Edna Adan Ismail - A Woman of Firsts

‘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.