31 January 2007

The Quiet War in the Horn of Africa

By KATE WILTROUT, The Virginian-Pilot
© January 28, 2007
ALI ADDÉ, Djibouti — A curious crowd of women and men in billowing skirts streamed toward the landing zone as two U.S. Marine helicopters touched down on rocky African desert.

The Marines had pistols strapped to their legs, but the choppers from New River Marine Corps Air Station in North Carolina were doves, not hawks.

Inside were an Air Force doctor and a team of Army civil affairs specialists on a mission to bring help – and hope – to 12,000 Somali refugees.

The forbidding landscape is a 20-minute flight – but seems a world apart – from Djibouti’s capital city, where the U.S. military has established a base, Camp Lemonier.

U.S. air strikes on suspected terrorists in Somalia this month called the world’s attention to the region.

However, the U.S. military has been quietly engaged in the Horn of Africa since 2002, using about 1,500 troops to build schools and medical clinics, dig wells, treat sick people and inoculate livestock. Dozens of Navy sailors and officers from Hampton Roads are part of the force, and more are preparing to head to Djibouti in early February.

With its mission to win hearts and minds through goodwill, this unorthodox military operation looks more like the Peace Corps than the Marine Corps. But the effort is primarily to deter al-Qaida and Muslim extremists from spreading throughout a region rife with poverty and despair.

“Our mission is not capture and kill,” said Rear Adm. Timothy Moon , deputy commander of the Navy-led task force.

Moon, a reservist from Suffolk, calls it an experiment. “I hope it works.”

There’s reason for the United States to worry about terrorists in Africa.

In three of the eight countries where the task force labors, al-Qaida has orchestrated anti-American attacks. U.S. embassies were bombed in Tanzania and Kenya in 1998, killing 250 people. And 17 Norfolk-based sailors died in a blast that crippled the destroyer Cole in Yemen’s Gulf of Aden in 2000.

Here in Ali Addé, the military visitors toured a newly refurbished health clinic about the size of a gas station. Renovated by the U.S. Agency for International Development, the tidy facility had a closet-sized pharmacy and a few exam rooms.

About 75 women gathered on the porch, ailing children in their arms. The wait was long. One toddler played with a discarded surgical glove blown up into a hand-shaped balloon.

Sgt. 1st Class Charles Parnell, a broad, balding Army reservist – and a police officer and paramedic in Cleveland in his “other” life – said a recent influx of about 5,000 refugees from war-torn Somalia had taxed the resources of this clinic and another nearby, which ran out of medicine.

Hungry people boil the bark of scrubby trees and bushes to soften it, then eat it. Chronic malnutrition, influenza and poor sanitation are the main scourges, said Parnell, his face and voice filled with distress.

He estimated that one to two women in this community die each week from diarrhea, pneumonia, tuberculosis, malaria or asthma. Children perish, about five a day, Parnell said.

Fatouma Ali desperately hoped her son would not become one of them.

Ali held her toothless, feverish 2-year-old beneath the bright orange shawl she wore. She didn’t know her own age – she guessed 45. She gave birth to her first child 11 years ago; five more children followed.

Through a translator, Ali said her family fled Somalia at the beginning of Ramadan last fall, coming to Djibouti in a car loaded with as many possessions as they could fit.

“Here is a peaceful country, and everybody wants to live in a peaceful area,” Ali said.

Somalia hasn’t had an effective central government since 1991, when warlords toppled dictator Mohamed Siad Barre and then began battling among themselves. Al-Qaida has moved in, prompting the U.S. airstrikes this month.

The clinic is another way to keep al-Qaida at bay. Here, a volunteer nurse and a local physician typically see as many as 50 patients a day. Air Force Col. Dan Shoor, dispatched here from Alaska, sometimes helps.

In an exam room with unscreened windows overlooking craggy mountain peaks, Shoor diagnosed a 3-year-old Somali child with pneumonia and an underlying case of tuberculosis.

Back home, Shoor would have prescribed antibiotics for the pneumonia, as well as a nine-month regimen of drugs for the TB. Active cases of TB often require at least four different drugs administered simultaneously.

Shoor said the child would get antibiotic treatment, and the clinic nurse also would try to treat the boy’s relatives, who probably have latent cases of TB.

He viewed the child’s odds of survival as even.

About 800,000 people in the region suffer from the infectious lung disease, Shoor said. Some are infected with strains resistant to multiple drugs. Sometimes, there is little doctors can do.

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