International Day of the Midwife is a day to observe the myriad health contributions midwives provide in their communities, helping women deliver safely and preventing injuries like obstetric fistula.
Edna Adan – Somaliland’s first certified nurse-midwife – has a dream to train and place 1,000 midwives throughout her country, helping to ensure safe delivery for as many women as possible.
We hope you will take a moment to watch these inspiring videos of Edna, discussing her work in her own words:
What a Difference a Person Can Make: A Conversation with Edna Adan
Edna Adan has made helping mothers and babies the mission of her life, and does so in her homeland of Somaliland, where the need is great. The area has one of the highest maternal mortality rates in the world, and Adan and the midwives she’s training are working to change that, one delivery at a time.
She’s the founder of the Edna Adan University Hospital in Hargeisa, Republic of Somaliland, and the hospital opened its doors 15 years ago. During that time, Direct Relief has provided critical supplies to enable the hospital’s mission.
Direct Relief has shipped 81 midwife kits that have enabled more than 4,000 safe births in the country.
Learning about Adan conjures up a host of “firsts:” she was the country’s first registered nurse midwife and even the first woman to get a driver’s license in the country. She was a nursing and mental health advisor for the World Health Organization, and has trained a host of midwives in their craft.
Adan spoke at Direct Relief’s Goleta headquarters on Monday, and shared her passion for the work.
Somaliland isn’t a place one can find on a map, she said, and is an autonomous region within the country of Somalia.
“You don’t hear about Somaliland, because we are just too busy rebuilding the country,” she said.
Due to the country’s civil war, many health professionals were killed or fled the area, making medical care for ordinary people difficult to access.
That’s where the 183 midwives, trained by Adan and her staff, come in.
Adan showed a picture of about two dozen midwives, many of whom are in their late teens and early 20s and will be called on to help keep mothers and babies safe as they deliver in their homes.
Giving these young women the training, and tools, they need is the key to keeping women from needlessly dying during birth.
“I want to multiply these girls to 1,000… There should be 1 million for Africa,” she said. “That’s how we reduce maternal mortality.”
A photo was shown of the young midwives carrying a small suitcase, no bigger than a small purse, that they use when they travel to help a mother deliver a baby.
That small kits contains some low-tech tools that can help increase survival exponentially, simple supplies like clamps and surgical gloves.
“That’s what we need,” she said.
Equipping young midwives with medical training and expertise is just one facet of working in Somaliland. Training midwives on how to dissuade family members about female genital mutilation, still an ingrained cultural practice in the area, is also key.
Adan is an outspoken opponent of the practice, which can make it anatomically impossible to deliver a child safely, causing a danger to the mother’s life as well as the child’s.
FGM is “endangering their lives and we have to fight it with everything we have,” she said.
On Sunday, as I watch the show again with millions of you, I will be doing so in Bristol with my family – probably in silence – but above all, with pride and the peace of mind that the cycle of FGM has ended in my family. In spite of the bruises and tears along the way, today I can say my niece, Sofia, will know FGM as a historical act and not as a chapter in her life and story.
It used to be near-impossible to talk openly about FGM, but this is no longer the case. Forming major storylines in BBC’s Casualty, Law and Order and now Call The Midwife, and with the help of amazing newspaper campaigns, the silence on FGM has been truly shattered. It is no longer seen as a cultural practice, but rather an extreme form of violence against girls. Groundbreaking work by politicians such as Jane Ellison and Lynne Featherstone have meant that the British public finally knows what FGM is and what measures are needed to end it.
Yet, although there is now much better awareness – and strong policies at UK domestic level at least – funding has not really increased for the front-line organisations around the world, which are leading efforts to end it. Without this, we run the risk of not making progress quickly enough.
FGM is almost universal in the region of East Africa where Nadifa was born. We don’t have separate data for Somaliland, but according to UNICEF, 98 per cent of women and girls have been affected in Somalia – largely unchanged since Nadifa’s time, but is finally reducing at last for girls who are now aged 15 or under.
Women – most of whom are over 60 and many of whom use their pensions to help fund their work – are having the most success in ending FGM on the African continent. They are rarely talked about. Edna Adan quit a highly-paid job at the WHO to set up a hospital in Somaliland and is on the road to training 1,000 midwives as part of her work. In the Puntland region of Somalia, Hawa Aden Mohamed runs the Galkayo Education Centre for Peace and Development, which teaches over 2,000 disadvantaged girls and makes sure that they are protected from FGM. It is a constant battle and Hawa’s life and wellbeing is often at risk.
Some donors and women’s organisations do understand though what’s needed. An international group called Donor Direct Action has set up a fund for African activists, which is named after my late friend and colleague, Efua Dorkenoo, a leading figure in the anti-FGM movement for over three decades. Their rationale is simple – we need to break free from funding international ‘middle-men’ and get as much funding to the frontlines as we can, to enable inspiring women around the world to be able to do even more. It seems like a simple solution because it is.
Leading anti-FGM campaigners on the African continent and around the world know how to do this work. They can be trusted to make the most of every single penny. It’s time we made it easier for them to just get on with doing it.
Ending FGM is finally a tangible reality for the first time I can remember. The UK is twinned with Somaliland in my heart, and we cannot end it in one place but not the other. In making this happen, women like Nadifa and girls like her baby – but born in 2017 – will have a much better chance of living safe and fearless lives on their own terms.
Nimco Ali, the co-founder of non-profit organisation Daughters of Eve, was the victim of FGM as a child and worked closely with show bosses on the BBC drama series.
She said she hopes the story will have a “positive effect” in the fight against it.
An estimated 200 million girls around the world have been put through the procedure, which involves the partial or total removal of parts of the female genitals for non-medical reasons.
Sunday night’s episode of Call The Midwife will highlight the plight of a pregnant Somali woman who is fighting for her life in the aftermath of an FGM procedure.
Nimco told the Press Association that viewers will relate to the character and her storyline, and praised the writers for their sensitivity around the topic.
She said: “I think viewers will see that this is a young woman just like many of them, who needs kindness and understanding.
“The fact that she is given both means so much. I think that’s the most touching aspect of it.
“It mirrors my own personal life in many ways and brings to life what has happened to so many women while giving birth, after having undergone FGM.”
Nimco said: “It is a beautiful episode and very sensitively done. It is hopefully going to have a very positive effect.”
She said: “The writers really wanted to listen – they came to the first meeting passionate about the issue but really wanted to tell the story of a young north Somali woman as true as they could.”
Writers also enlisted the help of campaigner Edna Adan, the former foreign minister of Somaliland and the founder of a maternity hospital in the country.
Nimco said: “(She) was a great help in giving, really, details information about what the midwife could expect having delivered many women with FGM herself.
“The story is told sensitively and there is no judgment, so for them it was about bringing it to life with these key details.”
The episode of Call The Midwife is set against the terror of the Cuban Missile Crisis, as the sisters of Nonnatus House listen to US president John F Kennedy’s ultimatum to Russian president Nikita Khrushchev.
Jessica Neuwirth, founder of international women’s group Donor Direct Action, said it is “fantastic” that shows such as Call The Midwife and others, including Casualty and Law And Order, are bringing the issue into the mainstream.
She said: “Awareness of FGM has increased dramatically in recent years in the UK, but activists working on the front-lines to end it are still not able to access the funds they need to scale up their work in countries such as Somalia, where prevalence is 98%.
“We need to fund efforts locally to end FGM globally and the UK and other governments need to do more to make this happen.”
Donor Direct Action runs an anti-FGM fund for frontline groups, which are ending the practice in Somalia and around the world.
Charity Barnardo’s, which runs the National FGM centre in partnership with the Local Government Association to prevent new cases of FGM in the UK and also support survivors in England and Wales, has spoken about the Call The Midwife storyline.
The centre’s director, Michelle Lee-Izu, said: “FGM, was a shocking discovery for midwives in the latest episode of the BBC TV drama, Call the Midwife, set in the 50s and 60s.
“What’s even more shocking is that this physically and emotionally damaging practice still goes on in the UK today. Despite FGM being illegal here since 1985 there still hasn’t been a single prosecution.
“Barnardo’s is tackling the issue by working with communities through training and education programmes at the National FGM Centre, run in conjunction with the Local Government Association.
“Agencies must also work better together to prevent FGM from happening by identifying girls at risk and helping to prosecute those who fail to protect girls from this type of abuse.”
The show’s creator Heidi Thomas has previously said she wanted to write about FGM for a long time but had to wait until the timeline of the show reached the 1960s.
Edna was invited by Somaliland First Lady Amina Weris to serve on the country’s delegation for the first Girl Summit in London on July 22, 2014.
The event, co-hosted by the UK Government and UNICEF, was aimed at mobilizing domestic and international efforts to end Female Genital Mutilation (FGM) and child, early, and forced marriage (CEFM) within a generation.
First Lady Weris stated that the government of Somaliland, one of the leading 30 countries in the practice of FGM, is fully committed to achieving the end of FGM and forced marriages through concerted effort.
As a mother, midwife, and former student of Edna’s, First Lady Weris is a valuable ally in the fight against FGM.
As of today, over 11,000 people have pledged to join in the Girl Summit movement to end FGM and Forced marriages and nearly 1 Billion people have been reached via Social Media.
Edna Adan Ismail is honored to have been awarded a Doctorate of Humane Letters from the University of Pennsylvania at UPenn’s 258th commencement ceremony and she has been named the inaugural recipient of the Renfield Foundation Award for Global Women’s Health from UPenn’s Nursing School which includes a grant in the amount of $100,000 in support of her work to improve healthcare for women in the Horn of Africa.
The Renfield Award recognizes demonstrated leaders whose work has had significant impact in improving the lives and health of women and comes at the conclusion of the Healthy Cities: Healthy Women Conference Series which aims to promote discussions about re-envisioning our communities to make them universally safer, healthier and more livable.
Penn Nursing Dean Afaf Meleis – herself a trailblazer in global women’s health issues – presented the award to Edna who went on to describe to those assembled the devastation in Somaliland following the brutal civil war which left some 95% of homes, hospitals, and schools in ruins.