A question of medical ethics from Somalia

BMJ 2004; 329 doi: (Published 08 July 2004) Cite this as: BMJ 2004;329:119
  1. Robert T A Scott, principal in general practice (
  1. Drumchapel Health Centre, Glasgow

    “Absolute morality is the regulation of conduct in such a way that pain shall not be inflicted”

    Herbert Spencer, Essay on Prison Ethics

    We were about to turn back from our evening walk when a nurse pushing a wheelbarrow hailed us. In it was a bundle of rags. Closer examination showed they were covering a girl curled like a sleeping dog. Two terrified eyes looked up in despair. The nurse snapped out the problem: “Bleeding for four days after circumcision!”

    Wordlessly I followed the small, tragic procession into the hospital. The wheelbarrow, with its tiny pathetic passenger, led the way into the treatment room, where a lamp sat in a puddle on a wooden bench. In the oppressive heat I could taste the nauseating fumes of paraffin. The barrow came to a stop and was abruptly bumped down.

    Why does such barbarity continue?

    The nurse scooped the girl into her arms and dropped her on to the couch. She barked out a command for her to bend her knees. There being no response, she roughly …

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