Somaliland: Our Most Colorful Trip Yet

Unrecognized and largely unsupported by the international political community, the people of the Republic of Somaliland have rebuilt a country savaged by eight years of Somali civil war which ended with de-facto independence in 1991.  On a former killing ground turned landfill the remarkable Edna Adan has built a maternity hospital from scratch.  Pawning her jewelry to buy plumbing and using award money from her appointment to the Legion d’Honneur by French President Sarkozy, Edna has created a full-service hospital and nursing school to provide healthcare in one of the world’s most resource constrained environments.

We learned quickly that one refers to the country as SomaliLAND not SomaliA.  Edna is perhaps the greatest nationalist in the young country. (Footnote: There are many places you can learn more about Somaliland, one of which is: http://somalilandgov.com/country-profile/)

We had traveled for almost two days in order to finally conduct UAM training and installation for the first class of nurse anaesthesia providers in Somaliland currently enrolled at Edna Adan University Hospital. I say ‘finally’ because this has been a long time coming: since Gradian’s inception, we have been in conversations with Edna Adan herself about installing a UAM at her hospital. However, until this year there was no native Somali anaesthesia provider in the country (surgery has been largely dependent on foreign teams of providers performing surgery at the hospital). So Edna decided to change that – to create local capacity – and arranged for Hosea Cheriyoot, a Kenyan anaesthetist, to spend a year in Hargeisa teaching the country’s inaugural class of nurse anaesthetists. With that kind of commitment to strengthening anaesthesia capacity in the country, we were convinced that this was a hospital – and a country – that would benefit from a UAM.  In fact, the UAM replaced a broken, 20+ year old North American anaesthesia machine in one of the two principal operating theaters. Now both rooms have safe anaesthesia capacity.

The training was straightforward, beginning with a didactic, classroom-based session followed by practical theatre-based use of the machine. Naturally, under Hosea’s tutelage the students have learned a tremendous amount about anaesthesia and were quick to pick up on how to use the UAM.

The trip, however, was one of our most colorful. We were continuously learning about the history and future of this nascent country. We traveled to ancient caves with perfectly preserved cave paintings dating back to 9000 BCE; we accompanied Edna as she determined whether to purchase a female camel and her offspring as a potential source of milk for her farmhands; we wandered the local livestock market and learned how to negotiate with hand-signals under a piece of cloth and we attended a local high school graduation where Edna gave a rousing speech to what she called “the future of the country”.

Our time there was, as always, too short, but we are hopeful that we’ll be back before too long…

A gallery of some of our trip photos below: