Hospitals have generally been considered neutral territory during the long years of civil conflict in Somalia, but that changed this week when gunmen seized control of an important medical facility in northern Mogadishu, causing many wounded patients to flee.
Medical services have been reduced to a minimum at the hospital, after militia fighters allied with a warlord, Muse Sudi Yalahow, took up strategic positions on the roof on Monday afternoon, officials said.
Yalahow is the trade minister in the fledgling Somali government and a member of the counterterrorism alliance that has been battling Islamic militias in Mogadishu with the backing of Washington, according to some academics, security analysts and other Africa experts.
The hospital takeover could not have come at a worse time. The city's medical facilities have treated more than 1,700 war wounded since the latest wave of fighting broke out in Mogadishu in February. The facility that was taken over -- Keysaney Hospital, which is run by the Somali Red Crescent Society -- has treated nearly 700 people, most of them civilians caught in the crossfire.
The International Committee of the Red Cross and the Somali Red Crescent Society issued a statement on Monday condemning the takeover and calling for the immediate withdrawal of the militiamen.
As militiamen took up positions around the hospital on Monday in heavily armed vehicles known as technicals, many patients feared that the hospital grounds would soon become a battleground.
"I saw technicals outside the gate of the hospital," said Said Abukar, who was visiting his injured brother on Monday. "Everyone was so shocked to see them there."
Keysaney, the only hospital in the north of the city, had been packed with wounded people before the militia arrived.
"There were patients everywhere," Abukar said in a telephone interview from Mogadishu. "I saw injured everywhere, including my brother."
But an exodus ensued, and as of Tuesday afternoon about half of the 120 patients had fled with their relatives, leaving 59 patients and a handful of medical personnel, officials said.
Hospital officials have prided themselves on treating all sides in the clan fighting that has devastated Mogadishu over the last 15 years. That philosophy has continued in the battle between warlords and representatives of Islamic courts.
"We've never had any problem with the medical facilities in Mogadishu," said Pedram Yazdi, a Red Cross spokesman in Nairobi. "They were respected. I think this is the first time we've had such an incident."
The UN has warned that interfering with medical care violates international law. The US government has been widely criticized for siding with the warlords, including Yalahow. A spirited debate has broken out behind the scenes in Washington over this approach. The US State Department's political officer for Somalia, Michael Zorick, was posted to Chad earlier this year after he criticized Washington's policy of paying warlords, US officials said on Tuesday, confirming an account in Newsweek magazine.
US ambassador to Kenya William Bellamy has disputed claims that Washington is to blame.