Edna Adan Maternity and Teaching Hospital, Hargeisa, Somaliland

Hospital Profile

The Edna Adan Maternity and Teaching Hospital is situated in Hargeisa, Republic of Somaliland.

The hospital is a non-profit charity that was built by Edna Adan Ismail who donated her UN pension and other personal assets to build the hospital in order to address the grave health problems that endanger the lives of women and children in the Horn of Africa.

The construction of the hospital was started on the 1^st of January 1998, and as it progressed, private individuals, business people in Somaliland and elsewhere, as well as international organizations, also made valuable contributions enabling the hospital to become functional on the 9^th of March, 2002.

The Project has the approval of the Government of Somaliland, and the Local Government of Hargeisa has donated the Land that measures 9,600 Square meters. The hospital is on the main road near the Bank of Somaliland at Dumbuluq, and is located in a less affluent area that contains a third of the population of the city in a part of the town that has never had a hospital in the past. The site is centrally and conveniently located, is well served by public transport making it easily accessible for emergency referral.

The Hospital is supplied by the city piped water supply and to the city electricity power. The hospital also has its own electricity back-up generator.

The Hospital started with 25 maternity beds. However, as the need for hospital beds became pressing, and as personnel became trained, the hospital services expanded to accommodate and additional 8 paediatrics and 13 medical and surgical beds, and a Private Room. The present total capacity of the hospital, including newborn babies, is 69 patients. While the hospital became fully operational on March 2002, the training of Nurses and Laboratory Technicians was in progress while the hospital building was under construction

Mrs. Edna Adan Ismail (who was appointed Minister of Social Welfare in August 2002 and then Foreign Affairs of the Republic of Somaliland in May 2003) is the Director of the Hospital and runs the Hospital activities with appointed Deputy Directors and the Hospital Administrators.

An 18 Member Honorary Board of Trustees, consisting of persons of good standing, and from different nationalities and clans of Somaliland, have been identified and invited by the proprietor, Mrs. Edna Adan Ismail, to advise on Management and verify to the Authorities the Charity Status of the facility as well as to scrutinize Auditing results.

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COUNTRY BACKGROUND

The Republic of Somaliland, formerly British Somaliland Protectorate, became Independent on 26/6/1960. It merged with the former Italian Colony of Somalia when it too became Independent on 1/7/1960. This merger was, however, doomed from the start because of economical, cultural and administrative differences and problems that made themselves felt very soon after the union of these two Somali Nations. As a result, the people of Somaliland took steps to disassociate themselves from Somalia as early as in 1961. Regretfully, it took a long and protracted civil war between the people of Somaliland and the troops of the former Dictator Siyad Barre, for the sovereignty of Somaliland to be finally restored on 18th of May 1991. During those years of struggle, the cities of Somaliland were bombed and ruthlessly blown to bits, over half a million Somalilanders lost their lives, and millions fled the country to seek refuge either in neighbouring countries or elsewhere in the world where they could find shelter. These vicissitudes have been well-documented by the United Nations and other International Human Rights bodies who have witnessed the extent of the destruction the entire country had suffered and also how its schools and health services were razed to the ground. An added tragedy was the death or disappearance of trained professionals who had served in the health services of the country. The result being that those health facilities, which recently have been rehabilitated (meagre as they are), suffer from a serious and ongoing deficiency of trained health manpower.

HEALTH PROFILE OF THE PEOPLE OF SOMALILAND

The health of the people of Somaliland is among the worst in Africa. This statement is supported by the fact that even before the civil war and the separation of the two Somali states, Somalia had one of the highest Maternal and Child Mortality rates in the world (Ref. UNICEF, The Progress of Nations, 1997, 160 maternal deaths per 10,000 live births). 

While recent valid data is not available, what national Maternal and Child Mortality rates have become after the destruction that has taken place in country is a frightening thought.

SERVICES PROVIDED BY THE HOSPITAL

Since the existing Public Maternal and Gynaecological facilities were over-crowded, ill-equipped and under-staffed, the establishment of the Edna Adan Maternity Hospital has provided much needed Reproductive Health Care to meet the requirements of the expanding population of Hargeisa and in the rest of Somaliland. The Hospital was designed to be run according to strict internationally accepted standards of Maternal and Child Care. With the services and supervision that is carried out by highly qualified Medical, Midwifery and Nursing personnel, it is possible to provide patients with the type and quality of personalized care that women and their babies everywhere have a right to expect.

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It is gratifying to note that during the short time that the hospital has been functional; the facility has become a referral hospital for obstetrical emergencies. Cases with severe complications have been received from a wide geographical area in the Horn of Africa, including from all parts of Somaliland, Somalia, as well as from the 5^th Region of Ethiopia.

Maternal Mortality Rate of the patients referred or admitted to the Edna Adan Maternity Hospital from March 2002 to 31 December 2007 has been dramatically lower than the national rate and has been 30 deaths out of the 6950 women who were delivered, or who were referred to the hospital after being delivered elsewhere. This makes the MMR for the Edna Adan Maternity Hospital 42.57/10,000. With continued training of personnel, and with better equipment and supplies, we are confident that we can reduce this figure even further.

OBJECTIVES

·        To make available in Somaliland a modern, well-equipped and efficient health care facility that provides a much higher standard of patient care than that which was previously available to women and children

·        To make available a model Health Care Institution, which provides not only good health care, but which also provides Training and Research opportunities to Medical and Para-Medical personnel.

·        To serve as an example to others and thus encourage national as well as international initiatives to invest in health services in order to improve the over-all welfare of the nation.

·        To make available to women and children 69 beds for Obstetrical, Neonatal care and general patient care, including Incubators for premature babies.

·        To make available to women Pre-Natal and Post-Natal outpatient services, as well as Immunization for women and children

·        To make available to women and children, diagnostic Laboratory facilities as well as a Blood Bank for emergencies.

·        To make available Ultrasound and visual monitoring facilities.

·        To make available treatment for Gynaecological problems including Management of Infertility, as well as the diagnosis and treatment of Sexually Transmitted Diseases including testing for HIV/AIDS and providing counselling as appropriate.

·        To make available facilities for carrying out medical research, studies and counselling, with particular attention to the health problems associated with Female Genital Mutilation  (FGM) , as part of the Comprehensive Reproductive Health services that are offered by the hospital

·        In collaboration with the Ministry of Health, UNICEF, and WHO, carry out training programs for health workers, with particular attention to the training of Nurses and Midwives.

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BENEFICIARIES

·        Women of child bearing age, under-five children and  adults  in Somaliland who seek inpatient, outpatient and emergency care in Reproductive Health-related or  other health problems

·        Health workers who are trained or who are employed by the facility, as well as those who practice healthcare throughout the country.

Overview of the Hospital Environment

·        Patients are accommodated in rooms of different sizes to meet the needs of patients with different economic levels. There are rooms with four beds, rooms with three beds and some with two beds. All rooms have bathrooms and toilet facilities attached. All patients are provided with full meals throughout their stay in the hospital.

·        Babies are accommodated with their mother, as the Hospital is a promoter of the Baby Friendly Concept the OPV0 and BCG vaccines are given before discharge. All other types of child immunizations and TT are administered on daily basis at our Antenatal and the well- baby clinics. 

·        Premature babies and those that need special medical attention are cared for in a suitably equipped Intensive Care Unit with Oxygen and Incubator facilities.

·        The Hospital has a Labour observation room as well as a Delivery room so that patients can be provided with the necessary supervision and care during all the different stages of the process of Childbirth.

·        To prevent the risk of infection to patients, all Surgical Instruments, as well as those used for dressings, are sterilized in a Central Sterilization facility staffed by suitably trained technicians.

·        Delivery of the newborn is carried out under strict aseptic conditions and by qualified personnel.

·        At all times, qualified medical and midwifery personnel monitor Maternal and Foetal condition with ultrasound machine 

·        The Hospital has an Operating Theatre and provides surgical facilities for emergency obstetrical interventions at all times. Gynaecological operations and other routine general surgical operations are carried out by appointment.

·        The Hospital has the capability of providing general, spinal and local anaesthesia facilities.

·        The Hospital has Post-Operative observation and Intensive Care facilities.

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Fully Operational Hospital Departments:

1.      Out patient Department

              -    Antenatal and Postnatal care

-          Immunization for <5 and TT for women

-          Health Education on Nutrition, Child spacing and Exclusive Breast Feeding

-          Out-patient services

-          STI  section

-          Ultrasound facilities

      2.  Laboratory

                   -    Routine Analysis and blood tests

-          Blood screening for HIV/AIDs

-          Routine syphilis test for all antenatal cases

-          Blood bank

      

     3.  Inpatient Department

                   -   Medical Ward (Male & Female)

-          Paediatric Ward

-          Observation Room for emergencies

-          Recovery Room

-          Delivery Section & New-Born Resuscitation area

-          Maternity Ward

-          Incubator for Premature babies

-          Operation Theatre

-          Sterilization Room

-          Minor Operation Theatre & Medication Section

-          Oxygen therapy  equipment and Ultrasound Machines

Achievements of the Hospital

As a response to safe motherhood initiatives and the overall aim to reduce the maternal and child mortality, the hospital provides the following services: