Quickly changing into his green gown, Dr. Maslah hurries to the operating theatre in South Galcayo hospital to perform an emergency operation on a young man who has been stabbed.

“The call came at 8 p.m.,” he explains. “By 10 p.m. we were in theatre and by 11 p.m. we had managed to stabilize the patient.”

The following morning, relatives of the patient gather in the hospital chatting and sometimes even laughing loudly as they receive news that the young man is going to be OK. They reassure friends and other relatives who arrive, having rushed to the hospital fearing the worst.

As one of 144 Somali staff working for Médecins Sans Frontières (MSF) in South Galcayo hospital, Dr. Maslah has played a crucial part in keeping the surgical activities running. In early 2008, at a time when the conflict in Somalia was intensifying and medical needs were increasing, MSF was forced to evacuate its international staff from the country. Since then, MSF’s projects have been run by Somali staff, supported and supervised by management teams based in Nairobi who visit whenever security allows. Without the work of Dr. Maslah and the hundreds of other Somali staff that work for MSF throughout the country, thousands of people would have been left without free, lifesaving medical care.

Night time phone calls for urgent operations are a routine part of Dr. Maslah’s work, as South Galcayo hospital is the only hospital to provide free emergency surgery in the area.

“Every month, I’ll perform around 40 operations on people with abdominal injuries, gunshots and stab wounds, injuries of the colon, and people who’ve been in car accidents,” says Dr. Maslah.

Surgery is just one of the services MSF provides in South Galcayo hospital, where some patients come from as far away as Ethiopia to receive care. The waiting room of the out-patient department, the in-patient department, the ‘out of bounds for men’ wards of the maternity department and the bright, ventilated compound of the tuberculosis centre all have one thing in common – they are all constantly teaming with activity. Every month MSF gives almost 4,000 outpatient consultations, admitting around 120 people for inpatient care and delivering more than 100 babies.

Prolonged drought, coupled with fighting and high food prices, means the nutritional centre is often packed to capacity. Pointing to a queue of depressed and frustrated looking women holding weak, dehydrated babies, waiting to be admitted to MSF’s therapeutic feeding centre, Jibril, the supervisor explains: “Every month we admit several cases of diarrhoea, measles, dehydration, and sometimes meningitis. But now severe acute malnutrition is becoming the most common problem. We are currently treating 90 patients in a space meant for only 60.”

The exhaustion on the mothers’ faces reveals the long journey that most of them have made to reach the hospital. Due to the ongoing insecurity, MSF teams are unable to go out in cars and collect patients. As one mother says, “Many in the village know that there is free treatment here, but the biggest problem is the journey. It can take many days and is often very expensive, costing around 500,000 Somali shillings (the equivalent of about US$10). A lot of people can’t afford it, so they stay at home and some of them die in the village.”

The burn marks on the bodies of a number of the young babies in the feeding centre shows that many of the mothers first turn to traditional healers for treatment and only come to the hospital as a last resort.

In sharp contrast to the group above is a woman wearing a big smile standing at the door of the feeding centre. In one arm she carries a healthy looking baby and in the other she holds a bag containing the family food ration she has been given by MSF to take home. She raises her voice above the deafening noise of the crying children to thank one of the staff. “She has been here for quite some time and today she is returning home with a healthy baby,” says Jibril.

MSF staff like Jibril and Dr. Maslah work around the clock at South Galcayo hospital with many other committed Somali staff to make a profound difference. “The staff at this hospital save many lives,” says Dr. Maslah.

In a country where violence, suffering and death from preventable and treatable diseases are commonplace, the provision of free independent medical care is vital.