On one day in March dozens of people gathered in a hospital in Hargeisa, Somaliland. The bright room was decorated with flowers and banners in red, green and white, the colours of Somaliland’s flag. Doctors –foreign and Somali – ministers, medical students, former patients and journalists filed in, greeting each other, standing in little groups and talking animatedly. A man walked to the front, bowed his head, and intoned a prayer over the crackly microphone, and the murmur turned to silence as people took to their seats.
Minutes later, a woman dressed in an elegant blue gown took to the podium. Edna Adan, the face of Somaliland’s healthcare and founder of the hospital where this event took place, is in her 80s, but the passion in her voice and her strong demeanour make her seem decades younger.We were all gathered to celebrate the 16th anniversary of the Edna Adan Hospital, which has been a shining example of healthcare and education since its inception.
“I always felt there was a need to provide Somalilanders with better healthcare,” says Edna, whose doctor father she credits with inspiring her to pursue medicine. “And that’s why, as a child, I decided I would build a hospital.”
Before she retired in 2002, Edna — who worked with the World Health Organization in the region after a working as a nurse — founded the hospital with the view of drastically reducing child and maternal mortality in the country.“Women in Somaliland have the world’s highest mortality rates because there are no health facilities and few health professionals,” she says. “Seeing the magnitude of the problem and knowing the limited resources, I decided to put everything I could into reproductive health, and it’s the most rewarding thing that we’ve done.”
Since opening its doors, the hospital has delivered thousands of healthy babies, and its maternal mortality rate is a tiny fraction of the national average. The hospital has also become a centre for the treatment of obstetric fistula, one of the most devastating conditions faced by women in developing countries.
“Fistula can happen when women go through a long labour, and especially when they deliver at home, far from hospitals, in rural areas with no facilities or doctors,” explains 32-year-old Dr. Shukri Mohamed Dahir, Somaliland’s first female fistula surgeon.“Pressure between the pelvic bone and fetal head kills the tissue of the bladder and rectum, and a small hole develops,” says Dr. Dahir. This hole – the fistula – can cause the woman to uncontrollably leak bodily waste, with shattering health and social consequences.
Shukri studied midwifery and nursing at Edna Adan Hospital, which later sponsored her through medical school. After she graduated in 2011, Dr. Dahir returned to Edna Adan’s hospital to learn about surgery.
“I always wanted to solve women’s problems myself, rather than hand them off to a male doctor to solve,” says Dr. Dahir. “And I also realized how important it was to have woman surgeons so women can feel free.”Unfortunately, getting her degree wasn’t always enough to convince patients of her expertise: “People were not used to seeing women doctors, and wouldn’t trust us to do the operations. Once, during a consultation with a woman suffering with fistula, I had to pretend to be a student, while my male student posed as the surgeon. After the surgery, I told her I was the one who had cured her, so she let me take over.”
Because of the hospital’s great results, patients are now used to seeing female surgeons, and many of those suffering from obstetric fistula even request to be seen by other women. And, thanks to the Edna Adan University, which was formally established in 2009, it is not only women in the capital who are now receiving world-class healthcare. Graduate doctors from all Somaliland are coming here for training, and returning to their rural clinics with newfound life-saving skills.
“I am glad we are turning 16,” says Dr. Dahir of the hospital. “We have made a huge change in this country.”
All surgery photos courtesy of the Edna Adan Hospital.