Building a System of Health Care in Somaliland

HARGEISA, Somaliland – Each morning at 7 a.m., after sharing breakfast and updates with her clinical staff, Dr. Edna Adan, a force of nature in Somaliland, walks from her modest apartment at the Edna Adan University & Hospital (EAUH) to her office. Her steps are purposeful, as is her mission: to transform the educational landscape and health care in Somaliland. With a legacy stretching back decades, Adan’s remarkable journey intertwines a deep compassion with a sincere desire to uplift her people. Her story is one of resilience, vision, and an unwavering commitment to change.

A Legacy of Healing: From First Lady to Lifesaver

Adan’s path to leadership began long before she established the EAUH. Somaliland’s first qualified nurse-midwife, she was also a former First Lady before Somaliland and Somalia separated. Yet it was not only politics but health care in Somaliland that would come to define her legacy. After spending decades abroad, working with international organizations such as the World Health Organization (WHO), Adan returned home in the wake of a civil war that left her homeland devastated. Health care in Somaliland was in ruins.

The decision to return was a challenging one. “I knew the challenges would be immense,” Adan once said. “But I also knew that my people needed me.” And so, armed with her expertise, passion, life savings, and pension, she built what would become the EAUH in Hargeisa, Somaliland. More than just a hospital, it was a beacon of hope for a nation struggling to rebuild.

A Nation in Need: Somaliland’s Struggles

Somaliland is rich in culture and history, yet it has long been plagued by economic hardship and political instability. For women, children, and young adults, these challenges are especially pronounced. High maternal mortality rates (742 per 100,000 births), child health vulnerabilities, and limited access to education make life difficult for many. For women, the risk of death during childbirth is a constant fear.

Without access to skilled healthcare professionals or emergency services, many women face life-threatening complications. Children like Ahmed, born with a cleft palate, often go without the surgery to lead a normal life. Educational opportunities for young people are scarce, especially for orphans or those from disadvantaged backgrounds. There are many challenges, but Adan saw them not as obstacles but as opportunities for change.

Building Solutions: The EAUH

Adan’s vision for the EAUH was not only to address the immediate needs of health care in Somaliland but also to lay the foundation for long-term improvement. Her approach was comprehensive, encompassing maternal health, pediatric care, general medicine, education and research. The university she founded now has 10 faculties and 400 students celebrated their degree graduation this year.

Maternal Health: A Lifeline for Women

With maternal mortality rates in Somaliland among the highest in the world, the EAUH is the only nonprofit hospital that offers high-quality, affordable services, including free or low-cost childbirth and life-saving cesarean sections for those who cannot afford to pay. The hospital’s renowned undergraduate and postgraduate nursing and midwifery degree programs train local women and girls to address the shortage of qualified professionals in the region.

Pediatric Surgery: Transforming Lives

Ahmed’s life changed the day he entered the EAUH for surgery. Born with a cleft palate, he had struggled to eat, speak, and fit in with his peers. The EAUH is the first facility to offer in-house surgeries for congenital abnormalities like Ahmed’s. These surgeries, performed with the help of international partners, not only save lives but also allow children to reintegrate into society without the stigma of untreated abnormalities. These partnerships bring more than just expertise—they bring hope. With every surgery, the hospital increases its capacity to provide specialized care, ensuring that no child in Somaliland is left behind.

School Health Program: Nurturing the Future

Recognizing the importance of child health in educational settings, Adan launched a school health program that provides health screenings, vaccinations, and nutritional support to the most vulnerable children. By addressing malnutrition and ensuring that children are healthy enough to attend school, the program creates a pathway for long-term success. Halima’s son had been unwell for some time and was diagnosed with Type 2 diabetes through the screening program. “This is more than health care,” Halima says. “It’s a future for our children.”

Education for All: Empowering Somaliland’s Youth

Education is the key to breaking the cycle of poverty and Adan knows this well. The university offers subsidized education to orphans, low-income youth, and those from marginalized communities. By working closely with local orphanages, the university provides scholarships to students who meet academic requirements, giving them the chance to pursue careers in health care, dentistry, education, and more. For students like Ayan, an orphan who now studies medicine at the university, this opportunity is life-changing. “Dr. Edna gave me a future,” she says. “Now I want to give back by helping others.”

The Future of Health Care in Somaliland

The work of Adan and her team is far from over. Every day, her vision grows and the impact of the hospital ripples across Somaliland. Her story, like Somaliland’s, is one of resilience, perseverance and hope. As she often says, “The work is never done. But each step brings us closer to a better future for our people.”

Dr. Fatumo Abdi is based in Hargeisa, Somaliland, and focuses on Global Health for The Borgen Project.

Photo: Flickr