Hamsa Hassam Hussein delivered her baby boy safely at Edna Adan's maternity hospital after arriving critically ill and in her fifth day of labour. Photo: Christian Aid / Georgina Treasure-Evans
'Female Genital Mutilation is also a huge problem which causes massive complications throughout menstruation and childbirth. Infibulation is practiced when the girls are 6-8 years old.'

As part of a series of 60 reports from around the world, surefish looks at the work of Christian Aid partner the Edna Adan Maternity Hospital in Somaliland and asks what Christian Aid's support has meant to its work

The Edna Adan Maternity Hospital is a registered Somali land NGO, with a large board of trustees drawn from different Somali clans and the expatriate community.

The construction of the hospital began in 1998 on land donated by the government and has now been completed. It has been funded from voluntary donations derived from local merchants, the Somali diaspora and Edna herself.

The hospital is not only providing health services, but is also a centre where young women are trained to become health workers.

Christian Aid first supported the Edna Adan Hospital in 2002 with a grant for a six-month midwife training course and start-up supplies.

Mortality rates and mutilation

The 2003 Infant Mortality Rate in the region was 175 per 1000 live births, the Maternal Mortality Rate 16 per 1000 and the Child Maternal Rate 252 per 1000 (1 in 4).

Female Genital Mutilation is also a huge problem which causes massive complications throughout menstruation and childbirth. Infibulation is practiced when the girls are 6-8 years old.

This means nearly all women need an episiotomy to give birth (to be cut open) and complications such as fistular, infections, uterine prolapse or inversion of the uterus, cysts and others.

Despite these complications most of the women said they would practice FGM on their children – because who would marry them if they did not.

This is part of Edna’s work – to teach women about the medical problems and break down taboos associated with FGM. Traditional Birth Attendants need to be trained to recognise and deal with these problems as well – and sensitised so that they too can raise awareness and prevent FGM.

Project information

The hospital started training with a batch of 39 students in July 2000. Some have dropped out due to health problems and other difficulties and there are now 32. The hospital is the only nurse training institution in the country, prior to this there has not been training for nurses and midwives since 1987 in Somaliland, before the civil war.

The training of these students is one of the most expensive activities that the hospital undertakes and it is hoped that the government nurse training school will be rehabilitated and the government will start training health workers again.

The overall goal of the programme is to improve child and maternal health in Somaliland through rebuilding physical and human capital that has been eroded by a decade of civil war. This project will significantly contribute towards this goal.

Interview with Hamsa Hassam (pictured above)

Where do you live and how many children do you have?

'My other children are 2, 3, 6 and 7 years old. I live in Hargeisa with my husband who has no work. We occasionally sell some things in the market at a stall.'

How did you hear about Edna’s hospital?

'I heard about it from friends when my waters broke. They urged me to come but I waited four days. The pain was so bad that I had to come – against my will. I have given birth at the government hospital and also at home – but I will come here when I get pregnant again as the care and cleanliness and the services are all far better.'

How was the delivery?

'Compared to my first delivery this was easy! Then there was no room for the baby to come out so they had to cut me open. The pain lasted about seven days. This time they gave me oxtoxin to increase the contractions and prevent the bleeding. And now I am on anti-biotics.'

What do you feel about FGM now that you have suffered such complications and pain?

'I remember how painful it was and I know the problems but it is a tradition and I will make my daughter have it. It is not a religious thing but a cultural one.'

What do you think about Western women who have not had FGM?

'It is fine – it is not their culture.'

Do you plan to have more children?

'Yes I want ten! It depends on Allah how many I have though. We believe in Allah, not family planning. The woman’s role is to have children. I cope with all my children.'

What do you wish for your children?

'I wish for good fortune for them.'