In December 2012, I had the honor of voluntarily traveling to the Edna Adan University Hospital in Somaliland for two weeks to learn, understand, educate and care for women who had been subjected to Female Genital Mutilation (FGM). Additionally, my desire was to also use my skills as a nurse in any way that I could.
Prior to my trip to Somaliland, and even after my return to the U.S., my colleagues and friends would ask me why I chose to go there. My answer was that while I was doing research about FGM for my doctorate, I came across the hospital's website. After reading the website in detail, and viewing all of the online video clips about Edna that I could find, I felt the pull at my heart to go there and help. I was so intrigued by Edna, her passion for the people of Somaliland and her desire to eradicate FGM, that I knew I had to meet her.
It took close to six months for us to make contact. After a few exchanges via telephone and by email, she graciously gave me the green light to come. Edna supplied me with the names and contact information of previous volunteers that I could speak with, about their experience and obtain answers to some questions that I had.
Although I had traveled to Africa three times previously, I had never traveled alone. Needless to say, I was a little nervous; however, I was not going to let my nerves stop me. I took the 15-hour flight to Somaliland on an early Sunday morning in December. Edna's staff met me at the airport.
The ride from the airport to the hospital was a long two and a half-hours, but the scenery was absolutely amazing. The roads were unpaved and there was visual evidence of the war approximately 21 years ago. Despite the rubble remains of what were once homes, and possibly businesses, Nomads and other Somaliland people were seen along the country side. These people in spite of their living conditions, appeared to be content in their situation.
When we arrived at the hospital, I was greeted by Maah, Edna's assistant, who was so kind to me and made sure that I had everything I needed for my stay. That evening I met my mentor Dr. Kitto at dinner. She was a very jolly person, and before long, we became inseparable. She was passionate about her work, and turned out to be an awesome mentor who taught me a lot.
While in Somaliland, I had the unique experience of interviewing a local, traditional cutter in order to understand the cultural beliefs and traditions of FGM. I believed that the information from the cutter would be vital in devising my education plan.
A traditional cutter is a woman who performs FGM on girls between the ages of five-thirteen. The cutter confirmed that it is a tradition to "cut," or surgically close the vaginas of young girls until marriage to prevent them from engaging in sexual intercourse with any other men besides their husbands. Although FGM is banned in Somaliland, the cutter stated that she performs the procedure on 15-20 girls per day. The cutter also reported that she charges $15-$20 per procedure.
When asked if she would ever consider discontinuing the practice of FGM, the cutter responded, "Not unless I am blind or dead." Having performed the procedure on her own daughters and granddaughters, the cutter affirmed her belief in the continued practice of FGM. She went on to say that, there is no other line of work in her country that would allow her to make the amount of money that she currently makes.
While at the hospital I also assisted in the de-infibulation procedures of several women. De-infibulation is the surgical procedure used to open the "closed" vaginas of women who were subjected to FGM as children. While heart wrenching, I felt that it was important to participate in the procedures to fully understand how to educate the woman of Somaliland.
The women undergoing de-infibulation were terribly frightened as they were being prepped and cut open. Surrounded by a team of competent clinicians who now viewed the procedure as normal and routine, my role was to offer comfort to these women with a friendly touch and smile.
After interviewing the traditional cutter and actually witnessing the de-infibulation procedures, I shifted my focus to educating and raising awareness among both professional and lay providers of the potential physical and emotional repercussions of FGM. I had the opportunity to spend a great deal of time with over 50 Somaliland nursing students.
In my lectures and discussions, I reviewed how endemic the practices of FGM still are in Somaliland and emphasized the significant, negative reproductive, urological and mental health sequelae of FGM. Students were grateful to learn more about the cultural practice that, although banned, still negatively affect many women and girls.
During my time at the hospital 27 babies born, all with good outcomes. I assisted in the delivery of approximately one third of those births. I also assisted with postpartum assessments, taught mothers how to breast feed their newborn babies, and educated many Somaliland women and men on FGM.
While working on the hospital's maternity ward, I also shared information with practicing locals physicians and nurses on FGM. In addition, I carefully presented facts about the practice, including the long-term sequelae of the traditions of FGM. Maintaining the delicate balance of respecting cultural traditions and raising awareness about the ill effects of a practice rooted in the history of that culture was instrumental in my success in connecting with the people I encountered.
It was a privilege and an honor to volunteer my knowledge of western nursing practice, and medicine, to educate nurses, health care professionals and patients on the taboo subject of FGM. While valuing the culture and beliefs of the people of Somaliland, I believe that I was still able to make an impact by educating the current and future health care professionals on the effects of FGM.
I cannot thank Edna enough for affording me this opportunity. While my visit to Somaliland is over, my work around FGM is not over. I am committed to educating my colleagues in the U.S., increasing awareness about Somaliland and the wonderful people there, encouraging others to volunteer their time and talents, and providing financial resources to deserving nurses to help them further their education. And, I will be back in Hargeisa in August to volunteer !