PODCAST: The Edna Adan Hospital

Solveig Rennan
Welcome to Under-Told: Verbatim. I’m Solveig Rennan for the Under-Told: Stories Project. We report from all over the world for PBS NewsHour, we’ve talked to experts and people making a difference in their communities. In this podcast, we’re revisiting those Under-Told stories to share extended interviews we’ve done with changemakers around the world.

Being pregnant should not be a death sentence. But for one of every 12 women in Somalia, it is. One of every eight newborns does not make it to age five. Somaliland lies in the northwest corner of Somalia. It declared its independence three decades ago, but it’s not recognized as a country by the international community. It is recognized for making some progress recovering in a land shattered by decades of civil war.

Edna Adan
hamdulillah.

Solveig Rennan
One of the anchors in this rebuilding effort is the Edna Adan hospital, which has safely delivered thousands of babies, treated their mothers and trained hundreds of nurses and midwives.

Edna Adan
I don’t think I could have gone to a PhD course to learn how to do this. I think it’s life that has taught me

Solveig Rennan
Edna Adan is not a doctor, but her life includes a career with the World Health Organization, a twice divorced former first lady of Somalia, daughter of a prominent physician, Adan spent many years in exile, including early on in neighboring Djibouti, where she was educated. Sitting in her office in Hargeisa, a dance spoke with our director Fred de Sam Lazaro in 2017 about her life, her hospital and her vision for the future of Somaliland.

Fred de Sam Lazaro
Why don’t we begin with I guess the chronology more than anything else, you were a pioneer in the sense that you were given the chance to have a career. Yeah. And you undertook to, to go to Britain to study

Edna Adan
We were British Somali Protectorate and the British had a system where, whereby they would send young boys who had succeeded, who had gotten good grades in Intermediate School, to be sent abroad for the secondary school education. And I happened to be the first girl who was given that opportunity to sit for that examination, to compete for a scholarship. The first year I passed, but I was still too young. And my English wasn’t good enough. So it was postponed for me to sit for the exam the following year again, and if I pass then I would get a scholarship. And I did. So in 1954, I flew from Hargeisa airport. Together with another girl from Aden and were sent to England that’s that was the beginning of my seven years in the in Britain.

Fred de Sam Lazaro
So you spoke French obviously in Djibouti or that’s where, so you were educated but did you speak English in the house? Were you taught English? Your parents?

Edna Adan
Some spoken English, yes. Because my parents spoke English as well one particularly when they did not want us to understand.

Fred de Sam Lazaro
So you had a functional

Edna Adan
I had a functional English, but not an English good enough to go to secondary school

Fred de Sam Lazaro
until you went for the

Edna Adan
Until I went to England when I did a pre nursing course because A. I was too young. B. my English wasn’t good enough. And C. I didn’t have my O levels. So that was an arrangement that with your pre-nursing course that was an equivalent to the O levels. Um, loved it. It was a great college, thousands of students, different departments learnt so many, made so many friends. And after the first year that, you know, the British Council were my, you know, the grantees of the scholarship and my reports would go to them and progress or otherwise. And the first year I was offered to do medicine, they said, well, you’re getting good grades. We’re very happy with your progress. And you may want to know that if you would, you would wish it you can apply for medical school. And being the stupid pigeon brain that I am, I said, seven, eight years? Nah, I’ll be too old, who will marry me then? No, no, I’m going to stick to my nursing three years. There are many days that I wish I had done medicine. And there are many days when I feel that I am glad I did not do medicine. Because if I had not done midwifery, I would not have done this hospital. And I think medicine might have taken me away, too far away for me to come to come want to come back. So I don’t know. I love my nursing. I loved my time in England, I learned so much.

Fred de Sam Lazaro
But it wasn’t your your intrinsic content of your training that made you come back here was something

Edna Adan
Oh, no, no, no, it was it was Oh, that

Fred de Sam Lazaro
might have happened regardless right.

Edna Adan
Now that this happened because as a young girl, I made this promise to answer. This had been my life, something that traveled with me all my life and whatever I did, and whatever I started, I was oh, that I’d like to have when I have my hospital. So I was going to have that hospital anyway, from age 11. Where, how, when I didn’t know and I had come out of, well, you know, I’ve had my ups my downs, political prisoner, my divorce, my marriage, my divorce again, whatever. I started to build a hospital in Mogadishu. I was, tell you what what made me want to revive that in me: I was working in a hospital in Mogadishu, the Medina hospital which now I think treats casualties there. So great hospital, built by the Italians, and I was in charge of the OBs and GYN. And one particular day there was a patient and there was a doctor who will remain unnamed. Who I can I call because this woman had a previous cesarian section, it was a definite c section today, this time also. I called him we got the theater ready. And he sneaked out. Didn’t tell me where he was going. He closed his telephone didn’t go home because whenever I called there were no mobiles. In those days when I called home he wasn’t home, whether he was or not, his wife said he was not and I had to get that baby out by forceps which is a very dangerous thing to do when somebody has had a cesarian section. Another cesarian section was the course of the intervention. Luckily, they made it, but by the grace of God, so I wrote a letter of, I resigned. I said, Unless corrective measures are made, disciplinary measures are taken against that doctor, I cannot work here, I will not work and nothing was done about it. And I said, Well, that’s it then that I’m going to build my own. We’re gonna have discipline where things are going to be done the right way. So that was again what made me build the hospital at that time in 1982. So started building it piecemeal, a bit by bit a bit you know, in the land. Compact Whatever doing the perimeter wall, getting water to it slowly, slowly everything I had was gone was taken by the by the revolution anyway the Marxist revolution took our home and our property but whatever I could put together I was working and then the second and then I got an I got called back by WHO so I went to the regional office but back to my UN career, which is good because I’ve got some money and and the war broke out in Mogadishu. I evacuated my family. I was already living in Egypt. So they again the second time, took our property and took my hospital which was a construction site. But which had swallowed over $150,000 That’s it. All my life. I had wanted to build a hospital. I did this. I put a lot of energy and a lot of my resources into it. This is what’s happened to it. I Have the deeds I have the documents I have the rights I have the right to be its own it. And somebody with a gun has it today. That’s it. turn my back on that. And I was never going to think about a hospital again. And then I came to Somaliland, I came to Hargeisa, my hometown. And so what had happened in the Civil War with Somalia, how they had destroyed my country, how they bombed it, how they left land mines, and that brought it back. I’m gonna do it again. But this time is going to be at home. And that’s, that’s where we are. And I’m so happy that I could finish it. And it’s 15 years old now

Fred de Sam Lazaro
you decided to invest in in healthcare here. What was the condition of maternal and child health

Edna Adan
very bad. Most doctors had fled. Some had been killed in the war. hospitals were destroyed the hospital government hospital, which at one time carried my father’s name was destroyed. People were being attended by anybody who had had babies themselves and say, Oh, I know I’ve had two babies. I’ll help you deliver yours. or neighbors or friends. We’ve had a patient here, who has been delivered by her nine year old daughter. It was the country was destroyed. leveled to the ground. No building standing, land mined. There were about 15,000 people living in Hargeisa, it was a ghost town many of the streets so the areas of Hargeisa you could not walk in because of the landmines. And the hospitals were full of squatters and goats. I’ll show you a picture of a goat in a hospital ward. That’s was one of the things that made me come back, that goat. And I’m was working in Djibouti as a WHO Rep. I have a very, very envied position, a very senior diplomatic position. I’m, I’m the Dean of the UN staff. I make several thousands of dollars a month. I have a staff I have. I have all the confidence somebody could wish for. I have the political power of the WHO representatives. I know I represent an organization that has clout in health services.

Fred de Sam Lazaro
UN agencies are very influential in these parts.

Edna Adan
And Djibouti having been my first, the country that had given me an education. I felt that it was not a job. It was my duty, it was giving back to the people of Djibouti. And it so happened that I went to I was transferred to Djibouti in 91. Because everything around the whole of Africa had broken down. Somalia, Somaliland had broken down. Ethiopia, the you know, the Mengistu Haile Mariam regime had collapsed, the Eritrea Ethiopian war. In Yemen, there was the Yemeni civil war there, you know that there were refugees all over the place. There was an internal conflict in Djibouti itself. We had outbreaks of cholera, we had outbreaks of disease. And that was a time when WHO transferred me to Djibouti because they needed someone who would go there one day and start working the next day. I speak the language I speak speak French I speak Somali, I had been there I know the people I have, I’m, you know, respected and and, you know, WHO wrote in their crystal ball and said I think she’ll be the right person there. And for me it was the right place because there’s so much that needed doing and the more I do the more I love it. And I was able to do a lot for Djibouti and I feel I’m, It was I who was blessed to be able to do that. And each time I came to my country, Somaliland, and then Somaliland was also added to my plate. I also was looking after Somaliland, the sub office in Hargeisa. And so I de-mined my house. that, I was coming back to build my dad’s house. So the first thing I did was I built my father’s house.

Fred de Sam Lazaro
You mean rebuilt what was standing there?

Edna Adan
Oh nothing! no, no bulldozed, de-mined and started from scratch. And I think that was also the first umbilical cord that reattached me to Somaliland because I was coming back very often, and I was getting closer to my retirement, and that’s how I decided that this is where I’ll do my, I could retire in London and live with my sister and die of boredom, or go somewhere else, but I felt this is where I this is where I belong and this where I should come back and I did, and I’m glad I did. So I got the land.

Fred de Sam Lazaro
You got the land and you put some of your or all of your?

Edna Adan
For me everything I have, everything’s got into it. Everything I have went into it. And and more. And I when I ran out, A lot of people from from town from the, a lot of merchants from Hargeisa helped me out. All the construction, the scaffoldings and all those cranes and stuff, which I normally would have had to buy, were donated by one man, one merchant, who also donated a couple of times 200 bags of cement, whatever. One donated all the steel bars that went into the concrete. Somebody would say use my pickup trucks. Somebody would give me the municipality gave me 30 truckloads of sand, dirt, for the construction. Laborers would come and volunteer work for me for nothing. The government gave me the land.

Fred de Sam Lazaro
So you were in the right place the right time.

Edna Adan
And then when it still didn’t get finished, because it was it this is a big, hungry monster. Big hungry monster for concrete and cement. Then I went to fundraise. I went to Canada to the US to UK to the Scandinavian countries and Somaliland, Somaliland people in diaspora, would do fundraising events for me and I would get $2,000 here and I would fly to another place and I’ll buy another ticket and I’d get another 3000 there or 1000 here. That’s how I, that’s how it was built. And then the Friends of Edna hospital, a group of the women got together and set up a charity. And all the tiles, all the doors and all the winners, were fundraised, were done with fundraising, done by those women in Connecticut.

Fred de Sam Lazaro
Did you have a grand plan and a vision of what this would look like ultimately? Or was it incremental as you went?

Edna Adan
No, my original plan was big, according to my my husband’s eyes, but it was small according to what it is now. So when this main building was built and my outpatients was one of the rooms downstairs, I had a delegation from USAID. And where do you do your outpatients? and it’s some very crowded little home. and they went back and said, I think we can, we can help you with that. We’ll build an outpatient. So they sent somebody out here who spent a couple of weeks with us to do a needs assessment. And that person was decided that it would be the outpatients, what was the help I needed most and I said well outpatients.

Fred de Sam Lazaro
You mean structurally unsound?

Edna Adan
Structurally sound. So I have to put it down before it kills somebody and do the foundation again, and then rebuild. How I don’t know. Hopefully USAID will come back and help me one more time. But I won’t hold my breath

Fred de Sam Lazaro
To people who are mindful of what it takes to improve people’s lives to eradicate poverty to deal with disease. How can you keep but feeling that anything that succeeds in development endeavors are just pure accidents. So I mean, is there a perverse sense of, you know, just happy coincidences and there’s a miracle happening here and one there and one, the one elsewhere

Edna Adan
No, I don’t think well, I’m sure miracles do happen because this in itself is a miracle. But there’s also the reality and I don’t think I don’t think I could have gone to a PhD course to learn how to do this. I think it’s it’s life that has taught me it’s the circumstances of my people that has taught me and that has shown me that we determination I can get the, you know that you should never start something unless you pretty sure that you can finish it. And throughout my life, I’ve been in situations where there has been a need to think and to do what is right, and with whatever you have. So learning to adapt, learning to use what you have, trying to make what you have lost as much as you can deal with people who are opposed to what you’re doing, because at the end of the day, I’m a woman, what business do I have to be building hospitals. Why can’t you get your male relatives to build that? Well, because simple reason they’re not as crazy as I am. I’m the only crazy person in my family to want to do that. So and the more they say that you cannot do it, the more you want to do it and you want to prove them wrong. And you say, Well, if there’s no there’s one thing I’m going to do, I’m going to prove you wrong. That’s how you build up and then you you learn to feel things. You you, you find yourself in a privileged position and you say well, now what I could have been that girl. I could have had Cesc, you know, I could have had a fistula, you know, up, you know, rectum and my bladder blown away. I could not have had an education. I could have been her. There was a time when I was young, as young as she was. So I’ve had privileges that have given me advantages, but then there’s I think it was an inborn. It was those early years of that giving, and doing and managing with what we had what he had. I think that also had an influence on me.

Fred de Sam Lazaro
I guess part of one way of asking this question is is it in the DNA

Edna Adan
I think it has to be in your DNA and you learn from people

Solveig Rennan
One thing Edna Adan says is in her DNA is campaigning to end female genital cutting or mutilation, a practice the UN estimates is performed on up to 3 million girls each year, in parts of Africa, the Middle East and Asia. Adan says she sees the harmful health consequences of this traditional rite of passage in many of her patients

Edna Adan
It has no place on this planet. It should not happen. All these damages. We’re fixing all the things are done wrong to those kids, when they were seven or eight.

Solveig Rennan
In a tradition bound patriarchal society with many decisions being made by men, she tries to advocate within the system

Edna Adan
And my mission now is to talk to fathers. I’m blue in the face talking to mothers, but the influence lies with a man and for this work, I will give credit to the men because when the father says no, usually it works. So how do we get the father has to say no? Every Father loves his daughter. Every father looks forward to having grandchildren from his daughter. And every father should also be concerned about how his daughter is brought up. And if, without his knowledge, and because somebody told him that it’s good for his daughters for the daughter to be mutilated, and cut up and damaged, to the point where she will not be able to give birth to children and his grandchildren, men usually understand. And I think the biggest time and energy and resources should be spent now. Men have had it easy for centuries, say ah it’s a woman’s problem. Now, I’ll come back when you finish talking about those issues. Now we say no, no, you sit down because you’re the father of thi girl. It’s your child who’s being mutilated. And I hope men will rise up to that occasion and defend and protect their daughters,

Fred de Sam Lazaro
But it’s the mothers who are taking the daughters to have this

Edna Adan
If the father says, no. He puts his foot down. There will be a chance that some of these girls would be saved. And I’m a great believer in the Ghandi philosophy. Half a loaf is better than no bread at all. So if I say 50% of the girls of the father’s helped me to save 50% of the girls, I’m still a winner.

Fred de Sam Lazaro
Final question.

Edna Adan
Yeah

Fred de Sam Lazaro
Has to do with succession.

Edna Adan
Who says I’m going away?

Fred de Sam Lazaro
I’m sure you live to 120

Edna Adan
25, God, don’t rob me of the last five.

Fred de Sam Lazaro
It’s your call, because you’ve called so much. Are you concerned?

Edna Adan
I am very concerned, like a mother. I’m a like a mother who’s going away on a long journey. And I have patients, and I have 1000 students, and I have 800 graduates from various courses, and I have thousands of people whose lives I’ve touched, either through the media, through classrooms, through speeches, through encounters, through word of mouth. And they’re all my children. And I’m still looking for someone who’s crazy enough to say, I look after them for you, the way you did.

Solveig Rennan
Our interview with Edna Adan was originally featured in our story called One Woman’s Life Saving Maternity Care, which aired on PBS NewsHour on August 10, 2017. To check out the full story, go to under told stories.org This episode was hosted by me Solveig Rennan and produced and edited by Simeon Lancaster. The interview was conducted by our director Fred de Sam Lazaro. Our next few episodes will explore bringing water to the Navajo Nation.

George McGraw
We’re looking at about 70,000 people without access to water sanitation

Solveig Rennan
and HIV prevention with the condom king of Thailand.

Mechai
We say it’s like a relay race. Whatever we received, we must pass on to others.

Solveig Rennan
You can find every Under-Told: Verbatim episode, virtual reality 360 experiences, and our entire library of under told news reports from around the world at under told stories.org Under-Told: Verbatim is brought to you by the Under-Told Stories Project at the University of St. Thomas in Minnesota. As always, thanks for your support.