Thanks so much to Edna Adan, tireless women's health advocate whose fight to build a maternity hospital in her native Somaliland is profiled in Half The Sky (pgs 123-130), for agreeing to answer Off The Sidelines book club members' questions for International Women's Day.
Q: Senator Gillibrand's Off The Sidelines effort is aimed at getting women more involved in their communities and to make their voices heard on the issues they care about. How did you find the courage to speak out for yourself and then later for others?
Edna: I guess I never had the luxury of being 'On The Sidelines'. From a young age, I learned to read with my male cousins as there were no schools for girls in my country when I was growing up. This made me very competitive. I wanted to prove to the boys that I was just as capable of learning as they were. Later, as I went to school in neighboring French Somaliland (now the Republic of Djibouti), I would go home to British Somaliland during the summer holidays, where I helped my father Dr. Adan, in the hospital.
Although I was only 11 or 12 at the time and knew nothing about nursing or patient care, I was the daughter of the 'boss'. So, whenever Dad would leave the ward or hospital, it was up to me to make sure that the nursing staff followed up on the treatments he prescribed. That was when I realised how little I knew about patient care and decided that some day I would study nursing so that I would be able to carry out the treatments that were needed by the patients.
When I really got Off The Sidelines in a big way was when I started to speak out publicly against female genital mutilation in 1976. Up until then, speaking about such a topic was considered taboo. Everything else after that was easy!
Q: What advice do you have for people who are aspiring to get off the sidelines and make a difference in the world?
Edna: If you feel strongly about a particular situation or practice, follow your heart. Often you will find others who have been looking for the same courage to speak out about the same subject. The more of you who collaborate together, the better and stronger you will be.
Q: Since you have accomplished good works for the women in Somlialand, have other women come forward, asking you, "How can I help empower other women in the communities by promoting education & economic goals that would benefit & enrich their lives?"
Edna: Yes, I often have individuals and groups of women who come to me to know how they, too, can start doing something for their communities. My advice to them is to first narrow down the area they wish to do something about. Secondly, since community needs are always overwhelming, prioritize and focus on the problems or issues they can address with the resources they have. My advice is to start small, use the first project as a learning one, and from there reach out to do even bigger projects. Never take on, from the beginning, a project that is too difficult and which cannot be completed. It discourages the volunteers and creates mistrust in the community.
I always enjoy being invited to the opening or completion of a project carried out by volunteers who I helped before they even got started. When I can, I always make a small contribution to such a project to demonstrate my support for the initiative. Self-help in Somaliland has now become very popular. Many schools, clinics, roads, water wells and other projects have been carried out by Somalilander volunteers.
Q: I admire your devotion in working to stamp out genital mutilation. What made you stay strong and not come unraveled?
Edna: Thankfully, we do not have in Somaliland all of the atrocities mentioned in "Half The Sky" but whatever atrocities exist in a community should be stamped out. The one that exists and persists in my community is female genital mutilation or female circumcision. I rebelled against it first because it has affected me personally, and secondly because I am a midwife and in my profession, I see on a daily basis how women's bodies are damaged by this practice. I guess I just reached a point in my life when I couldn't take it anymore and I just kind of exploded. I have been fighting against the practice ever since.
Q: What were the three most important elements that contributed to making your work on behalf of women and girls successful?
Edna: 1. Access to education in neighbouring French Somaliland, when there were no schools for girls in my native British Somaliland at the time.
2. A rebellious character and the courage to speak out against what I find to be unjust.
3. A father who was a doctor, who did not stand in my way, and who respected by opinion and judgment.
Q: What are the biggest mistakes made by Western aid organizations and philanthropists attempting to improve public health outcomes in East Africa? What is the most effective way the West can help?
Edna: Westeners try to replicate in Africa the public health approaches that work in their own countries. They need to realise that every country has its own challenges and therefore needs to develop its own way of addressing these problems.
Even within each country in Africa, there is a need to adapt or even modify approaches since different communities within a single country may have different challenges and would need different ways of dealing with their public health needs.
Above everything else, helping the community to identify its problems, and then teaching them to come up with workable solutions is among the most valuable contribution that can be given. What must be avoided at all times is to come in and carry out temporary measures to address some of the problems, because this basically creates a situation of dependance on outside help, which leaves the community with the impression that they cannot do anything for themselves without external assistance.
Another thing to avoid is to go into an African country with solutions that have already been developed elsewhere without even knowing what the country's needs are.
Q: How can we help and support the hospital you started?
Edna: A hospital in any part of the world needs help. Our hospital is no different. The most valuable help we could get is to find teachers to help with the training of our health workers. I am of the opinion that the greatest gift that I can leave for my people is the gift of knowledge. I am looking for trainers of nurses and midwives to help us train the future leaders of nursing and midwifery.
We have just started the training midwives to the level of Bachelor's of Science Degree and we are desperate to find nurses and midwives with an academic background, who can teach these bright undergraduates students.
I have two very specific ambitions. First, to train 1,000 public health midwives for the Horn of Africa. Currently we have 63 who are already trained and 45 who are studying. Midwives, who are able to visit rural villages in areas where there are no doctors, provide the best support for pregnant women in these communities. In my opinion, they are the solution to many of the problems women face in Africa.
Second, I would like to develop a midwifery training manual in the Somali language. This could be used by nearly 20 million Somali-speaking people in the Horn of Africa, who cannot make much use of textbooks in the English language. Somali language training manuals would bring knowledge of midwifery to more women and make childbirth that much safer for our communities. But this is far beyond the financial resources of the hospital.
Q: Do you need and accept volunteers at your hospital?
Edna: Yes, we do. In fact, over the past decade we've had 100 volunteers come work with us from the US, Canada, UK, Sweden, Denmark, Norway, Finland, Holland, France, Switzerland, Italy, Japan, China, Ghana, Ethiopia, Spain, Kuwait and other countries.
Since we are a referral and teaching hospital, we prefer to have volunteers who have a medical, nursing or midwifery background. We've also had a few volunteers who came to help in our medical laboratory or to teach English as a foreign language. Others have come to help us sort out and catalogue the books in our library or to assist in our administrative department.
Before we accept a volunteer, we like to have a letter of reference from their university, a teachers or employer.
Q: What is the length of the preferred tour of duty for volunteers, if you have them?
Edna: Any period shorter than two weeks is definitely too short and a waste of time for all concerned. Four weeks or longer is preferred. A few volunteers come for several months and these are the most appreciated as they start an activity and have time to complete it or to see it well on its way to being developed.
Q: How does one apply?
Edna: Many volunteers find out about us through the Internet and the hospital website (www.ednahospital.org). A few learn about us from past volunteers and many have discovered us through "Half the Sky".
Potential or interested volunteers write to me, tell me about their background and the area of work they are interested in or wish to study. I then answer them to let them know whether or not I feel they can learn something useful from us or can contribute to any of the hospital activities.
The placement of a volunteer usually takes several months and many email messages between us. Once the decision is made from both sides, we then start the process of obtaining clearance from the Ministry of Health, if the person is a medical professional, and security clearance from the immigration services to obtain a visa to enter Somaliland.
I sometimes also get messages from parents of potential volunteers who wish to be assured of the safety of their son or daughter coming to us in Somaliland. This is when we reassure them that Somaliland is NOT Somalia and that I would not be there myself if it were not safe for me to be ther
Q: What steps should a young Sudanese woman, raised in an orphanage in Nairobi and educated at Colorado University, take in order to be able to help women and children with AIDS in Kenya? She tried as an intern and found nobody cared about those people and didn't want anyone coming in with new ideas.
Edna: Although I am not familiar with AIDS activities in Kenya, there must be many organizations dealing with women and children with AIDS. Seek them out and offer your help in whatever area of assistance they provide. This will give you an introduction into what AIDS related activities are taking place and from there, identify the activity that appeals to you the most and to which you can make a contribution. Always research and never go into something blindly.
Q: What have you learned from the feminists of the 20th century to help you in your fight for gender equality in the 21st century?
Edna: A woman whom I met during the early 1970s, when we started the fight against female genital mutilation, was Fran Hosken. If you haven't heard about Fran Hosken, please look her up. She wrote a huge report on the countries where this terrifying practice occurs. Fran was a very determined woman who had lived through the atrocities of the Second World War in Europe. I gained much from her courage and determination to fight injustice, and female genital mutilation in particular.
Below you can watch Edna Adan's TED Talk on the health of women and children and the importance of training midwives in Somaliland.