MOGADISHU, SOMALIA — Even in a country that has endured so much suffering, few images could more tragically convey the senseless violence gripping Somalia today than the expressionless stare of a 5-year-old boy named Omar.
As he slept next to his mother one recent morning, a stray bullet from a nearby gun battle struck him in the back of the head. He made no movement or sound, so his family members didn't even notice at first. Later they saw blood oozing from a small hole in his head and thought it was a snakebite.
But an X-ray of his tiny skull revealed the terrible trajectory of the inch-long bullet: how it entered on the left, tore through his brain and wedged behind the right eye.
It's a miracle that Omar Osman Ali survived, doctors say. Recovering from surgery to remove the bullet and his right eye, he lies quietly on a thin mattress on the ground in a makeshift African Union hospital tent.
Doctors don't know the extent of brain damage because the once-garrulous boy, who loved spaghetti and enjoyed helping his mother with the wash, hasn't spoken since the surgery.
But he's awake, responsive and keenly alert. With his remaining eye, the boy silently watches everything around him: the doctors inspecting the bandages, his grandmother trying to coax a smile, even the body of a 13-year-old girl who died of malaria that morning, lying in the next bed.
Each day, his grandmother, Fatuma Ali, talks to Omar and searches his face for a sign of recognition. He rarely displays emotion. No fear or pain. But sometimes there is a trace of something else behind that stare: anger.
"He never smiles, and he used to laugh so easily before," Ali said. "Now he just watches. Just looks. Who knows what he's thinking."
Children have long been the greatest casualty of Somalia's 18-year civil war. One in five is acutely malnourished. Few attend school. Most spend their lives running from violence, drought and poverty. Boys often become child soldiers, and girls have babies as soon as they reach puberty.
"What kind of life is this for children?" Ali said. "When I was young, there was school. Children could play outside. Today there is nothing for these kids but war. What hope is there for children?"
A third of the beds hold children at this facility, which provides free healthcare to about 2,000 people each month.
"This place is filled with kids," said Florence Mohamed, a Somali nurse at the clinic.
Malaria, tuberculosis, genital excision and fistula were once the primary problems. But as violence in Mogadishu, the capital, has soared to new heights, children are increasingly ensnared in the fighting between government troops and insurgents. Now children are showing up regularly with gunshot and shrapnel wounds, burns and other conflict-related injuries.
"This is a very violent city," said African Union doctor James Kiyengo, a surgeon from Uganda who operated on Omar. "The evidence is all around."
In the next room is Abdi Rahman Sheik Nur. The 7-year-old had been arguing with a young friend on a Mogadishu street last month and had turned away in a huff to march home when he felt a sting in his back.
"I thought my friend threw a rock," he said. But he saw the blood on his stomach and collapsed. A bullet -- no one knows from where -- had struck him in the back.
Lying naked on a blanket with bandages around his midsection, the boy put on a brave face. "It didn't hurt that much," he said in a barely audible whisper.
But the injuries probably will be permanent, doctors say. The bullet pierced his colon. Now waste is escaping from the wound, and they lack the capability to properly treat it.
In a nearby treatment room is Mohamed Abdirahman, 3, whose chest and right arm are encircled by a plaster cast.
"He fell off a step," his mother said sheepishly.
Not true, a doctor later explained, pointing out that he had removed mortar shrapnel from Mohamed's shoulder. "The mother is too frightened to tell the truth," the doctor said.
Surviving nearly two decades of clan-based conflict, warlords and, most recently, Islamic insurgents, Somalis have learned the defensive art of keeping their eyes down and their mouths shut.
Mohamed, however, reminded everyone of the resilience of children. He beamed and laughed, oblivious to the doctor cleaning and re-bandaging the puncture wound. Perched on an examination table, he relished the attention, playfully tossing off his sandals and watching each one drop to the floor.
Outside is a line of patients waiting to see a doctor. The worst off is Abdukhadir Hussein, 4, who lies in agony in his mother's lap. She gently fans his shirtless torso, which is badly burned. Most of the upper layer of skin is gone. He grimaces in pain and cries softly.
His mother, Bint Aweys, said he was playing in the house and knocked over a pot of boiling water. She said her husband disappeared four years ago, leaving her to raise four children alone on the $3 a day she earns hauling goods in Mogadishu's main market.
"It's all I can do to feed them," she said.
But like most parents, she clings to hope that her children will have a brighter future.
"If we can just survive, one day I know their lives will be better," she said. "We just have to get through this."