stress
The outdated ambulances Aamin uses are not the only challenge facing the nonprofit; managing the mental stress on staff that results from working in a conflict-torn area is another. Kimutai recalls an experience where a first-time volunteer lost consciousness after seeing many dead bodies at a location where the ambulance service had gone to rescue victims of a bomb explosion. “The young man saw dead bodies and ran in a different direction. He couldn’t talk for four days, and he was later caught five miles from home. No food, no water,” he said.
To ensure its staff are in the best state of mind when responding to emergencies, Aamin partners with mental health experts to provide mental health counseling to staff, in addition to the annual mental health training it holds for them. Aamin also has three staff support groups, including paramedics, drivers, and management staff. Each group is headed by a mental health expert.
After Osman was taken to the hospital, it took him one year to fully recover. In 2020, he moved to Turkey to pursue a master’s degree program in political science and international relations. He graduated last year, excited to have fulfilled his dream, which may not have been possible if Aamin Ambulance had not rescued him on the day of the deadly explosion.