Report From Edna Adan Hospital

From Dec 28, 2013

Judith-ThompsonJudith Thompson is an Australian nurse, trained in London, who was actually born in Hargeisa. She came back in order to volunteer at Edna Hospital, and here is her report on her time spent with us. She brought along her husband, Dr. Rod Thompson an orthopaedic surgeon; a bunch of medical supplies from Australian Doctors for Africa; and enough money to fund the construction of our new Radiology Unit. Here is Judith’s story.

I am blessed and privileged to have been taught by and inspired by many strong women with common sense, intuition, and compassion. They include Nightingale nursing tutors and ward Sisters, Dame Cicely Saunders Palliative Care, Sister Kilian, compassionate, intuitive St John of God Sister. Inspired also by strong Cockney patients, and as a pupil midwife the long suffering Docklands mothers as I pedalled my bike complete with black delivery bag around Rotherhithe.

I absorbed more as ‘Sister Julia’ from the sometime stoic, sometime violent patients in the frantic Kings College Casualty through the Brixton riots, bombings and train crashes. Moving to Country Western Australia in 1982, I am also inspired by the coping mechanisms of suffering women, country, farming and pioneering and the strength of couples struggling with infertility.

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Somaliland’s Edna Adan is another hugely energetic, truly inspirational woman. We were both born in Hargeisa Hospital, in 1951 and 1937 respectively. I was inspired by my Colonial Service Father John Hunt, who wrote the still widely used General Survey of British Somaliland. She was inspired by her Doctor Father training as a nurse and midwife at Borough/ South Bank Polytechnic London where I did Clinical Teaching. I always meant to return to Somaliland but it has taken a long time.

Edna, now aged 76, is not the typical, subservient, fatalistic Muslim, Somaliland women. She has been Foreign Minister in her own right, Prime Minister’s wife, and worked for the World Health Organization (WHO) for years. Edna is an outspoken pioneer in the struggle to abolish female genital mutilation, and change the tribal rape laws, but her primary mission is to improve the health of Somaliland women.

Refugee Camp

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Most of Hargeisa was destroyed by the Somali Civil War and all the Health Care workers fled. On retiring from the WHO, Edna spent her savings and pension on building a hospital for her poor people, opened in Somaliland’s Health statistics are amongst the World’s most dismal, reputedly both 1 in 8 neonatal and maternal mortality rates. Somaliland (the old British Protectorate) is recognised by the UN as an autonomous stable state but not a sovereign entity.

Pleas to be recognized as an independent country are ignored. Somali piracy, bombing in Mogadishu’s Turkish embassy, the Al Shebab attack in Nairobi are all shocking atrocities in which Somaliland wants no part. The World draws its collective breath and looks the other way. Medcins sans Frontier have pulled out and currently there are 200 polio cases in Somalia with minimal healthcare and now no International Aid. That is a world problem!

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Judith Thompson with Dr. Rod Thompson

My husband, Rod, an orthopaedic surgeon and I had been in contact with Edna by email for a year. “Come, I need midwives and have plenty of orthopaedic patients, but no instruments!” What to do? We had a Sundowner / fundraising party at our home, mobilized longsuffering, good friends and family to cook and serve, Vintage Rock Band to play, a dancefloor, artwork and wine to auction and raffle and begged for donations.

Donated medical supplies from Australian Doctors for Africa

Judith-Thompson-5We thank all of our generous supporters. Most of the funds raised are building the new Xray Department at the Edna Adan Hospital, which we were able to inspect daily as we could see it from our bedroom window.

Huge excitement also as we received a container of Medical equipment shipped by ADFA including donated and purchased instruments we’d collected. Rod also carried in a case of surgical instruments.

Edna is a brilliant woman with a wicked sense of humour, huge energy and charisma. She is the director, matron, engineer, architect, teacher, spokeswoman on Women’s Rights, sometime rally driver, farmer, water diviner. She bought a farm 40kms out next to the CocaCola plant (the only hi tech laboratories and green lawns in Hargeisa) to sink a well. 2 trucks of water daily supply the hospital. Sometimes the taps are empty. Sometimes there is no power so she is working on solar power.

Edna plays hostess to the itinerant band of AID workers within her flat on the second floor of her hospital and we are virtually under house arrest as she cannot risk any AID worker being hurt. Edna presides over a United Nations Table d’Hote, including Somalilander Doctors, Ethiopian pharmacists, and Public Health Lecturers, Kenyan anaesthetists, a Dutch medical student, Swiss FGM researchers and we 2 Australians working under the auspices of ADFA, Australian Doctors for Africa, a Perth based charity. There is always plenty of goat stew, spicy goat livers, rice, water melon and oranges from her farm. The food is cooked downstairs outside on open charcoal braziers.

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Being shown around, we saw Edna in full flight multi-tasking. First the Xray department being built from our fundraising. [See HERE for Construction Photos]

“No, too narrow for trolleys, move that pillar!” Before rushing off to harangue a man unloading matresses from his car. “Of course I always have room for the patients and their carers. NOT room for these bug infested things. OUT!”

Inside the hospital she is attending a patient waiting for minor surgery, before berating staff for not having an emergency theatre available. In the Maternity Ward she was busy fixing a baby on a breast whilst scolding and demanding the midwives give some hands on care and empathy in the delivery room. She spoke, everyone jumped!

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Edna driving through Hargeisa’s filthy streets, trees adorned with various coloured plastic bags, mercifully not stinking as the goats had done their scavenging, recycling work. Shooting through potential spaces, ostensibly driving on the right, but many cars so old they are still left hand drive. Brightly clad smiling women alighting from buses in the middle of the road, traffic converging from all sides including donkey carts laden with water drums, apparently suicidal goats meandering, lorries with highly decorated windscreens almost obscuring all vision, laden with people and bunches of yellow plastic water containers of all sizes and shapes. Every few minutes someone would recognise our driver and the chant would start “Edna, Ha Edna!” Everyone knows and loves Edna.

Only once did I see a shadow of concern. Driving through the maze of narrow dirt tracks and pathetic humpies of the refugee camp near her hospital, the crowds looking pretty hostile. “Bother, Now I am lost!” says Edna. Suddenly, an urchin shouts “Edna, Ha Edna!” The mood changed, everyone was laughing and shouting, directions were given.

Somalilanders shout all the time in person and on the phone, sounding aggressive, but the conversations usually end in smiles and hugs, Edna tells us it is because they are nomadic people with their camels wandering the desert far apart.

Edna’s mobile rings continually. “Edna, the light bulb is broken.” “Edna, there is no water.” And from her farm, “Edna there is a snake in the room!” “What do you want me to do? You want to hold the mobile phone next to the snakes head and I will ask him to go away?” I hear the tirade down the phone.

When we did get out, it was with an armed guard Askuri complete with loaded AK 47. I felt most at risk as he sat next to me tapping it on my foot. Or when Edna, who wasn’t impressed by the need for Askuris, ensured they earned their wages by picking oranges, digging, weeding, all still with AK 47 nonchalantly slung on the back.

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Boys Do Clean

My aim was to get daily cleaning and emergency equipment checked. I typed out small lists attached to the drawers in Labour Ward, Operating Theatre, Special Care.

The nurses do the best job they can with the knowledge and equipment they have, and serving as a Regional Centre, the serious condition some patients are in when they arrive, some having travelled for days. It must be difficult having yet another new, well meaning Aid worker arriving, scolding, dogmatic, preaching and with new priorities. You don’t change the World in 5 minutes and Edna taught me.

“Baby steps.” Firstly I had to get the trust and respect of the Midwives, teaching by example, turning up each day still cleaning and advocating basic ABC and care. They would laugh saying “We cleaned yesterday” and I’d say, as I watched another fly buzz inside the incubator, landing on the 28 week premmie’s face, “Yes and we clean again today!’

And then there was “Boys don’t clean.” That was a learning curve! They found with me that “boys DO certainly clean”. And of course they make very good caring nurses too.

Many patients had little education and certainly no antenatal care. I nursed pathetically grateful fistula patients and at least two with full blown eclamptic fits every week. Edna took us out to breakfast to celebrate Eid, the end of Ramadan, everyone dressed in their bright finery. Everyone, including Edna was giving out little presents of money to children and those whom have helped them during the year. Returning to the hospital, I found a packed delivery ward. Three mothers about to deliver, each with between 2 and 8 female attendants milling around. 6 emergency C sections in that 24 hours.

Judith-Thompson-9Prem baby with respiratory distress syndrome and severe rib recession. Finding one woman, bandages on her hands and cottonwool up her nostrils, I thought I had the wrong patient. 34 weeks pregnant, painlessly bleeding for a week, she had continued cooking, sweeping and fetching water. She had no platelets. Her Hb was 2.1 and amazingly she and her baby survived. 5 Premature babies less than 28 weekers in Special Care, with only 1 phototherapy unit, 2 incubators and one “hot box” (warming electric light bulbs underneath, but you had to be careful, not TOO warm.)

The babies had CPAP continuous positive airways pressure with oxygen nasal prongs, one end bubbling through an ordinary water drink bottle. Whilst bubbling it was working! Reciprocal learning, we worked together and learned from each other. Necessity is indeed the Mother of Invention.

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Edna took us to the gala closing of the International Hargeisa Book Fair. Firstly, the panel consisting of cabinet ministers, Doctors, Sultans, elders, tribal leaders, religious leaders and lawyers, apologised to the huge crowd in attendance. “Now you are all here, we have to talk about two very important women’s issues, FGM, Female genital mutilation and rape. Please listen. FGM must stop and if a 13 year old girl is raped, then the ridiculous tribal law says the man who raped her must marry her must stop.”

Edna gave an inspirational, impassioned speech which was well received, loudly cheered and applauded. All the leaders were agreed. Edna remains optimistic for the future for women in Somaliland who need education and healthcare. She needs help, support and a succession plan. Edna is an energetic, vibrant, inspirational lady with a brilliant mind and the compassion of a midwife. I am humbled to have helped her just a little.

Further donations to an ongoing worthy cause are always welcome and can be made fully tax deductible through ADFA Australian Doctors for Africa a Perth based charity, now, excitingly, recognised by Ausaid.



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