By Ethil Ahmed
I’ve known about Edna for a long time, because she is really well respected among the Somaliland diaspora in Canada and around the world. So when I came to Somaliland on vacation with my mom and sister last year, I was already thinking about how I could help the hospital. I met with Edna and she told me that the hospital’s Research Coordinator was leaving and that I could help out in the research department. I accepted. So at the end of our vacation, I stayed on while my mom and sister went back to Canada.
I am one of 16 advisers responsible for organizing undergraduate students who are in the last year of completing their degrees in nursing, midwifery, public health, and as medical lab technicians. Everyone in their final semester at EAUH has to write a formal thesis that includes data collection and data analysis. There are about 120 students working on their thesis this year.
I just recently decided to extend my stay for three more months, because taking off in the middle of the semester would leave students hanging, especially students working on their thesis.
I also teach an Introduction to Chemistry course to pre-med students at EAUH. If you are not from here, teaching can be challenging, you have to learn the culture, often students are reluctant to ask questions in English, but we’ve grown to understand each other over time.
My other task is to oversee a long-term FGM study going on at the hospital itself. In the morning I am there collecting patient records on FGM – what this means that we collect data on the FGM status of mothers delivering here, and possible FGM-related difficulties to mother and/or child during delivery – the goal is to demonstrate the impact FGM has on maternal and newborn health compared to other Muslim countries that do not practice FGM.
I have also been working on the latest EAUH hospital newsletter that has put me in position of writer, photo and text editor.
My personal observation as daughter of Somaliland diaspora is that as a woman here you almost always have to prove yourself. People create assumptions that you don’t know something, and you have to push your way into the male-dominated workforce. It’s not dissimilar from a Western country per se, but here the sexism is more blatant and more obvious, though on the whole, it’s less of a problem than I had expected.
Unlike most volunteers who live at the hospital, I’m staying with my extended family. My parents have been very encouraging about my stay here. I have just graduated from college and my parents told me that this is the time to explore and see where I want to end up.
My dad is very big on education and that plays a huge role in his support of what I am doing here.
Coming from Canada, which has socialized and inexpensive health care, seeing first hand how people struggle to pay for medicine required to treat them, and sometimes to keep them alive was startling. And then to see Edna say: “oh they can’t afford it, let’s give it to them for free,” was inspiring and moving.
It takes a lot of money to run the hospital, but Edna is still willing to put everything aside for her patients. Regardless of the financial strain, regardless of the time it takes — she’s up all hours of the night — and, till recently, running the hospital full time while delivering babies… She’s really a big role model for women in Somaliland and I’m enjoying seeing how she works up close.
The plight about a set of conjoint male twins born at the hospital seven months ago really touched me. I interviewed their mother recently, and saw what a strong woman she is. This was her first pregnancy. She and her husband are very poor, and I remember the father going to Edna asking for any help she could provide. It was a very trying time for the parents and Edna took them in for several months for free. Some time later, the possibility of a surgery that would separate the twins came up, and the father asked whether that meant that one of the boys would die and said he would not, could not, choose between his two sons and said that one needed the other to survive and that the family would not opt for surgery. In saying that, the element of humanity was added to the concept of medicine, which too often in the West is so much about data and probabilities and percentages.
I will remember this hospital as a place filled with great local people that have amazing potential and as a place of hope that Somalilanders will continue the excellent work Edna started and that I’ve had the privilege to observe first hand.
Length of Volunteering: 9 months (Ethil originally signed on for six months, and recently extended for another three).
Recent graduate from the University of Calgary: B.Sc in Chemistry
By Dr. Sharan Abdul Rahman
I met Edna in 2014 when she came to the University of Pennsylvania to accept her honorary doctorate. I was very impressed with all that she had accomplished. And she expressed that there was always a need for doctors at her hospital in Hargeisa. From that meeting, it took two years until I was finally able to make the trip happen.
What surprised me is the high volume of high-risk OB. It’s not as though I haven’t seen high risk OB before but this was like OB on steroids – many patients with preeclampsia, for example. Rare in the US, severe preeclampsia is rampant here. I also saw many more cases of placenta previa.
In addition to high-risk obstetrics the hospital’s doctors are also dealing with pediatrics, internal and family medicine. That’s mind-blowing to me, because back home you have a family practitioner, a pediatrician, and then there’s the OBGYN. Here, one doctor is all those things! So I felt my own limitations in that I could do the OB, but when there was an adult or pediatric patient I felt like my ability to contribute was limited. It certainly gave me an appreciation for all that the doctors do — you essentially have highly trained generalists who can provide medical care to a population across the board. In the West, where we are more specialized, each medical professional offers much more circumscribed care.
Limited resources and high-risk patients are a challenging combination for a visiting doctor not used to similar conditions. For example, an ultra-sound may not be readily available. Or, in another example, the whole idea of [fetal] viability, that was the first big shock to me — that a 30-weeker may not be considered viable. Back home, we’re more like 24 weeks.
Steps to do a caesarean section are universal – don’t cut anything, know how to tie a knot — but after being here I can see why surgical camps [where surgeons from abroad bring along their own operating team] work so well because the visiting surgeon transplants himself with equipment and ancillary help, which is totally different from the “let me see what you have” experience of a doctor who arrives on her own, like I did. The greatest hurdle I encountered was the language. I didn’t anticipate what the communications barrier there would be between the patients and me.
What moved me the most was seeing people work together. Especially in emergency situations, pulling together to help someone survive. And the compassion people have for each other, the willingness to pull limited resources together, and that includes the doctors.
I really like that women in Somaliland come together and are really there for the laboring woman. They are THERE from the moment she gets to the hospital to the moment she’s delivered. They eat together and pray together, that sisterhood and that womanhood is something special that you don’t often see in the States. These are strong women, most going through labor without pain medication. Not that they don’t feel discomfort, but they manage somehow.
The best experience I had, I guess the highlight of my stay, was the feeling you get when you think you’ve been able to impart a bit of knowledge or information that someone will be able to use. It’s almost like a relay race and like you allowed it to continue. Demonstrating, or showing by doing, is more useful than simply doing a procedure –and hopefully someone will be a little wiser, more adept, and that new skill can be used in the future.
From a personal point of view, just being in Somaliland, a country that was bombed in ’91 and has been rebuilding itself out of the rubble, has been an extraordinary experience. I’ve never been in a country that had been so freshly devastated. The overriding question in Somaliland and in the hospital, for that matter, is how do we go from here. The streets of rubble, the expats, the [Somaliland] Diaspora coming back…which way is up?!
I will remember Edna’s hospital as a beacon of light, as a dynamic process and as an ever-evolving effort to improve healthcare. The whole experience opens your eyes in a way that an experience in the US or UK just would not.
Dr. Sharan Abdul Rahman
Matriculated at University of Pennsylvania, undergraduate
Yale Medical School and University of Pittsburgh School of Business
By Samantha Heley
I read the book Half the Sky [by Nicholas Kristof and Sheryl WuDunn] and then we happened to learn about Edna’s hospital in a Women’s Studies course at my university. We were learning about different waves of feminism and the discussion turned to feminism in developing countries. That’s when our professor started to talk about Edna and her battle against female genital mutilation (FGM) and oppression of women.
At the time I was a mentor for a group of junior high school girls in a pilot program and the whole point of it was to encourage and empower them to reach their intended goals. And that’s when we happened to be learning about Edna and it propelled me into action – I was mentoring these girls, and I wanted to transfer that to a community setting outside the US. And that’s one of the things I got to do by working with local staff of a small non-governmental organization (NGO) with a focus on women’s health that Edna’s hospital works with.
After I leave here I will be studying international law and human rights. Coming here has shaped my view of what I will be studying. In other words, it shaped HOW I want to address the issue of human rights: I like the idea of working with local governments, as opposed to NGOs because I feel like my experience here showed me that development is really dependent on how well a government operates. One of the issues I think about a lot are human rights — how you give people dignity and allow them to prosper and so much of that is reliant on government. As a lawyer I would like to work with governments in developing countries and consult them on these issues.
One thing I learned that I didn’t grasp before I came to volunteer for Edna is the impact of culture on daily life. In the work that I hope to do, I will have to be very sensitive to the culture I’ll be working in. Understanding and being sensitive to the culture of any given country is paramount before you can affect change or help improve the lives of its people. Before coming here I did not quite grasp how important it is to get involved with a local community and how, in order to do that, you must be responsive the country’s culture.
One piece of practical advice: I wish I had brought more comfy clothes, sweatpants, sandals and casual wear in general.
Samantha Ashley Heley
Student, Bachelor of Sociology from BYU
January 2017- March 2017
Non-medical volunteer. Helped to fine tune administrative record keeping; created HR filing system for employees; did community outreach and trained local staff to ensure outreach becomes self-sustaining.
Samantha Heley at a Hargeisa orphanage. EAUH has recently established a relationship with the orphanage where university students will do community service for extra credit, accompanied by Edna’s volunteers like Samantha.
By Vicky Glover
I learned about Edna and her hospital from an excerpt of Half the Sky that I saw as part of a show at a museum in California. Edna’s message on the video resonated with me, particularly that the fetal and maternal mortality in Africa was so high. I’ve been doing ultrasound for 25+ years with extensive experience in OB GYN.
There is few times in your life that you can actually affect the outcome for generations by teaching. And this was one of them.
I initially emailed Edna and it took me three years following that email to create a meaningful amount of time to make the trip to Somaliland.
Turning thought into actions was inspired by Edna’s vision and commitment to saving lives, educating women, battle against FGM, improving the lives of those who cannot improve their own lives, sometimes by turning one stone at a time.
What I’ve learned since coming here is you must maximize what you have to work with. I always say: I’ve done so much for so long with so little that I am now qualified to do anything with nothing.
One piece of practical advice: Bring something for self-entertainment.
Vicky Glover, 59/Phoenix, Arizona, USA
Registered Diagnostic Medical Sonographer (RDMS)
Registered Vascular Technologist (RVT)
Radiographic Technologist (RT)
Radiology Phoenix, Arizona
Vicky Glover teaches a nurse midwife how to do a sonogram at Edna Adan University Hospital.