Kim Law in Hargeisa Somaliland

Recently the Nurses for Edna team traveled to the Abdi Idan MCH Clinic in one of the poorest neighborhoods’ in Hargeisa, Somaliland. This  free, government funded clinic provides multiple services including antenatal and postpartum care, low risk deliveries, nutrition clinic, pediatric health and immunization clinic, and a lab services. In a recent report from nurse, Kim Law, she describes her experience:

        “After a thirty minute drive down what one would generously call a very bumpy road, or realistically call a 4x4 trail, we arrived.  The clinic is next to what looks like a military or police building, but it's hard to be sure. In between the two buildings is a heaping pile of garbage. There is no waste disposal system in Hargeisa, so garbage lines the streets; it is a common site to see 'urban goats; chewing on discarded plastic.

     On arrival, we were given a quick tour; there was already a lineup at the pharmacy for the nutrition program. Next we settled into the antenatal clinic. The antenatal clinic is staffed by one community midwife, and two community midwife students. Patients were given an antenatal record that they are expected to bring with them to every clinic. At her first visit, the woman is weighed, her height is measured and her obstetrical history is taken. Many of the women guess at their age and the years their children were born.

I noticed a trend that many of the women's first children were born at home, but their more recent deliveries where at an MCH clinic or hospital. Hopefully this is an ongoing trend.

        If available, the women are offered an on the spot HIV, Syphilis, and Hep B testing, but supplies are scarce. On the day we were there, there were only Syphilis tests available, and we ran out of those before the day was over.  After the finger prick, the woman's blood pressure is checked, and then she is assisted onto the examining bed. Her fundal height is measure, the fetus is palpated with Leopold's maneuver, to determine its position, and then the fetal heart is assessed with a fetoscope.

       Joining us on this trip was Dr. Mary Margaret O'Neil, and OB/GYN from California. I had never used a fetoscope before nor done very few antenal exams before 25 weeks gestation, so, she was instrumental in not only teaching the midwifery students, but teaching me as well.

I spent a lot of time helping the students learn how to accurately measure blood pressures, their technique significantly improved over the course of several hours. We instructed them on how to improve their Leopold's maneuver, and the importance of determining fetal position to make it easier and faster to locate the fetal heart. The students very quickly improved their technique for measuring fundal height.

     Another aspect we were able to reinforce, was caring and compassion. For example, helping the woman sit up and get off the examination table, not
leaving her to fend for herself.

     Muuna, the Community Midwife who runs the clinic was so patient with us, letting us teach the students. We definitely made the clinic run late, but the extra time was worth the knowledge we were able to share.”

Thank you everyone for your help and support in making my dream a reality. ~ Kim Law, RN.BSN