Somaliland: Every Woman Deserves Obstetric Care Fit for a Queen


By: Edna Adan IsmailDr Edna Aden

Somalilandsun – It’s been a little over a week since Britain’s royal family welcomed their newest addition to the world. Living to see Week 2 is a cause for great celebration here in the former British protectorate of Somaliland, as it is in many places where mothers and babies are lucky to survive childbirth.

As a midwife of more than fifty years and founder of my country’s first maternity hospital, I have seen how easily joy can turn to grief and tragedy when expecting mothers lack access to the expert medical care the Duchess of Cambridge received (and that many women in developing countries take for granted). Giving birth is a difficult business for all women — that’s why it’s called labor. But for tens of millions of women around the world, too often bringing new life into the world means risking their own.

Women in my country have a one-in-ten chance of dying in childbirth. In developed countries, it’s closer to 1 in 4,000. Access to trained midwives and doctors is quite literally the difference between life and death. The future King of England was delivered by two expert gynecologists. That’s the same number of gynecologists who practice in all of Somaliland, population 3.5 million. While women in the developed world receive medical care throughout their pregnancies, only 9 percent of Somali births are attended by a trained professional.

It’s no secret that in the Horn of Africa, life is hard. We have survived famine and poverty, battled warlords and even pirates. So what does it tell us that in one of the most dangerous places on earth, the most dangerous thing a Somali woman can do is become pregnant? The crisis of maternal mortality is not unique to Somaliland, or even to poor countries. In Afghanistan, giving birth is 200 times more likely to kill a woman than bullets or bombs. Even in the U.S., the maternal mortality rate has doubled in the past 25 years and is creeping upward.

Our women are dying of causes that no woman in this day and age, when man has reached the moon, should die of. According to the UN, a woman dies every 90 seconds of pregnancy-related causes. That’s 1,000 women a day. That is too many lives lost, too many homes and communities left without their central pillar. When a mother dies in labor, her child is significantly more likely to die before the age of 5.

In 1960, I became Somalia’s first qualified nurse midwife after spending seven years studying in the UK thanks to a Colonial Welfare and Development Scholarship. I trained not too far from St. Mary’s Hospital in London where the Duchess of Cambridge gave birth. I felt an obligation to give back to my people, to spread the life-saving knowledge and skills that I received. I joined the World Health Organization and was responsible for the training of nurses and midwives in 22 countries in and around the Middle East.

After retiring from the UN, I returned home to Somaliland to build my own hospital, the Edna Adan Maternity Hospital, which opened in 2002. Since then, the hospital’s nurses and doctors have delivered more than 14,000 babies, performed several thousand general surgeries, and trained over 800 nurses, midwives, laboratory technicians, and pharmacists.

I’m proud to say that we have cut maternal mortality to a quarter of the national average, largely through training of midwives, improved prenatal care, early referral, and immediate response to obstetrical emergencies. If we can do it here, with our limited resources, it can be done anywhere. It is simply a matter of will. 300,000 maternal deaths a year are preventable. But governments must decide that the health of their mothers is a worthwhile investment.

I and everyone at the Edna Adan Hospital send our blessings and wish proud parents William and Kate great happiness as they bring home their bundle of joy. My greatest wish is that one day every mother in labor will be treated like a queen.

Edna Adan Ismail, a former First Lady of Somalia and Foreign Minister of the self-declared state of Somaliland, is founder and director of the Edna Adan Maternity Hospital.

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