I believe in hope.
Their photo holds a special place on my desk. She is an elegantly garbed Somali woman with a radiant smile. She holds a plump and curious infant, who is grasping an American MRE (meal, ready-to-eat) spoon. That scene is special to me because I took that picture of them as they sat on the ground in one of dozenss of feeding stations deep set up by non-governmental organizations in Somalia’s interior during Operation Restore Hope in January 1993. They were survivors in the midst of a terrible famine and civil war.
I was the sole physician for a 1200-person US Army engineer group that was sent there to restore hope by rebuilding some of the infrastructure destroyed during their long civil war. I was in Somalia during the “good times,” before the events documented in the book and movie, Blackhawk Down. Times were good—the local people would join us and sing and dance as we opened roads, built bridges, covered wells, and cleared mines.
The photo also brings back the memories of how hope can vanish in an instant. One day we arrived at a vacant lot. A week before, a cinder-block shell of a building that was to become a new school stood there. Once our engineers put a roof over it, it would be ready for children. A disgruntled clan leader had ordered his people to dismantle the building block-by-block, rather than have the Americans build a roof for a new school. That event and others I experienced seemed to foretell the troubles to come.
Since that time, I have focused my attentions as a military family physician on training future physicians, especially in the care of older Americans. In caring for older adults, I have learned there are two different types of hope—one is the hope for a specific outcome (to cure cancer or to stop a progressive dementia), that never seems to be answered or fulfilled. The second type of hope is more general; it is the hope that is given to others by listening, caring, companionship, safety, and compassion.
Were we successful in Somalia during Operation Restore Hope? The most common response would probably be “no,” because people only remember how things ended. I rarely find hope when I look at the events of the world, yet I seem to find it when I look into the individual faces of people. My hope is a faith, or a blind trust, that my efforts matter, one patient at a time, even if I can’t see the final outcome.
The hope present in the smiles of that Somali woman and child remind me that the efforts of generous and loving people can prevail over despair.