Direct Relief International


Partnering to Improve Maternal Health

and Access to Obstetric Fistula Treatment

Direct Relief International Direct Relief International and Edna Adan University Hospital are working together to improve health services for mothers and children in Somaliland. Since 1948, Direct Relief’s core activities have been aimed at expanding the quality, availability, and access to health services for all people with a principal focus on supporting interventions that reduce threats to women during pregnancy and childbirth. Edna Adan University Hospital opened in 2002 to provide quality medical services for the women and children of Somaliland and has expanded rapidly to become a primary referral hospital and key teaching facility in the Horn of Africa. Working together, Direct Relief and Edna Adan University Hospital, believe they can do more to ensure that all women and children receive good quality health services.

Direct Relief and Edna Adan University Hospital – then the Edna Adan Maternity and Teaching Hospital—entered into partnership in 2005. Direct Relief has provided donations of medical supplies to improve the Hospital’s maternal health capacity, and in November of 2005 supplied items to help upgrade the operating theater and delivery room including an examination table, operating room light, sterilizer, instruments, general and surgical hospital supplies, pharmaceuticals, and nutritional products. Over the years, Direct Relief had provided substantial and valuable supplies and equipment.

In 2009, Direct Relief, in collaboration with The Fistula Foundation, increased support to Edna Adan University Hospital to improve the hospital’s ability to provide treatment and care for women with obstetric fistula, one of the most tragic injuries of obstructed childbirth. This support includes the construction and equipping of an operating theater and the development of a training curriculum for midwives and nurses in obstetric fistula management. The grant funding makes possible the construction of not only one operating theater, but three, so that the Hospital can increase its capacity to treat patients and grow in its essential role as a leading teaching and referral hospital in the Horn of Africa.

Many women have received treatment for obstetric fistula at Edna’s Hospital, and with continued support from Direct Relief and The Fistula Foundation the number of women receiving life-restoring treatment will increase. When asked about the importance of providing fistula repair Edna remarked: “I am grateful as a woman and human being to be able to help women like them; people think I have given something but they don’t know how much I am getting. There is no bank in the world big enough to hold what I get from the satisfaction of seeing a woman who was leaking urine for 30 years leave the hospital and go home dry.”

Direct Relief report from Somaliland

Lindsey Pollaczek, Program Officer (Africa)

Down a bumpy dirt track nearly three hours south of Hargeisa, the capital of Somaliland, Edna Adan and I crawl our way to the town of Baligubadle, just steps from the Ethiopian border.

At the Maternal and Child Health Center in this small town, which serves approximately 25,000 in Somaliland plus those from neighboring Ethiopia, we meet Sado, a 25-year old Community Midwife who has been hard at work providing health care to the mothers and children in this community for four years.

Sado was part of the first class of graduates from the Edna Adan University Hospital training program for Community Midwives, one of the remarkable programs instituted by hospital founder Edna Adan. When asked why Sado decided to become a Community Midwife, Sado said it was the lack of trained health providers in her community that made her interested in this work. Having a trained Community Midwife present in every village in Somaliland is part of Edna’s vision to reduce maternal and newborn mortality across the country.

The purpose of the Community Midwife is not to replace the doctor, who has a critical role in providing emergency cesarean sections for women experiencing complications, but to serve as a front-line health worker providing care in often rural and remote parts of the country. Until now there have been few or no health providers that can provide high quality care during pregnancy, delivery, and in the days and weeks after birth in these remote Maternal and Child Health Centers.

When Sado was undergoing her 18-month training, the hospital frequently received women in labor from the Baligubadle area who arrived with very serious complications. Many times, they arrived too late for anything to be done. When Sado graduated she knew it was important for her to return to this rural area to use her midwifery skills to help women deliver safely at a health center near their home, and to use her knowledge to refer women with serious complications early to emergency care to save their lives and the lives of their babies.

This report continues at Direct Relief’s web site: Supporting Midwives in Somaliland