A Woman of Firsts

EDNA ADAN ISMAIL was Foreign Minister of Somaliland from 2003 to 2006, and had previously served as Somaliland’s Minister of Family Welfare and Social Development.

She is the director and founder of the Edna Adan Maternity Hospital in Hargeisa, which opened in 2002, and an activist and pioneer in the struggle for the abolition of female genital mutilation. She is also President of the Somaliland Association for Victims of Torture.

In 2010, she opened the Edna Adan Ismail University in Hargeisa, Somaliland. She was married to Mohamed Haji Ibrahim Egal who was Head of Government in British Somaliland five days prior to Italian Somalia’s independence and later the Prime Minister of Somalia (1967–69) and President of Somaliland from 1993 to 2002.

A Woman of Firsts

Edna Adan Ismail

Copyright

An imprint of HarperCollins Publishers Ltd

1 London Bridge Street

London SE1 9GF

First published in Great Britain by HQ in 2019

Copyright © Edna Adan Ismail 2019

Edna Adan Ismail asserts the moral right to be identified as the author of this work.

A catalogue record for this book is available from the British Library.

This novel is entirely a work of fiction. The names, characters and incidents portrayed in it are the work of the author’s imagination. Any resemblance to actual persons, living or dead, events or localities is entirely coincidental.

All rights reserved under International and Pan-American Copyright Conventions. By payment of the required fees, you have been granted the non-exclusive, non-transferable right to access and read the text of this e-book on-screen. No part of this text may be reproduced, transmitted, downloaded, decompiled, reverse engineered, or stored in or introduced into any information storage and retrieval system, in any form or by any means, whether electronic or mechanical, now known or hereinafter invented, without the express written permission of HarperCollins.

Ebook Edition © July 2019 ISBN: 9780008305369

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This book is dedicated to my father Adan Ismail and to all those, like him, who devote their lives to caring for others with humanity, compassion and kindness.

This memoir is based on my recollection of events which may not be as others recall them. Where conversations cannot be remembered precisely, I have re-created them to the best of my ability. Any mistakes are my own.

The borders of Somaliland

Contents

Cover

About the Author

Title Page

Copyright

Note to Readers

Dedication

Map

Prologue

CHAPTER ONE

CHAPTER TWO

CHAPTER THREE

CHAPTER FOUR

CHAPTER FIVE

CHAPTER SIX

CHAPTER SEVEN

CHAPTER EIGHT

CHAPTER NINE

CHAPTER TEN

CHAPTER ELEVEN

CHAPTER TWELVE

CHAPTER THIRTEEN

CHAPTER FOURTEEN

CHAPTER FIFTEEN

CHAPTER SIXTEEN

CHAPTER SEVENTEEN

Epilogue

Give

Acknowledgements

About the Publisher

Prologue

Mogadishu, Somalia, 1975

‘Come with me,’ I told the military director of Medina Hospital, seconds after bursting into his office unannounced. ‘I need you to shoot a baby.’

The colonel, sitting at his desk in uniform with gold braid and pips on his epaulettes, looked up at me aghast. ‘What?’

Spotting a weapon lying on his desk, I grabbed it and waved it at him. ‘Is this your pistol? I presume it’s loaded?’

‘Y-yes, Edna,’ he faltered, as his lieutenant drew his own gun and stepped forward protectively. ‘B-but…’

‘Then bring it with you, follow me back to the maternity ward, and shoot a premature baby,’ I repeated. ‘Isn’t that what you carry a gun for – to kill people?’

‘I don’t understand,’ he pleaded, palms turned to the ceiling.

Leaning across his desk and staring straight into his eyes, I told him, ‘Then let me explain. I haven’t slept for the last three days. I’ve been caring for a premature baby in the only incubator I possess, a generous gift from a patient. I’ve been feeding this tiny infant through a pipette. She’s a fighter and she’s trying to stay alive but the oxygen level on the incubator is running out. I sent a nurse to you twice this morning to ask for a replacement cylinder. Half an hour ago it was returned unfilled with the message that we’re using too much oxygen and putting your hospital in the red.’

I paused to watch him squirming in his seat. ‘When the oxygen runs out in less than an hour,’ I continued, ‘that little baby weighing less than a kilo will gasp painfully for her final breath as I watch helplessly with her mother. If you’re really planning to murder this baby then I must insist you come with me now and end it quickly. Then you can show the whole world how brave you really are.’

The colonel’s face froze. He didn’t move or speak. Seething, I grabbed the document he’d been reading, flipped it over and scribbled on the back the following promise: ‘If I don’t receive oxygen within the next fifteen minutes and – without question – every time that I ask for it thereafter, I, Edna Adan Ismail, herewith declare that I will take no more responsibility for the patients in my care at this hospital.’ I signed and dated my declaration and, before anyone could stop me, I picked up a bottle of Superglue, squirted it generously over the back of the piece of paper, and stuck it with force to the door on my way out.

Still fuming, I drove back as fast as I could in my little Fiat to the maternity ward that was at the far end of the vast hospital grounds. The facility had been built by the Italians when my husband, Mohamed Egal, was Prime Minister. I’d attended its grand opening and visited as First Lady. There were still photos of me hanging on the walls. Since 1972, I’d been a mere employee – the head of the maternity department until today, when I looked set to quit for the sake of a premature baby.

I didn’t much care about the consequences at that point. I was far too weary to worry. I’d empty my desk and walk away. After all, what more could the regime do to me? They’d already taken my home and my belongings; they’d broken up my marriage; they’d imprisoned, harassed and interrogated both my husband and me. They’d even shot my beloved cheetah. My only concern was for the three-day-old girl fighting for her life in an incubator.

I hurried to the ward where the baby’s mother was waiting anxiously for news. Her hands in supplication, she asked, ‘Will they send more oxygen?’

I shrugged. ‘I don’t honestly know, but let’s prepare to take your baby to the Martini Hospital just in case. The doctors there won’t let your daughter die.’

Before we could unplug the machine and wrap the baby in a blanket with a portable oxygen mask, a breathless soldier appeared carrying the cylinder I’d requested. ‘The director sent me,’ he said, wiping the sweat from his brow as he put down the heavy canister.

‘About time,’ I said, pointing to where I needed it to be rolled so that I could connect it to the machine. ‘You can tell him from me that he must never, ever refuse me anything like this again. This oxygen isn’t for me, it is for a sick little baby and I never want to fight about this again.’

The soldier agreed to carry my message but then stood around sheepishly.

‘Yes?’

‘The director says to tell you one last thing,’ he added, looking ready to make a run for it. ‘He asks that next time you promise not to use Superglue.’

Turning away to hide my smile, I nodded and waved him away.

Erigavo, British Somaliland, 1950

It was twenty-five years earlier, in the Year of Red Dust, known as Siigacaase, that my journey to nursing really began. The April rains in our part of Africa had failed again and the desert winds had dried the land to a powdered rust that choked and stifled. We were well accustomed to the dry season or jiilal from December to March each year; it was a time of thirst and suffering. In this our worst drought in years, though, more than seventy per cent of the livestock had perished and our nomadic people were penniless and starving.

I would turn thirteen that autumn, but even at such a tender age I saw for myself what famine and malnutrition did to the human body. As the eldest daughter of Adan Ismail – the most senior Somali medical professional in the country and its so-called ‘Father of Healthcare’ – I accompanied him every day of that long, hot summer to the forty-bed hospital where he worked tirelessly to treat people and try to save lives. Hour after hour I’d follow him on his rounds, taking instructions to feed a weak child or making sure that an elderly patient had their saline drip renewed. I cut up old sheets for bandages, washed syringes, and sterilized instruments long blunted. Although the city of Erigavo was the capital of the Sanaag region and part of the British Somaliland Protectorate, it was – as Dad said – ‘too far from the cooking pot’ – which translated to limited supplies and little support from the authorities based in Hargeisa.

As the man in charge of health services for the entire region, my father often had to leave town and drive long distances alone in his ex-British Army Bedford ambulance to tend to destitute families in the outlying refugee camps. In his absence he had no choice but to entrust the running of his hospital to the largely illiterate auxiliaries, only a few of whom were qualified. Fearing for his patients, he’d ask me to oversee them until his return. I was still only a child but his hospitals had always been my playground and I knew my way around. Whenever he was away, he’d leave me little notes telling me what to do so that I wouldn’t forget. ‘Make sure they remove the catheter from that patient tomorrow, Shukri,’ he’d say using the name only he called me. Or he’d remind me, ‘That mother’s sutures need to come out on Monday… and don’t forget to change the dressings on the child with burns in Ward 3.’

Known to all as ‘Adan Dhakhtar’, my father had been trained as a medical assistant by the British in the Crown Colony of Aden before the Second World War, and then later in England. He’d hoped to become a doctor, but a medical degree was never open to someone like him because it would have taken too long and cost the British taxpayer too much money. Instead, he was sent back to his country to take on the full responsibilities of a doctor (on a fraction of the salary), in a series of postings around the country that generally only lasted two years before he was moved on to a new home and a new hospital and new patients to treat. In each new city he was expected to do all this seven days a week and run an entire hospital compound in a role designated as a Compounder.

Far more revered than any British doctor and a versatile all-rounder, Dad treated every patient he encountered– no matter how poor, dirty, smelly or sick – with the utmost dignity and respect. I remember being enlisted by him once to hold a bowl under the face of a hawk-faced old man with an infected abscess in his jaw. The patient was elderly and unclean and my disgust at the pus my father lanced must have shown in my expression because once the old man had been cleaned up and left the room, Dad closed the door and turned on me.

‘Don’t you ever show such an ugly face to any of my patients again!’ he said, his eyes flashing. ‘If you cannot show respect, then stay away from this hospital.’ His reprimand marked me for life and was my first important lesson in nursing care. It was then that I fell in love with medicine. The dirty old nomad was more precious to Adan Doctor than me, his first-born. To this day, if I see something smelly or disgusting or oozing I make a point of diving right in with both hands. It’s my way of training my students that a nurse has to do whatever it takes and treat everyone with the same respect and care.

My father worked seven days a week, 365 days a year, and he loved every minute. Adan Ismail was my hero. He still is. I will never be as compassionate as he was. I will never be as kind and generous as he was with his time, his emotions, and his affection. My father was a very good man. Every day he was hindered by a chronic lack of funds and supplies, many of which he ended up paying for himself. And yet every day he still put on his uniform and went to work with a smile on his face. My mother used to call him ‘the man with holes in the palms of his hands’ because money slipped through them, usually spent on his hospital or his patients. Every day he’d say, ‘If only I had more medicines’, or ‘I wish I had a better sterilizer.’ He’d have happily bought these things himself but they weren’t easily available in our forgotten part of Africa, so he was forever asking me to wash a pair of scissors or some other instrument because he didn’t have enough or the quality was too poor. ‘Not those ones,’ he’d say, gently. ‘They don’t cut well. Bring me the others.’ I wished I could have bought him a whole tray of sharp scissors, a box of gleaming new scalpels, or a pair of forceps that actually worked.

Watching him deal with these challenges every day planted a fertile seed inside my head: a quite fantastical thought for any little girl, but especially one growing up in a developing country. I can’t recall the exact moment when I decided that I would one day build him a hospital, but I do know I had a very clear idea of how it would be run. My only image of the outside was that it was large and white, but I never sketched out any drawings or plans. My dream had much more to do with it being the right kind of place – a perfect new medical centre that would do my father proud. In my head it had all the equipment, instruments and trained staff that he’d need. It was a place where he would be delighted to work. And where I would happily work alongside him.

Back in 1950, my fantasy was little more than a child’s wish to please her beloved father. It was far from realistic in a Muslim country that didn’t even allow schooling for girls. Education for girls was unavailable in case we dared form any opinions or – worse – voice them. Anyway, there was little point when every Somali woman was expected to be a dutiful wife and mother, bound by archaic social traditions as well as often harmful traditional practices. Dad never saw me that way. I was his adored Shukri, his first child and one of three to survive out of five. He called me the ‘apple of his eye’ and encouraged me to read English from an early age. It was he who arranged for me to go to school in French Somaliland, determined that I should have the kind of opportunities he’d been given as a child. Like me, he dreamed that I would one day train as a nurse and help him offer the kind of healthcare he longed to provide for the people he loved. My father wanted me to be the best I could possibly be.

If I were to fulfil that wish then what better gift could I give him than his own hospital? How I would achieve it, I didn’t know. What money I’d use to make it happen, I had no idea. Neither of us knew that political turmoil and civil war would soon devastate our country. We could never have foreseen the suffering. At twelve years old, I only knew that one day my father’s name would be placed for all to see on a large white hospital built in his honour. I didn’t even tell him of my secret plan. Yet the idea sprang into my young head so clear and bright and certain. It lodged in my subconscious like tumbleweed caught on a thorn, and that’s where it remained for more than fifty years until I finally had the time and resources to do something about it. This is the story of how I made that happen, against insurmountable odds.

CHAPTER ONE

Hargeisa, British Somaliland Protectorate, 1937

Seven days after I was born at 9 p.m. on 8 September 1937 following a long and difficult delivery, my father gave me the name ‘Shukri’, which means thanks. This was because I was considered something of a miracle after two years of my mother’s infertility.

The only reason I know the date of my birth is because I was born in a hospital in Hargeisa, unlike the majority of Somalilanders. We didn’t mark birthdays in the same way as people in the West because we didn’t then have a written language, very few people could read, and no one knew what a calendar was. Many my age don’t know when they were born and say simply ‘the time of bad floods’, or ‘the month before the long drought’. Age was counted by the rainy seasons, of which there are two, so a child who has seen two rains would be described as two years old when they were really only one.

I was a big, healthy baby although I carry two scars on my head from the forceps used by the English obstetrician who delivered me. Perhaps the miracle of my survival in a country where infant mortality is still the fourth highest in the world is the reason I became such a headstrong child and a stubborn adult – to which many will attest. With ninety-four in every 1,000 babies dying at birth in Somaliland (compared with four or five in the UK and the US), it is customary for newborns never to be named until they are a week old for fear their parents become too emotionally attached.

At my naming ceremony on 15 September, my mother Marian, a Somali who’d been raised a Catholic, called me Edna in honour of a Greek girlfriend who insisted that if I was a girl then I should take her name. It was a moniker Dad never once used. My arrival ended what my mother feared was a curse against her ever since she’d married my father two years earlier. Many of those who liked my father disapproved of his marriage and believed that he should have chosen a Muslim wife. This view only gained currency when Mum hadn’t yet borne him a child, as, in our culture, it is normal for a wife to conceive straight away. If she doesn’t it is usually blamed on ‘the evil eye’ or some other bad spirit and Allah is prayed to, so when Mum finally became pregnant with me the evil eye was considered to have blinked.

My father was over six feet tall, charismatic, generous, fluent in several languages and the best doctor and communicator I’ve ever met. To him, teaching people about healthcare was not only a duty but also a pleasure, and he threw his heart and soul into educating anyone he came across. One of his favourite expressions was, ‘If you cannot do it with your heart then your hands will never learn to do it.’

His own father, Ismail Guleed, was something of a legend in Somaliland. A successful, silver-haired merchant from the noble Arap Isaaq clan of nomadic warriors and camel herders, he was known as Ismail Gaado Cadde, which means White Chest. This referred to the white hair on his chest that spilled over his tunic.

Wealth in my country is measured in camels – a female and her calf can cost £1,000 in today’s terms – and my grandfather exported large herds of them. Independently wealthy, he hired traditional dhow boats to carry goods destined for Ethiopia and service his lucrative contract to supply livestock, firewood and ghee to the British garrison in the Aden Colony, sixty kilometres across the Gulf of Aden – the gateway to the Red Sea.

Grandfather Ismail naturally expected that his two sons – my uncle Mohamed and my father Adan, born in 1906 – would help run his business. He and his wife Baada had moved to Aden once their sons were of school age specifically so that they could be educated at St Joseph’s, a Roman Catholic Mission School, the only place in the region where they could learn to read and write in English. Little did he know that my uncle Mohamed would jump on a ship bound for the Indian Ocean aged sixteen to become a merchant seaman for the rest of his life, while my father would choose medicine. Sadly, Grandfather died in his early sixties, so I never knew him. After his death my father tried to keep the family business going but it became too difficult to manage on top of his medical duties.

I sorely wished I’d asked Dad what made him decide to study medicine because it was truly a vocation for him and something he dedicated his whole life to. Perhaps there was an incident that inspired him. As far as I’m aware, he was never ill, but he did have multiple scars on his legs from playing football and hockey so perhaps that was how he encountered the miracle of medicine.

***

My earliest childhood memories are of my grandmothers’ faces, fleeting images of their beaming smiles. These women were perhaps the most influential in my immediate family, although the men in our vast extended clan traditionally exerted the most control. As another Somali girl child my infancy was rather uneventful, apart from the day I disappeared as a baby. Mum left me sleeping on her bed with cushions stacked all around me to prevent me from falling off, then went to the outdoor kitchen at the back of our house to prepare lunch – probably sabaya flatbreads with some curry or beans and rice. Our single-storey detached house had two bedrooms as well as a living/dining room. There was no flushing toilet, just a shaded pit latrine in the yard, and my mother, the cook and a maid heated water over firewood laid on stones and cooked meat over a charcoal burner made from oil drums.

When my mother came to check on me a little while later, she found me missing and the pillows undisturbed. Perplexed, she thought my father must have come home from the hospital in his break and carried me outside. When she couldn’t find us in the yard, she believed he’d taken me back to his hospital without telling her. In a country with regular epidemics of smallpox and other diseases she, like most Somali women of her generation, had a terrible fear of taking a healthy child to a place full of sick people so – furious – she hurried to the hospital only to find Dad alone. He was just as surprised to see her because she never visited unless for a medical emergency. Mum immediately started wailing that I had been stolen. They hurried back home and they, the servants, our neighbours, and eventually the police looked frantically for me and traces of my ‘kidnapper’. Amidst the hubbub, no one thought to look under our dining room table to which I had crawled beneath the tablecloth to resume my nap. Once I was discovered my mother never lived down the embarrassment and Dad would often tell me how lucky I was that I wasn’t chained to the bed after that.

I was only two when the Italians declared war on the Allies in June 1940 and in August invaded British Somaliland and Ethiopia. I have no recollection of the events of the Second World War or the impact upon our family. Nor do I recall the events just before that when my mother’s next child, my unnamed infant sister, died a few minutes after birth following another harrowing forceps delivery. Mum was frail and still recovering when the British declared that all the wives and children of civil servants should evacuate to a small fishing village on the Gulf of Aden. From there we’d board a British naval destroyer for Aden.