This week, Edna Adan University Hospital is host to another Helping Babies Breathe training course. The class is designed to train healthcare workers to intervene quickly when a newborn baby is in respiratory distress. Two of our own doctors, Dr. Naima and Dr. Shukri, have taken the class in the past and are now among the trainers for the seminar. We are extremely proud of them both!
In developing countries, it is estimated that approximately 10% of all newborns will experience breathing difficulties within the first five minutes of life. A healthy baby should begin breathing spontaneously in less than one minute, but in Africa 2-3% will need the assistance of a bag and mask in order to take their first breaths. This means that in Somaliland, anywhere from 5,000 to 10,000 babies per year are at risk of dying at or shortly after birth.
The Helping Babies Breathe curriculum was developed by the American Academy of Pediatrics in conjunction with the World Health Organization. The three-day program covers preparation for birth, routine care, and bag and mask ventilation. Lessons are highly interactive and involve skill practice utilizing life-like mannequins. Students who demonstrate all of the requisite skills and who pass an oral and written examination are awarded a certificate of completion. Attendees included midwives in training at Edna Hospital along with those working in government hospitals, many of whom received their professional training from Edna.
Helping Babies Breathe is currently taught in over 30 countries and is being hailed as one of the most cost-effective maternal/child health programs due to its low cost and its tremendous potential to save lives. In Somaliland the program is sponsored by Noleeynta Naruurada Mustaqbalka (NNM), a Norwegian non-governmental organization, and funded by the Norwegian Agency for Development Cooperation (NORAD).
The seminar was opened by Edna who emphasized to the students that their ability to perform these skills will make the difference between life and death. Dr. Shukri and Dr. Naima are joined on the seminar faculty by representatives of NNM and the Kenya Pediatric Association.
I’ve donated to support the Edna Adan University Hospital since I learned about its founder in 2011. Edna Adan is a remarkable woman who came to my attention thanks to a New York Times column written by Nicholas Kristof on Mother’s Day two years ago.
As you may know, Kristof along with his wife, Sheryl WuDunn, co-wrote a book and started a movement, both entitled Half the Sky, dedicated to raising awareness of the worldwide oppression of women and girls and providing concrete steps to fight these problems and empower women. Towards that end, Half the Sky has highlighted a number of women-focused charitable groups committed to bettering the condition of women. Edna Adan’s Hospital is one of their featured programs. Currently, Half the Sky is partnering with The Huffington Post and The Skoll Foundation on the RaiseForWomen Challenge, a fundraising campaign designed to raise money for organizations that support women and girls. The organization that raises the most money by June 6 will be awarded an additional $40,000, the second place team will get a $20,000 cash prize, and the third place team will walk away with $15,000. If the hospital wins the first place prize, Edna will purchase her country’s first mammography machine. I am doing everything that I can financially to help Edna win this challenge, and am asking YOU to join me to help the women and children who will benefit from the hospital’s work.
So why should you give to one hospital halfway across the world? And why am I so invested in seeing Edna’s team place in the top three?
Imagine you are a woman turning sixty (as I will be later this year). You have already enjoyed a long and distinguished career in public service. You were the first woman qualified as a nurse-midwife in Somalia; a former First Lady of Somalia; and when civil war ravaged your country and forced you into exile, you worked for many years in senior positions at the World Health Organization addressing pressing maternal and child health care issues such as the need for skilled birth attendants and ending the practice of female genital mutilation.
Many in Edna’s position might have justifiably chosen to rest on their laurels. Instead, upon retiring from WHO, she decided to continue giving back to her country. While I applaud the celebrities and CEOs who have applied their wealth and/or fame to humanitarian causes, Edna is a humanitarian of a different sort — cut from the same cloth as Mother Teresa or Paul Farmer. In fact, she has been called the Muslim Mother Teresa. Instead of retiring to enjoy her golden years in comfort, she sold most of her possessions and invested her life savings to fulfill a lifelong ambition — building the first maternity hospital in Somaliland where too many women were dying in childbirth, girls were regularly being subjected to female genital mutilation and infant mortality rates were among the highest in the world.
What could a single woman possibly hope to accomplish?
Newly-trained Midwives at graduation
In the 11 years since the Edna Adan Maternity Hospital opened its doors in 2002, remarkable changes have occurred. Even though the hospital sees the highest risk cases, maternal mortality among mothers in the hospital is just one-fourth of the national average. Skilled birth attendance and facility-based deliveries have been expanded with over 14,000 babies safely delivered. The number of women and newborns receiving quality post-natal care has increased dramatically, and more than 300 women have undergone successful fistulae repairs. And in a region where the ranks of nurses and midwives was decimated during a brutal civil war, Edna has trained and/or recruited over 100 senior midwives and another 100 community midwives, 200 nurses and 250 lab technicians and pharmacists — and counting.
The list of women humanitarians who have devoted their lives (and livelihood) to helping oppressed women and children in the poorest corners of the world is relatively short — Nawal El Saadawi in Egypt, Wangari Maathai in Kenya, Yanar Mohammed in Iraq, Shitin Ebadi in Iran and of course Mother Teresa in India. Edna Adan deserves to be included in this company. She is the real deal — a tireless advocate in defense of maternal and child health, a courageous and vocal opponent of female genital mutilation and at age 75, still a real force of nature with a will of steel.
She’s my personal hero.
I hope that, like Mother Theresa, Edna Adan will continue her extraordinary work for many years to come, but she has already ensured that her hospital and her legacy will endure by training the next generation of nurses and midwives in Somaliland.
Please consider joining me in supporting Edna and her work. A donation of any size would be greatly appreciated.
Born in Hargeisa in 1937, Edna Adan Ismail is one of Somaliland’s most prominent public figures. From 1954 to 1961, she studied in Britain – the first Somali woman to do so – to become a nurse and midwife. After working as a civil servant, she held the position of Minister for Family Welfare and Social Development and most notably held the title of Somaliland’s Foreign Minister from 2003 until 2006. Throughout the 1980s, she served as advisor to a range of councils at the World Health Organisation before retiring in 1997 when she dedicated her life to her most recent project: the Edna Adan University Hospital.
Alas the gravity and magnitude of Ismail’s career is lost in simply detailing her achievements. It’s important to remember that Edna Adan, as a young girl growing up in Somaliland, was not expected to go to school or acquire any qualifications. “Britain used to select boys from secondary schools to study in England and in 1952 or 53. The very first school for girls was opened in Somaliland and I was a pupil-teacher at the time,” she remembers.
It was a year of waiting before she and another girl were finally sent off to study nursing. “We were the only two [Somali] girls in London at the time. It was very challenging; it was a great opportunity to study something that I certainly felt very passionate about. I loved learning, I loved studying and to be given this opportunity was a great gift, and I loved every minute of it.”
However, on returning to her homeland, she found her dreams of making a Florence Nightingale debut were squashed by the newly independent Somaliland government. “I was the only woman, the only qualified female nurse running all the female section of the hospital,” she explains. “So that was challenging, and of course there were very few doctors and many of the emergencies and the medical care that was needed was beyond the training of a nurse. Very often I just had to substitute for what a doctor would have done, because there would be no doctors. So, very often you just had to do what you had to do.”
It took the government nearly two years to finally concede defeat. “I refused to quit,” she declares. “I just worked for 22 months without a salary. I just stuck to my guns and eventually, they had to give in. I was appointed to the civil service. So, to me, that was a victory because that opened the door to women to be appointed to the senior civil service.”
While working for both the World Health Organisation and the United Nations, Edna Adan had made several attempts to set up a hospital of her own. However, efforts were often thwarted by the political climate. The civil war with Somalia had left Somaliland completely ravaged. Medical professionals had either fled the country during the conflict or been killed by enemy forces. Hospitals had been destroyed in the fighting, leaving the country with one of the highest maternal and infancy mortality rates in the world. “I just recycled my whole life,” she explains. “I just turned everything I could dispose of into cold cash and started to build a hospital.”
Edna Adan’s credentials as a nurse, a midwife and a health advisor, made her one of the most qualified people to set up a medical centre. But, according to Ismail herself, it was the memories of her father that truly stirred her to establish the Edna Adan University Hospital.
“My father was someone who was known as the father of healthcare in Somaliland,” she recalls. “As a teenager I would be home for the holidays, from school in Djibouti, and I would be hanging around the hospital, giving him a hand. And I would often hear him complaining about a piece of equipment, and I just made a kind of mental, subconscious promise that one day I would build the kind of hospital my father would have liked to work in.”
The Edna Adan University Hospital started life as a maternity hospital. After four years building on what used to be a garbage dump, the hospital was opened in 2002. For over a decade, the hospital has taken in literally thousands of patients and, to this day, continues to expand. Despite her position as both the founder and director of this monumental institution, Ismail remains humble about her contribution. “I’m doing less and less legwork,” she notes.
But Ismail is kept busy by the cascade of political issues that still flood the hospital. Gender politics still lie at the heart of what she does in Somaliland. The hospital, along with educating women to become nurses and midwifes, is using its influence to try and stop female genital mutilation – a tradition still practised in parts of Somaliland. “The more we do, the more we see that more needs to be done,” she admits. “What we’ve done now is a drop in the ocean.”
However it’s not just within the walls of the hospital that women are treated unequally. Ismail remains as passionate about gender equality as she was as a little girl. It’s important to note that when she was young, only boys were educated in Somaliland. “At that time, education was considered undesirable for a girl,” she explains. “Friends and relatives would come and say ‘God has given you one daughter and you are teaching her to read and write? What good will come of it? She will disgrace you!’ I grew up with that and I was always trying to prove to them that education was good.”
When she sat in Cabinet in the new millennia, she was the only female minister around the table. Even now there are only two women elected to Parliament and just one female in the Senate. “This is what I’ve had to fight all my life and we continue to fight because it needs to be fought. Somebody’s got to speak for these voiceless women. Somebody’s got to stand their grounds. If I had that opportunity to do that then I must do it. It’s a responsibility that I must accept.”
There’s no doubt that progress has been made. Once upon a time women were not even allowed to drive cars, and Ismail agrees that the changes that have occurred have made her optimistic about the future for women in Somaliland. “I would like the change to be bigger and I would like more women to keep that pressure going,” she says. “The world needs both men and women. Because it’s not a question of men or women, it’s a question of both men and women doing a job together to make the world a better place for humankind. That’s all.”
Throughout her life, education has been at the core of everything she’s accomplished. Her thirst for learning has fuelled her career and now she intends to impart her wisdom onto others in hopes that they will continue her mission. “My real gift that I wish to leave for my people is the gift of knowledge; for them to love knowledge – to encourage them to seek more knowledge.”
As always Ismail practices what she preaches and has dedicated her later life to encouraging young women to join the profession. She notes that it is still hard to persuade Somali families to let their daughters study but over time Ismail has persuaded masses of girls to take the opportunity to become a nurse or midwife. “These are exciting years,” she exclaims. “I am proud that the first lady of Somaliland today was one of those young students, young women who we talked into taking up nursing in those days.
There’s still a mountain ahead for Edna Adan Ismail, but she’s still enthused by the belief that people need change and its these young women who are able to deliver it them. “I want to be a role model, to show them that anyone can do it and so can you,” she explains.
Her love for what she does and her ability to convey such a wealth of knowledge onto others is what has made Edna Adan such an influential and compelling teacher. “I feel blessed at 74 that I can still do that. An old woman following her lifelong passion. And loving every minute of it.”
The preceding profile was written by Joanne Butcher, BA Politics, University of Sheffield.
“Today was a big day in my life and a big day for Midwives and a big day for Somaliland!
“My daughters – 21 of them! – graduated with a Bachelor of Science degree in Midwifery.
“The President of Somaliland and other dignitaries were there for the total of 640 students who were graduating from Hargeisa University. Our sincere gratitude goes to the Friends of the Edna Adan Hospital who have sustained us during the past 12 years as well as to DFID for having sponsored the Bachelor of Science course for our midwives. Appreciation and blessings to all who have supported us from around the world.”
– Edna Adan
It was the proudest day for Edna and the Edna Adan Hospital, for the girls, their trainers, their families and for Somaliland.
Here is a video of Margaret Chrichton speaking to THET about her many varied and treasured experiences teaching these Midwives at Edna University Hospital and helping to educate young mothers in Hargeisa.
Edna was invited to Geneva three weeks ago to address a TEDx conference where she spoke about Somaliland and the building of the Edna Hospital.
She described how important is the training of midwives to the goal of reducing high rates of maternal and infant mortality.
If Edna, beginning at the age of 60, in a war-ravaged and unrecognized country can accomplish her goal to build a hospital and use it to train midwives then anybody with determination can do the same elsewhere.
Edna’s goal is to train 1000 midwives and return them to their communities. Watch the video below: