A Conversation with Edna Adan

Edna Adan at 76 years old has more energy than a woman half her age.  The nurse-turned-UN diplomat-turned former foreign minister of Somaliland retired to launch the Edna Adan Hospital in Hargeisa to provide competent medical care for those living in the region. She's been likened a "Muslim Mother Teresa" and has received the French Legion of Honour. Edna Adan sold her car and poured her life savings into turning a former landfill into one of the better hospitals in rural Somalia that has a fraction of the mortality rates elsewhere in the country. Born the daughter of a Somali doctor, she was afforded opportunities that many of the other residents of British Somaliland were not. She didn't hesitate in seizing them becoming the first woman to get a driver's license and the first woman to become a nurse. Despite a bout of illness, she agreed to meet me in the modest office of her hospital.

You started the Edna Adan Hospital as a maternity hospital, but today it is the most important general medical facility in Somaliland. How do you credit the transition?

My main focus is to have as many health workers trained as possible. This was not in my original plan when I built this hospital - a plan I carried in the back of my mind throughout my career. The plan was always a maternity hospital but the reality has dictated that there is much more needed than a maternity hospital. It is now a general hospital: there are very often more male patients than female patients and there are not enough trained health workers in the country. So, we are the main teaching hospital, not just a referral hospital for anything that happens.

Therefore [we are] focusing on training health workers, which is why we opened the Edna Adan University a year ago. Certainly, there is so much more to accomplish in terms of training the health workers. In fact, it's not only the buildings and structures, the bedpans and the forceps, that are needed to look after the sick; it's also the knowledge and skills of the health workers that make a difference.

A drive around Hargeisa reveals dozens of educational institutions. How do you compare yours to those?

Yes, there are universities in Somaliland with 4,000-5,000 students, [although] I'm not sure of the quality of the education. Our strategy is to stay small. We had 150 students in our first year and 180 in the second year - we are concerned with quality [more] than quantity. We only concentrate on [training] lab technicians, midwives, pharmacists, nurses, and public health workers. If we had the expertise and the teachers, we would add nutrition, environmental hygiene, and general medicine because Somaliland is in critical need of properly trained doctors. Another difference is [the emphasis on] hands-on experience. We have doctors come to my hospital and sometimes we don't see eye-to-eye on how these students should be trained. They prefer the theoretical to the practicum, but in my book, medicine requires strong practical discipline.

In addition to quality, you mention in nearly every interview you give that your goal is [to train] one thousand midwives before you die…

I talk too much [smiles] - that is the goal that helped start this whole project. We graduated 42 [students] in December 2013, although I'm still 800 away from my target. I must thank the UNFPA for their support and the three classes they trained.  I just met with them in New York, and I shouldn't start counting my chickens, but they made a verbal commitment to train 40 more students. This is a place where there is clearly a need.  If you look at the map of Somaliland, there are vast areas where no midwives operate. Women in those places […] become infected or obstructed during labor and die. The need for more trained and competent midwives is an issue I draw attention to across Africa. I was recently speaking in Gabon and have also been in communication with hospitals in Ethiopia on this issue.  "Yes, a trained doctor would be better; yes, I know, but we don't have doctors for this task." And midwives are a [feasible solution] to bridge this gap.

Were you were involved in similar efforts when you lived in Mogadishu?

Well, this is actually my second hospital; my first was in Mogadishu. My family had to flee Mogadishu before it was finished in the 1980s when the civil war broke out. I have deeds and documents, of course, but it means little when someone uses force. I haven't been back to Mogadishu to see it, but I heard that when the Americans were there for "Operation: Restore Hope," the hospital was rented to the marines as a container storage depot. I lost a lot of money in that project over - $150,000USD - that would have helped me with this project.

How were you treated by Siad Barre's communist regime?

I was arrested several times. I was [on] house arrest for six months and thrown into jail just because I wasn't a communist. My home was searched in the middle of the night. I was called an antirevolutionary, a capitalist pig, an imperialist stooge, and a foreign agent - and they punished me. So when I got my passport back in 1975, I fled. I [acquired positions] at the WHO and UNICEF, and pretty soon I had a career in the WHO focusing on Africa, the Eastern Mediterranean, and Afghanistan.

You have some historic "firsts": From being the first nurse to the first woman with a driver's license! What inspired you?

Well, my father inspired me the most and got me on the right path to becoming a health worker myself. He taught me the principles of perseverance and dedication. These are principles you need to [possess] regardless of whether you are giving an injection or whatever it is; there is a compassion that is necessary.  My father has inspired me. What we have achieved here so far is modest. If you want to really see someone who has done well in the world, go talk Dr. Catherine Hamlin at the Addis Ababa Fistula Hospital. She is someone who has [greatly] inspired me.  With the help of her husband, she set up the Addis Ababa Fistula Hospital and brought to light women who suffer from this problem, helping hundreds of women at any given time. She has also sent me doctors and trained staff that have experience helping women with fistula problems.

In the past, you've been critical of your tenure as Foreign Minster …

Well, one does the best job one can in the driver's seat and I was aware of my limitations from the start. So yes, I don't think of myself as the best Foreign Minister Somaliland could have had but I gave it my best shot. But diplomacy isn't an assignment; it's an art developed through a long career. I, of course, could [boast about] my time as a UN diplomat, but in the UN, you have resources. Somaliland had no resources: no email, no photo copier. I used another ministry's telex machines and fax machines. I used my salary to train my staff to use computers.

You have been member of the Somaliland project since the beginning. Somaliland is still unrecognized. What are your thoughts on this?

I think Somaliland is better today. It is still unrecognized internationally as a separate country, but we're doing far better unrecognized and stable than Somalia is doing as a recognized, yet unstable, country. Yes, recognition has brought them international aid money to loot and license, but it hasn't taught them how to govern a country. Meanwhile, we in Somaliland have pulled ourselves up by our boot straps. [Our integration with] Somalia was a failed marriage which has had unpleasant results, so being neighbors is far more valuable. It is also more natural than forcing [together] two countries and two peoples who have no intention of going back to living together as one country.

Joseph Hammond is a freelance journalist, an energy market analyst and former Cairo correspondent for Radio Free Europe.

Photo Credit: Fortune Live Media via Flickr