Quality healthcare and nutritional support for all newborns and women is essential for a healthy world. This month, Women Deliver Young Leader Musu Bakoto Sawo joins Dr. Edna Adan Ismail to discuss maternal healthcare, midwifery, and women in politics.
Musu Bakoto Sawo: Marking the 25th anniversary of the International Conference on Population and Development (ICPD), advocates, health practitioners, and world leaders will gather in November at the Nairobi Summit in Kenya to take stock of the progress made in efforts to realize girls’ and women’s SRHR, reduce GBV, and improve maternal health. What concrete actions should world leaders, especially other African leaders, take to drive progress towards gender equality and prioritize the health and rights of girls and women?
Dr. Edna Adan Ismail: As an African woman who is a health practitioner as well as an advocate who campaigns for gender equality and who wishes to see concrete actions that prioritize the health and rights of girls and women, I urge African Leaders to make a national declaration that is specific to their own individual country. I also urge them to identify a national committee, whose mandate will be to prioritise, pursue and facilitate actions that promote gender equality and the health and rights of girls and women. When formed, national committees will be required to make public reports on their actions, obstacles, and achievements on a yearly basis. International support would be welcome to assist where possible and reward countries that make substantive progress.
Musu Bakoto Sawo: From becoming Somaliland’s first qualified nurse-midwife to its first female cabinet minister, you have led a life of ground-breaking firsts. And now, you are widely recognized as a leading advocate for the health, particularly the reproductive health and rights of girls and women. What inspires you to continue breaking boundaries to advance gender quality, in Somaliland and beyond?
Dr. Edna Adan Ismail: As detailed in my memoir, ‘A Woman of Firsts,’ my own parents lost two of their five children because of poor maternal and child health services in my country. My mother lost one baby to a forceps delivery when a Caesarian section could have saved the fetus that had become impacted in her narrow bony pelvis. And a few years later my parents lost a second baby who was delivered alive but was then accidentally dropped by the untrained midwife who had delivered it. The newborn fell on his head and died instantly. Because of this tragedy, midwifery has become my lifelong passion to prevent other parents from suffering as much as my parents have.
After training in the UK and returning home as Somaliland’s first trained nurse/midwife, I became faced with the myriads of health problems women in our parts of the world face during pregnancy and childbirth because of lack of education, poverty and un-employment, but also because of the damages caused by female genital mutilation. In addition to the physical and health issues, I found that our women did not have a platform where their opinion and concerns could be voiced. These are the situations that made me campaign for our rights and which in time made more women join our efforts. That then led to the setting up of women’s organisations that could then put pressure on the government and the political parties who needed the votes of women.
My years with the World Health Organisation have also helped me to spread the word to other countries and women’s groups.
What really inspires me today is how far we have come but also how far we still have to go to achieve our goal of equal human rights for all.
Musu Bakoto Sawo: You initially founded the Edna Adan Hospital to help reduce maternal and infant mortality by training midwives to provide life-saving health services. Now the facility has evolved into a full-fledged hospital while also teaching thousands of future nurses and doctors. What will your next priorities be and how do you hope to continue advancing maternal and newborn healthcare across Somaliland.
Dr. Edna Adan Ismail: Following the devastating civil war with Somalia (1982 to 1991), the health services of Somaliland became totally destroyed. Since 1991, we embarked on a massive national drive to re-establish health and education services for our 4 million people.
Today, we have over 500,000 children attending public and private schools and over two dozen universities and colleges where a new cadre of young people are training in skills and acquiring academic qualifications to care for our people.
Sadly, because of the unjust lack of political recognition of Somaliland, our people have been denied access to higher and second level degrees in other countries since these high level postgraduate training courses are not easily available locally. For this reason, and because we now have a good number of health professionals with diplomas and Bachelor Degrees in different disciplines, we have started postgraduate courses in Obstetrics, Gynecology, Pediatrics, and Nursing/Midwifery. Raising the bar to a higher level of competence, confidence and leadership for our professional women to prepare them for managerial positions is our goal for which we invite partners and collaborators.
Musu Bakoto Sawo: Alongside your commitment to mothers’ and babies’ health, you have been a voice for ending female genital mutilation (FGM). In my experience in The Gambia, there is sometimes a gap between the laws, knowledge and practice, whereby existing laws to combat FGM or knowledge of the negative health consequences of FGM do not always influence the exercise of this practice within communities. There are also instances where gaps in the law create minimal protection of women and girls from FGM. In what ways should social norms that promote FGM be shifted? What message do you have for communities, including parents, religious and traditional leaders, and local authorities in their role(s) to end FGM?
Dr. Edna Adan Ismail: The fight against FGM has been a long and difficult battle for me after I pioneered the fight against it in 1976. I know many battles have been won during the past 42 years and the fact that the world knows about it is proof that our message has been heard. Sadly, however, little girls are still cut, damaged and killed all because of this cruel tradition that has no place in the world. While every action that saves even one child is good, we should broaden our campaigners and now include college and university students who are the parents of tomorrow. We strongly wish for and welcome the support of fathers whose daughters are the ones who are being damaged to the point that they may not be able to one day give them the grandchildren every parent wishes for. It is through these concerted efforts between parents, traditional and religious leaders, legislators, activists, and women’s organisation that we will save our daughters. Passing a Law alone will not be enough and at the end of the day, we cannot put all our mothers and grandmothers in jail. Legislation that punishes the one who performs FGM is the kind of legislation that I would like to see.
Musu Bakoto Sawo: Young people are already leading the way in the fight against FGM, including my fellow Women Deliver Young Leaders Jamie Quam and Isaac Ejakhegbe. However, to create lasting change, more young people’s voices and perspectives – especially adolescent girls’ – need to be included. What leadership role do girls and young women have in efforts to end FGM and gender-based violence (GBV), and fulfill their sexual and reproductive health and rights (SRHR) more broadly?
Dr. Edna Adan Ismail: In my university, regardless of the courses students are taking, every student must have a course on the Harmful effects of FGM and every student must make a public statement condemning FGM. Any student who does not wish to do this cannot remain in my university.
Musu Bakoto Sawo: Drawing on your experience as a health practitioner and advocate with a career spanning from politics to international development, what last word of advice would you offer young advocates for gender equality today? How can they change the narratives?
Dr. Edna Adan Ismail: Become better educated, study the issue thoroughly, develop your strategies collectively, make your voices heard as a group and through written articles, research results for publication and discussions in the local media and journals. Learn what works from others, and share with them what has worked for you. Never give up!