Somaliland’s first midwife Edna Adan Ismail: 'I started writing about my life because I came so close to death'

Delivering babies and policies is all about persuasion, says Edna Adan Ismail

Edna Ismail appears as part of the 2020 Emirates Airline Festival of Literature in Dubai. Courtesy: Emirates Literature Foundation.

Edna Adan Ismail is used to counselling patients to a healthy mind in the hospital ward. As a midwife and administrator at her own hospital in Somaliland, the self-declared and breakaway state of Somalia, she has seen her fair share of patients distressed by their afflictions.

Despite this, however, Ismail is not immune to the trauma a sudden brush with death brings. It happened to her 15 years ago when what was initially thought to be a routine cold became full-blown pneumonia. Recalling her stay in hospital, Ismail says she feared she wouldn't survive.

"Things like that make you think," she says. "This was really the first time I ever came close to death and I thought about how I should begin writing down what happened in my life. I have been blessed to live a full life, so I knew I had a story to tell."

It is one of many understatements Ismail, 82, delivers in her interview with The National. We meet in Dubai, where she took part in the Emirates Airline Festival of Literature, which was held earlier this month.

It was mission accomplished at the six-day event – not only did she sell out her sessions, but she also sold every festival copy of her memoir A Woman of Firsts.

True to its title, the engaging and powerful work has Ismail retracing her footsteps through a pioneering life – from growing up in a poor and traditional household, to becoming Somaliland's first qualified midwife and its first female government minister.

She also showed tireless commitment to women's education across Africa and called for the eradication of female genital mutilation. With so much ground to cover, Ismail's memoir is not so much one story, but a series of startling personal journeys. Some of them are enchanting, while others are heartbreaking.

It took Ismail a decade to produce the book and she describes the process as painful. "It was not that I was sitting around doing nothing," she says. "I was teaching and had a hospital to run, which I still do to this day. So the idea of finding the time to write my story, which I believed was important, was extremely hard."

The solution was as effective as it was ingenious – Ismail recorded her story on tape and paid someone to transcribe it. Not only did this method result in the book's conversational style, it was also Ismail's most natural form of expression.

“I come from a predominantly oral culture, so telling my story this way felt authentic,” she says. “It made me describe things more clearly and say things that I truly feel.”

Ismail picked up that last quality from her father, who is a powerful and inspirational presence throughout the book. He was a doctor and one of the few men with a degree in Hargeisa, the capital of what was known at the time as British Somaliland.

He is methodical, ­unscrupulously honest and ethical. Ismail first got her love for hospital scrubs by accompanying her father on trips and home visits. "I was his assistant in a way," she says. "Since I was with him, he thought that I may as well be useful and I would assist by giving him forceps and assist with bandaging. Even when he was gone for a few days he would give me, as a 12-year-old, instructions on things like making sure people got their medication."

Her father's forward-thinking vision was in sharp contrast to the conservative nature of Somali society at the time. It is the conflict between these elements that serves as a constant source of tension throughout A Woman of Firsts.

It seems that every inspiring passage about her father's quest for excellence and ethics is contrasted by tragic realities in Somaliland. There are two particularly harrowing moments detailed in the book, events that have shaped Ismail's life ever since. At the age of 6, she witnessed the home birth of her brother by an untrained elder. "He was only born for a few minutes and then he died," she recalls. "What happened was the woman dropped him and he fell on his head. That was it. I didn't know what was happening. All I saw was that they were taking this beautiful baby to the grave and I kept thinking 'why can't we keep him?'"

The other moment came two years later. With her father away on a work trip, Ismail's mother and grandmother arranged for her to undergo female genital mutilation. "That was the attitude of the time," Ismail says. "It was something that happened to all the girls and there would be a feast after to celebrate the daughter of so and so."

Ismail's father was furious when he returned home. "I remembered him shouting 'how could you do this?'" Ismail says. "It made me think that if my father thought this was wrong, then there is really something wrong with this practice."

That belief was supported by the knowledge Ismail received when she trained as a nurse and midwife in London. Upon her return to Somaliland, she became an advocate of ending the practice, as well as calling for midwives to be used to reduce the country's infant mortality rate.

"A lot of it comes from this idea of not going to see the doctor or going to the hospital," she says. "It was frowned upon and instead people kept it private and would call a traditional healer or someone else. I wanted to change that perception."

That was the driving force behind the near 30-year quest to build the Edna Adan Maternity Hospital. Opened in 2002 after being built on a site donated by the government – it was formerly a rubbish dump – the hospital has about 70 beds and as many as 400 babies are delivered there every year.

Her work there was so demanding it made her time as Somaliland's foreign minister – she was in office from 2003 until 2006 – seem like child's play. Her responsibilities at the hospital resulted in rather hilarious anecdotes in the book, such as the time she stopped a meeting with an international delegation to rush back to the hospital to deliver triplets.

The cut-and-thrust of hospital life, Ismail says, also made her an effective government negotiator. "I am a midwife first. It means I am patient and I know how to coax [people]," she says. "This helped me in several discussions because it gave me an understanding of reasoning and the ability to convince people that what we are doing can benefit both of us."

With our interview coming to an end, I suggest Ismail has enough stories to fill a series of memoirs. She immediately shrugs off the notion and says she prefers to be out in the field, whether it's in her hospital or talking to officials at conferences.

As far as she is concerned, A Woman of Firsts has done its job by showcasing what African women can achieve in the right circumstances. "I am in Dubai as a Muslim, black and African woman who was significantly powerful in her own small way and who wrote a book about her life," she says.

“For some, I am considered a rare species, but I know there are many others out there who have their own stories to tell.”