Let me share with you yet one more reason that makes me happy to have built my hospital.

UPDATE: May 16, 2013

Thank you to all our friends who have taken an interest in Baby Zuber. We originally thought that his breathing difficulties were attributable to congenital heart failure. However, we took him for an echo and the test shows that his tiny heart appears to be in good shape. Since Zuber was born with his heart on the right side, instead of the left, it seems that it might be intermittently constricting his bronchial tube.

So the good news is that it looks like Baby Zuber will not need heart surgery! He was just taken for chest x-rays and we hope the images will help our doctors determine a course of treatment for him and his family.

UPDATE: May 21, 2013

Many of our friends are worried about Baby Zuber, who was born with his heart on the wrong side of his chest. We were so excited when a cardiac echo showed that his tiny heart is in fact healthy and would not need surgical repair.

Our doctors concluded that Baby Zuber’s heart was compressing his bronchial tube. We started him on a bronchial dilator to expand the breathing tube -basically the same way you would treat an asthma patient. We hoped that in time the bronchial tube would become more rigid and we could stop the medication. It looked like a happy ending.

Unfortunately, after two days Baby Zuber’s breathing became worse. We would really like a high-resolution CT scan to help us see inside this chest, but that technology isn’t available in Somaliland. The x-rays that we have suggest that the misplacement of his heart has similarly pushed the bronchial system out of position. His left lung seems to be functioning very poorly and the bronchial dilator is no longer helping.

All we know for sure at this point is that there’s not much more we can do for him here at Edna Hospital. Baby Zuber’s parents have grown very attached to him – as we all have – and want us to do everything we can for him. We’re contacting hospitals in Ethiopia and Kenya to try to find a specialist who can give us some advice. Please check back for more information.

This is Baby Zuber. He was born at home approximately six weeks ago. He was born in very poor health and has had trouble breathing since birth. The only reason he has lasted as long as he has is because he has a very devoted and loving mother who has given him around-the-clock attention. But Baby Zuber developed pneumonia and even his mother’s tender loving care was not enough, so she brought him to our hospital. We discovered that Baby Zuber was born with a defect where his heart is located on the wrong side of his chest.

We also found burn marks on his chest where a traditional healer tried to fix the problem. Please understand that his parents did not do this to be cruel to their child but in our society many simply do not know any better and often believe that “fire and disease do not stay in the same place.” His mother was caring for him the best way she knew.

Baby Zuber is now on oxygen as we try to figure out the best way to treat him. He needs a cardiac echo but we don’t have the necessary equipment at our hospital. The test can be done in a diagnostic center in Hargeisa but so far he has been too sick to transport to another facility. We hope that after the pneumonia subsides, we can have an echo performed to help our doctors have a better sense of his condition, and can then arrange to have him taken to a hospital in Ethiopia that has a dedicated cardiac unit where his tiny heart can be repaired.

Needless to say, he is being treated at our hospital free of charge and we are also ready to help with the cost of transporting him to Ethiopia.

Baby Zuber’s case would be tragic in any corner of the world, but it is especially moving here in Somaliland where we don’t have health insurance, we don’t have specialized hospitals, we don’t have cardiac surgeons and we don’t have resources to help every child who needs assistance. What we do have is a dedicated team of health workers and mothers who love their babies just as much as mothers do everywhere.

Here attached are pictures of baby Zuber with his loving mother.

- Edna Adan

On Mother’s Day, Let’s Invest in Women

When I first arrived in Somaliland in April 2011, I became immediately aware of the societal norms and cultural value system that was distinctly based on gender. I saw how the male perspective was the only one that mattered regarding human sexuality, while women’s reproductive rights were non-existent. Women in Somaliland have no voice — their bodies are culturally controlled long before puberty and their very worth is male-dictated. Their maternal health is a matter of chance and luck yet an abundance of children is inherently expected and valued above their well-being and often their survival.

Despite the immense adversity of circumstances I witnessed, I was inspired by the great work I saw Edna Adan doing in her native country. Edna became a personal hero of mine — even just from reading the chapter about her in the book Half The Sky. She exemplifies what it means to be a true “nurse,” as well as an ambassador of her nation’s women. Edna is a genuine inspiration who has earned every bit of respect and esteem through her determined efforts in a wildly patriarchal society.

Diane Lane & Edna Adan

Because of Edna, I clearly see the interconnectedness between access to education and opportunity for women and preventing maternal mortality. When a mother dies, all her children are orphaned and the entire community is left to endure the burden of her void — emotionally, physically and spiritually.

These issues need not be overwhelming. There are so many ways to empower women: via education, the right to vote and the right to participate in sustainable local commerce to name a few. Opportunities like this aid women in so many ways, contributing to their families, exponentially elevating their communities, and increasing a woman’s worthiness of preventative healthcare.

Film star Diane Lane will appear as Superman’s mom (Mrs. Kent) in the new film.

I am so grateful to Edna Adan for my experiences in Somaliland. Although I saw the deprivation of poverty, I witnessed how beautifully the human spirit can persevere even in unforgiving drought. Thanks to Ms. Adan I grew in my understanding and compassion for cultures quite different from my own. My visit with the kind people of Somaliland encouraged me to lend my voice to the life-and-death issues that are often ignored, or worse tolerated, in spite of being shockingly preventable.

Edna gives me hope through her “power of example.” She once told me the fable of the tortoise who, without “sticking his neck out, gets nowhere.” And just like her native desert survivor, the Tortoise, Edna Adan is a marvel of accomplishment on behalf of her people.

This Mother’s Day, please support her work so that her legacy continues to flourish through her many students and grateful patients — whether via midwifery, medicine or her womanly wisdom.

Dr. Romanzi spent over a month in Somaliland primarily helping fistula patients. Without assistance from specialists such as Dr. Romanzi, fistula patients will have a lifetime of suffering.
Dr. Romanzi’s visit was sponsored by The Fistula Foundation.

Obstetric fistula, while virtually unknown in the US and Europe, is one of the most devastating – and preventable – conditions faced by women in developing countries. An obstetric fistula is caused when a woman suffers with obstructed labor for a prolonged period of time, often days, without access to a medical professional who can perform a caesarian section or provide other medical relief. One cause of obstructed labor is an underdeveloped pelvis, which may occur when women give birth at an early age before their bodies are ready for the rigors of labor and childbirth. The other primary cause is incorrect positioning of the child in the womb.

When labor is obstructed, for any reason, the baby cannot be delivered without medical intervention. If care is not available, then the baby continues to push inside the womb. The end result is almost invariably a stillborn baby, and the situation can threaten the mother’s life as well. Even if the mother survives the trauma, she is likely to develop a fistula, or small hole, between her birth canal and her bladder or rectum. This fistula causes the woman’s bodily wastes to leak uncontrollably. She will likely be rejected by her husband because of her inability to bear more children as well as her incontinence; she may be shunned by the entire community.

In Somaliland a skilled attendant is present at less than one-third of the births.
With support from Direct Relief and The Fistula Foundation we were able to build operating theaters where fistula surgeries are now performed.

Fistula Surgery being performed in Somaliland

With proper prenatal care, this tragic injury can be prevented. A qualified midwife can detect the early warning signs of obstructed labor and refer the mother to a hospital or other facility where she can get the help she needs. However, in Somaliland a skilled attendant is present at less than one-third of the births. The Community Midwife program at Edna Adan Hospital, which is supported by UNFPA, seeks to train 1,000 women from all over Somaliland to be qualified healthcare workers in the hopes that they will return to their homes and provide assistance to women who currently have no access to care.

Placing the Spinal before Fistula surgery

In addition, Edna has been a leader in providing relief to women suffering from obstetric fistula. Fistula repair surgery is a delicate operation requiring a skilled surgeon, a qualified support team and a proper facility. But under the right conditions, these procedures have a remarkably high success rate. Edna Adan Hospital is one of the few facilities in Somaliland where women suffering from fistula can turn for help. With the support of The Fistula Foundation, we sponsor “fistula camps” where women can receive this life-altering procedure, and where local doctors are taught how to treat fistula patients. With Edna’s help, fistula sufferers can lead normal lives – return to their husbands, rejoin their communities, raise their children and even become mothers again.

Video from The Fistula Foundation

Amoud University medical students read Kees Waaldijk obstetric fistula manual on Day 2 of training in Boroma.

Top trainers Dr. Shugri from Edna Hospital & Dr. Muumin from Boroma National Fistula Hospital.

Getting set up. All of these medical students were efficient, keenly interested and coordinated their actions well.

Visit FistulaFoundation.org
Visit DirectRelief.org

Being ‘a hospital for mothers,’ we know firsthand the challenges women face everywhere but particularly in poor countries like ours, Somaliland.

Since two years ago Mother’s Day when we were so greatly honored by Nicholas Kristof – Beyond Flowers for Mom – who continues to refer to us as ‘The best,’ we have continued to serve with diligence and perseverance in spite of the challenges that we face due to the pressure on our limited resources.

If you would like to help support Edna Hospital, we ask that you make your donation through The Raise For Women Challenge sponsored by the Huffington Post. This fundraiser runs until June 6. If we come out on top then we’ll be awarded an additional $25,000.
You can make the donation in honor of your Mom.

I prefer however to focus on the progress that we have made since our hospital was opened twelve years ago. This last year has brought to us an increased number of women who come to deliver with us or who are referred to us because of complications. We have also seen an increasing number of premature babies to care for and am sure you have all been following the progresses of ‘Tiger’ and other pre-term babies who have all now gone home but who return for growth monitoring. [Read about our Neonatal Intensive Care Unit]

I take this opportunity to thank the volunteer surgeons, volunteer doctors, volunteer nurses and midwives who have cared for these babies and their mothers and who have worked with us during this past year. I am sure many of you have been following the messages these volunteers have been posting in their websites and in the in the hospital blog.

With the support of the surgeons from the USA and Britain, we continue to perform more surgical operations on patients who come to us from all corners of the Horn of Africa and whose recovery we consider as a blessing rather than an added burden.

What we do is only a reflection of your support for us and the generosity of your encouragements both in words and in deeds.

Please help us help more mothers on the occasion of this Mothers Day.

~ Edna Adan Ismail.

Here is Nicholas Kristof discussing motherhood in Somaliland:

These posters are displayed throughout the country, showing examples of medical conditions which we can treat and the time periods when surgeons will be here.

Extremely premature infant “Tiger” is doing well now. Seen here with his mother on a follow-up visit to the hospital.

Surgeon Dick Bransford and his team come to us 4 times a year

“As a hypothetical exercise, picture in your head a country in Africa limping into the end of the 20th Century facing widespread disease, poverty and war. Now let’s take this country and split it in half.”

What if we gave the one side everything they needed, an enormous credit card to build their infrastructure and aid in times of famine. “And the other side, we just leave it up to them to figure out how to pay for key infrastructure projects without access to support from international development experts. Leave it up to them to figure out how to secure peace without our guns.”

“Fast forward 20 years. Who’s winning? Which side has built world class hospitals that treat patients from across the region and which side is still battling malaria, HIV, and other infectious diseases?”

“Where do you think you’d find a private sector driving it, reaping the rewards of economic growth and where do you think you’d run into massive corruption? But most importantly, where would you find peace? And where would you find unmitigated war?”

“It wasn’t long ago that we heard a rumor of a place that this exact scenario was playing itself out in a place called Somalia.”

“There’s a place in the south called Mogadishu that is commonly referred to as the most dangerous place in the entire world. …while the world was focused on pouring countless developmental funds into Mogadishu a tribe of nomads had gathered in the north without the support of the international community to endeavor on their own path to development. Rumor had it that this section in the north was thriving. Still held in obscurity from the rest of the world but they had an atmosphere of economic growth and stable peace. We had to go and see it for ourselves.”

Students at Abaarso Tech in Somaliland

At just short of ten minutes, Mr. Digilov describes being in a hotel lobby in Somaliland when a certain woman sweeps past. He was struck the fact that this woman was walking about 3 paces ahead of a pack of about 10 men. “So, I knew I had to meet her.”

“Edna Adan has been able to put women on the front lines for the battle to improve health care for the population as a whole. And by doing so she makes sure that there will always be a seat at the decision-making table for women in Somaliland.”

“But if you and I had all the money in the world, we couldn’t figure out how to do what Edna has been able to do.”

“Surgeons come from around the world and spend weeks performing the same surgeries over and over again for people who have traveled great distances. But you can’t just send an email to a rural nomad to tell them about the opportunity to receive medical care. Edna has been able to use hyper-connected tribal networks that are able to spread news of an opportunity overnight to thousands of people. The work that they do at her hospital, maternal care, preventative health, and limiting the spread of infectious diseases, reverberates and has an impact of every Somali present or future.”

“Every month, Edna sends her own pension from the U.N. as [the hospital's] operating budget, but of course she couldn’t have done it all by herself. That’s the question that we at Firestarter grapple with every day. There’s a lesson that I learned in the brief time that I worked at an investment firm here in Houston. You don’t invest an idea. You don’t invest in a strategy. You don’t even invest in a company. You invest in people. So, when we invest in a charity we have to consider the same ideals. We can’t just send money to people who look like they need it the most. We send our social dollars to people that inspire us to action. At Firestarter we have a holistic approach to giving to charity and to helping to fuel growth in the developing world.”

“Ain’t no mountain high enough for the people of Somaliland to be kept from the dreams of building their country.”

“Edna Adan’s hospital, though it’s the most modern medical facility in the region, is still fighting to get the diagnostic facilities they need to support surgical procedures and mammographic exams.”

“But most importantly, there is a very crucial role for us all to play. As individuals, simply knowing that a place like Somaliland exists helps to support the efforts toward peace that have succeeded, amid conditions that have historically led to nothing but war.”

Edna with Construction Co. owner

For the time being, the radiology building will be home to the Hospital’s new x-ray machine. Patients requiring x-rays currently are being referred to other facilities – quite a reversal for Edna Hospital as we are more accustomed to patients being referred to us. Once the building is completed and the x-ray unit is installed, not only will we be able to provide better services to our patients, but we expect to be a referral center for other patients needing imaging services.

Next Up: Mammography

But of course Edna’s long-range plans are much more ambitious. The building will have sufficient space to accommodate what Edna has been dreaming of for some time: a mammography machine. Worldwide, breast cancer accounts for over 20% of all cancer found in women and is responsible for over 400,000 deaths per year. It is well known that early detection is the key prolonging the life of breast cancer victims. Yet there is not a single mammography machine in Somaliland! That’s right, an entire country with no means of detecting breast cancer in its early stages – almost inconceivable. We look forward to the day in the not-too-distant future when we have the ability to provide this vital service to the women of Somaliland.

The construction of the radiology building is being made possible through a generous donation from Australian Doctors for Africa. ADFA is a Western Australia charity that was founded in 2005 by Dr. Graham Forward, an orthopaedic surgeon from Perth. The organization is active in Somaliland, Ethiopia and Madagascar, and we always look forward to their visits. We encourage you to learn more about Australian Doctors for Africa at www.ausdocafrica.org.

There is no timetable yet for the construction but we expect work will start in earnest towards the end of the rainy season in Hargeisa. Look for news of the grand opening sometime this summer.

In its inaugural year, the Students Rebuild Awards aims to fuel global awareness and anti-oppression efforts by elevating the game changers who are working to improve the lives of young people in their communities. We applaud these young women who often go unrecognized, fighting bravely to improve life conditions for their peers and to end the oppression of women and girls in their communities and countries.

We published a profile of Nimco one year ago. The following is a statement by our own nursing school and midwife graduate, Nimco.

My name is Nimco Cabdillahi. I am a 26-year-old woman from Hargeisa, Somaliland. I am a qualified nurse and a midwife. To achieve these qualifications, I studied nursing at Edna Adan Hospital for three years and studied Midwifery for one more year. I chose nursing and midwifery because I want to help mothers and children. I have a particular interest in nutrition and family health.

I am now working in the village of Balligubadle, which is near the border with Ethiopia. There are 33 small villages and towns in the area with a combined population of about 20,000 people; some of them travel as much as 50 kilometers for health care. Although my family is in Hargeisa, I chose to work in Balligubadle because that is where I am needed.

Balligubadle has one community health center and one TB center. There is no doctor at the health center. There is a visiting doctor who comes to the TB center about three times a week. Before I moved to Balligubadle, there were no qualified nurses or trained midwives. The only assistance available to pregnant women were traditional birth attendants who do not have medical training. Anemia is very common in pregnant women in our area. We now have two Community Midwives (trained at Edna Hospital) in Balligubadle and someone is always on duty. In addition to medical services, we provide training on nutrition and other subjects. When necessary, we refer patients to Edna Hospital. Hargeisa is only 68 kilometers away but the trip takes four hours because of the poor condition of the road.

I was very excited to get the news that we had won the Students Rebuild/Half the Sky Award. Our health center has one small ward where we assist with a minimum of 30-35 births per month. At least five births per month have some complications. With the prize money we plan to build a second ward to reduce overcrowding. We also will be able to improve our equipment. The things we need most right now are an ultrasound machine, incubators and oxygen for premature babies.

I am a young girl, but I recognize the need to increase our knowledge in the area of health care. Health is the foundation of life. I ask the world community to increase its commitment to health care, especially for rural and nomadic communities who lack money, education and transportation.

Edna’s presentation is wide-ranging. She begins by speaking about Female Genital Mutilation, and then goes on to discuss her important education-related work. Educating against FGM while also training Community Midwives, Nurses, Pharmacists, Lab Technicians, and Public Health workers.

Edna’s speech which, as usual, is given without notes, begins at about the 15-minute mark in the video below.

Edna paints a very vivid picture of her work.

She discusses the difficulty of fighting FGM, which is so embedded in the culture of her region – but which is not required by Islam. At least 97% of women in Somaliland suffer FGM, even after 35 years of fighting it. And 95% of that 97% suffer the most severe form of FGM. Most often, in Somaliland, it’s done to these little girls at about age 7 or 8.

Also, she talks about the difficulty some people have with the mixed-gender classrooms at her Hospital/University… especially when it happens that the girls finish at the top of the class. And the difficulty some people have accepting the idea of vaccinations, which some fear will make their children sterile or give them AIDS.

She tells the story of a woman who stubbornly resisted a needed C-Section and who feels “defeated” after she gave in and accepted.

Many of Edna’s early students were born in refugee camps following the civil war, and learned to read and write on sand. Now, they have gone on to become nurses and teachers. “If you set your mind to it, then you can do it.”

Ohio University presented Edna with the African Childrens’ Hero Award

Most of the people of Somaliland are poor and many are nomads. That’s part of the reason why the community midwives are so important. Edna trains them and sends them back where they came from so that they can improve the health of their own people, where they are known and trusted.

And she tells of her very great pride when two of her female nursing students accepted scholarships from Edna and went on to become fully-trained medical doctors. “They are the pride of my life… girls who were taught to read and write on sand.”

She discusses, too, how the success of Edna Hospital has been the result of contributions from all sorts of people, including governments, NGO’s, and individuals, both Somalilanders and others.

The battle against FGM has usually been treated as a problem of mothers and grandmothers, and efforts were made to change those people’s minds. But now, Edna believes it should be made everybody’s problem. Fathers and grandfathers, religious leaders – everybody should be made aware of what’s wrong with the practice of FGM and all should be made a part of ending it.

“If we do not go into this battle with every single bullet that we have, we will continue to lose little girls and one of the most painful things that I have ever seen. I’m a nurse and I have seen crashes and battles and bullets and all kinds of things but one of the worst things that I have ever seen was an 11-year-old child who was born with Down Syndrome. She was circumcised that morning and because she was 11 and strong, she fought the circumciser whose knife cut everything. And so of course they were afraid because she was bleeding so badly. But they waited until evening before bringing her into the hospital when she was as white as a sheet. She needed 5 units of blood. Her urethra was gone. Everything was gone to the bone. And that’s an 11-year-old child with Down Syndrome who had every problem that God could give her and this was added to it. She is going to be incontinent. Well, she lived, but what kind of a life?” ~ Edna Adan

Neat the end of the video, Edna answers questions from the students in her audience.

Here is an article by Arianna Huffington announcing the Challenge. The RaiseForWomen Challenge: Investing in Women Who Change the World

The charity that raises the most throughout the Challenge will receive an additional $25,000 contribution from the Skoll Foundation. Second place gets $15,000 and third gets $10,000. We’re doing this to raise money, but beyond fundraising, this is a great chance to help spread the word about all the great work being done at the Edna Adan University Hospital.

Update: Jackie and Mike Bezos gave $25K to the prize total, so the top prize is now $40K! Second and third place are $20K and $15K.

Did you know that:

• A normal delivery costs around $30 We’ve delivered over 14,000 babies since 2002! We treated an additional 15,000 sick patients suffering from various conditions, many needing surgery.
   
• Training a community midwife costs $200/month. Since 2002, we have trained over 150 General Nurses with an additional 60 in training; 100 Senior Midwives; 66 Community midwives and with 42 in training now; 100 Laboratory Technicians; and 150 Pharmacists.
   
• A fistula surgery costs about $550. Over 300 women have had fistulas repaired, thanks to our doctors and partners. We have performed over 5000 operations of various kinds including C. sections.

To donate now, please Click Here and give whatever you can. Every donation makes a difference, no matter how small!

Or, if you want to go one step further, visit the page above and click ‘Create Your Fundraiser.’ In seconds, you’ll have your own fundraiser that you can share with all of your family and friends so that you can raise money for our cause too.

Please Email CrowdRise if you have any questions at all and they’ll help solve everything. raiseforwomen@crowdrise.com

Thanks so much for your support!

Dr. Bransford and Dr. Rhodes are generously donating their time and their skills to perform surgeries that that make a tremendous impact on the lives of their patients; in some instances, the procedures are literally life-saving. Hydrocephalus, commonly referred to as “water on the brain,” is a medical condition in which cerebrospinal fluid accumulates causing, among other things, a progressive enlargement of the head. The condition can be fatal in infants; those who survive typically suffer severe damage resulting in delayed development, epilepsy and other complications. These young patients are treated with the insertion of a brain shunt to relieve the pressure and drain the excess fluid.

Surgery on Infant (2012)

Waiting to be prepped for surgery (2012)

Cleft Lip Surgery (2012)