Iignored their call, so they came to my gate unannounced: six members of the Somali insurgent group Hizbul Islam, with a request to speak with me in person. By this time, April 2010, their militia had controlled our area for the past year—the latest in an endless line of transitional leaders, warlords, and regimes I’d seen since the collapse of Somalia’s government. I was examining a severely malnourished child, who hadn’t eaten for at least four days, when a security guard ran in with the news. I was not willing to abandon my patient for a conversation with people whose only clear goals were to rob, to take over, or to kill.

My medical practice began in 1983 as a one-room clinic on my family’s farm, ten miles outside Mogadishu. As hard as it may be to imagine, Somalia was peaceful when I moved here. But now, after more than twenty years of civil war caused by interclan fighting, that one room is a four-hundred-bed hospital; the land behind it, once fertile, now utterly parched, offers refuge to more than ninety thousand internally displaced people—a fraction of the nearly half million who now live along that main road, which stretches northwest from our destroyed capital city. (About 1.5 million Somalis have been displaced by the violence.) The need in our area is unimaginable, but my mission as a doctor is the same. I rise long before dawn with a singular focus: to meet my patients’ needs.

As I spoke with the child’s mother, one of my fellow doctors tried to reason with the Hizbul Islam soldiers—jittery, aggressive young men with henna-dyed beards, wearing red-and-white checkered scarves. He told them that in our area, we are known as a safe haven, a refuge; we treat all victims of the conflict equally, no matter what side they’re on. The six men refused to leave, so I assembled my committee of elders and we sat down together to talk.

One of the militants began the conversation with an insult: “You are an old woman, and we are stronger than you,” he said. “You have to hand over the authority of the hospital and the management of your camp to us.”

“That’s impossible,” I said. “This is my property. I am the doctor here, and I have the knowledge for it.