East Bardera Mothers and Children's Hospital
Encyclopedia
East Bardera Mothers and Children's Hospital (EBMCH) is a non-profit institution
Non-profit organization
Nonprofit organization is neither a legal nor technical definition but generally refers to an organization that uses surplus revenues to achieve its goals, rather than distributing them as profit or dividends...

 women's and children's hospital located in Baardheere, Somalia
Somalia
Somalia , officially the Somali Republic and formerly known as the Somali Democratic Republic under Socialist rule, is a country located in the Horn of Africa. Since the outbreak of the Somali Civil War in 1991 there has been no central government control over most of the country's territory...

. The hospital was started by expatriate Somalis
Somali people
Somalis are an ethnic group located in the Horn of Africa, also known as the Somali Peninsula. The overwhelming majority of Somalis speak the Somali language, which is part of the Cushitic branch of the Afro-Asiatic language family...

 based in North America
North America
North America is a continent wholly within the Northern Hemisphere and almost wholly within the Western Hemisphere. It is also considered a northern subcontinent of the Americas...

. The hospital, locally referred to as Isbitaalka Bariga Baardheere, is managed by a team of nurses in addition to one of the most experienced midwives in the Bardera district of the Gedo
Gedo
Gedo is an administrative region , formerly part of the historic Upper Juba Region in southern Somalia. Its regional capital is Garbahaarreey. Gedo is a region created in 1980s and is bordered by the Ogaden in Ethiopia, the North Eastern Province in Kenya, and the Somali regions of Bakool, Bay,...

 region.

With a competent medical staff and access to supplies from safe markets in Canada and the United States, East Bardera Mothers and Children's Hospital stands as one of the best organized hospitals in Somalia. Women also make up 75% of the hospital's staff, which offers women and children a safe and comfortable environment in which to receive medical advice and treatment.

History

EBMCH in Baardheere, Somalia was established in May 2006. Bardera did not have anything resembling maternity hospital for the longest time before EBMCH came into the picture. Bardera is the home of the largest district and most populous city in Gedo Region.

UN agencies such as WHO
Who
Who may refer to:* Who , an English-language pronoun* who , a Unix command* Who?, one of the Five Ws in journalism- Art and entertainment :* Who? , a 1958 novel by Algis Budrys...

, UNICEF and other international NGOs such MSF
MSF
MSF may refer to:* Mail Summary File , file extension used by Earthlink, Mozilla Thunderbird, and Netscape mail clients to store folder data in Mork.* Marvel Super Heroes vs...

 have supported the health-care services which are carried out in Bardera District. Just as recently as 2007, Medicines Sans Frontier (MSF) of Spain
Spain
Spain , officially the Kingdom of Spain languages]] under the European Charter for Regional or Minority Languages. In each of these, Spain's official name is as follows:;;;;;;), is a country and member state of the European Union located in southwestern Europe on the Iberian Peninsula...

, has tried to man, equip and re-supply the main Bardera Hospital which was out of service since 1994. Some armed militias have obstructed this noble cause. EBMCH and two other MCHs with even lesser resources have been the only medical centers serving Bardera city.

The majority of medicines, medical supplies, and information comes from friends of the hospital who live in the United States
United States
The United States of America is a federal constitutional republic comprising fifty states and a federal district...

 and Canada
Canada
Canada is a North American country consisting of ten provinces and three territories. Located in the northern part of the continent, it extends from the Atlantic Ocean in the east to the Pacific Ocean in the west, and northward into the Arctic Ocean...

. The hospital has some of the most up-to-date equipment in all of the MCHs in Bardera City. The general hospital which served the community during the previous 40 years, was demolished with the central government in 1991.

Well-trained medical staff who are working towards the same goal and safe medicine from Canada and US is making East Bardera Hospital one of the best managed expanded MCHs in Somalia. All of the beds in the hospital were welded by a local entrepreneur, and as expansion is sought to further serve the community, more supplies will be bought from the community business people
Businessperson
A businessperson is someone involved in a particular undertaking of activities for the purpose of generating revenue from a combination of human, financial, or physical capital. An entrepreneur is an example of a business person...

.

Creation of Bardera Maternity Hospital

East Bardera Mothers and Children's Hospital was envisioned to be a step-by-step and long-term oriented medical facility where basic medical needs of Gedo's largest city would be met. With the support of a few friends, including Dr.
Physician
A physician is a health care provider who practices the profession of medicine, which is concerned with promoting, maintaining or restoring human health through the study, diagnosis, and treatment of disease, injury and other physical and mental impairments...

 Aden Loyan and trained nurses, EBMCH founders are able to pay all the expenses of EBMCH including medicines and medical supplies, rent for facilities, and staff salaries. Annual operating costs for Bardera Maternity Hospital is little over $30,000.

The founder of EBMCH retells a story of a woman who in early 2006 had received financial support from overseas family members and after a relatively normal pregnancy, gave birth and almost died from ensuing bleeding, receiving no immediate medical advice and no recovery help of any kind in Bardera. Then the question, "Imagine, what other women in similar situations are going through across Somalia and in Bardera?" is asked.

The woman in the story, How EBMCH Started, could have purchased medical supplies such as supplements long before she got weak and could have also gotten nutritional advice, but there was no maternity hospital in Bardera at the time. It is concluded that other women were suffering many times worse. Therefore, he set out to create EBMCH with few thousand dollars on hand. First, as a maternity hospital, and second, as a place with knowledgeable staff who can offer all the possible medical services to the community. To locals, EBMCH is more than a place for women and children. All sorts of people seek medical services from EBMCH. Among other things, unexpiried medicines and reliable midwifery services are some of the best liked services and attractions at EBMCH.

Correct nutritional information and basic prenatal services will go a long way for pregnant women
Pregnancy
Pregnancy refers to the fertilization and development of one or more offspring, known as a fetus or embryo, in a woman's uterus. In a pregnancy, there can be multiple gestations, as in the case of twins or triplets...

 in Bardera as food is mostly available in the largely farming town. Over 96% of households in Bardera purchase their household food needs.http://www.fsausomali.org/uploads/Other/775.pdf

Maternity Services at East Bardera Hospital

Women in Bardera now get the advice of trained nurses and midwife. Few hospitals in Somalia offer maternity and children's services. Most hospitals in Somalia are concerned with wounded people from war zones. Bardera Mothers and Children's hospital was established to give women and children the care they deserve. Expecting mothers and nursing women also get reliable supplements and medicines as well as medical advice throughout the pregnancy and after the child is born. The EBMCH has a pharmacy and supplies are being are imported from Canada and the US with the help of EBMCH friends as well as local NGOs. The Bardera Red Crescent
International Red Cross and Red Crescent Movement
The International Red Cross and Red Crescent Movement is an international humanitarian movement with approximately 97 million volunteers, members and staff worldwide which was founded to protect human life and health, to ensure respect for all human beings, and to prevent and alleviate human...

 donated supplements to the EBMCH, and the UNICEF arm based in Nairobi gave some medical supplies to the EBMCH in early 2007.

EBMCH as a maternity hospital

East Bardera Mothers and Children's Hospital was initially envisioned as a maternity hospital but the need of the community for broad medical services facility was an immediate need which needed an urgent solution. Currently, all women and mothers can get medical advice and relatively cheap medications. The UNICEF has afforded EBMCH some supplements for expecting women and new mothers. Nurses make scheduled visits to homes of new mothers where they dispense basic medical services including free supplements for the mothers as well for the new babies.

EBMCH name has been changed to Bardera Maternity and Children's Hosital. At the beginning, the name of the hospital included the word "east", both sides of Bardera is now served by this maternnity and children's hospital since December 2008. Hence, the name change.

Since there is no functioning ministry of health, the hospital staff does whatever it can to help improve the health of the community, particularly, the health of women and children. Prevention of problems is the goal of the staff at East Bardera Mothers and Children's Hospital.

East Bardera Hospital services and facilities

Patients who receive medical services include children as well as adults. The hospital mostly focuses on women's and children's health services. Nurses and midwives go out into the community where they give medical advice and services to women in their homes. During 2007, over 1400 women received prenatal and maternity help in their own homes or at EBMCH facilities.

Maternity Services Rendered 2007 & First Quarter of 2008
Year At EBMCH Cared at Home Stillbirth Total
2007 1,478 1,481 10 2969
2008 313 770 2 1085*

*2008 first quarter figures. The previous year shows almost equal number of women being helped at their homes compared to those at EBMCH maternity ward.

2008 annual report

Adults <5 Years < 1 Year Prenatal Care Live Deliveries Stillborn Total
818 655 201 977 931 29 3,611


Facilities at East Bardera Mothers and Children's Hospital contain five rooms, with three rooms having patient beds including a delivery bed. As of the end of 2007, no other MCH in Bardera offered full maternity services and this has overwhelmed the staff at East Bardera Mothers and Children's Hospital in their quest to provide maternity services to women across the city. Data compiled by the staff shows close to 3000 women being helped either at the EBMCH facility or in their own homes. Lack of emergency response vehicles made half of those women who were given maternity services to give birth at home
Home birth
A home birth in developed countries is an attended or an unattended childbirth in a non-clinical setting, typically using natural childbirth methods, that takes place in a residence rather than in a hospital or a birth centre, and usually attended by a midwife or lay attendant with expertise in...

.

2009 and 2010

Armed oppossing groups made Bardera one of their important war fronts during early 2009. Most public services including hospitals and schools were shut down for considerable period of time. Supplies became hard to be brought in. There were a lot of choas and inconveniences for the population as well as service providers in the region.

2010 Figures

{| class="wikitable"
|-
! Adults
! <5 Years
! < 1 Year
! Prenatal Care
! Live Deliveries
! Stillborn
! Total
|-
| 380
| 75
| 41
| 187
| 134*
| 5
| 822*
|}
*Deliveries include all services including those done home by Hospital due to lack of transportation.

**August 2010-December 2010. Factors contributing to service decrease included lack of transportation, patient financial difficulties due drought and security issues.
As the situation has changed in late 2010, when the hospital was moved to its third location in four years. Operating hours were increased to 24 hours. Teams on duty consist of 3 midwives, one nurse and junior pharmacist are on duty.
The hospital has set up mechanisms where maternity cases are transferred to Mandera, Kenya. Supplies and availability of trained medical staff are coming back to normal again.
Source: Dahir Abdi Dini, Field Office Assistant, 2009-December 2010

Bardera West Maternity Unit

The west side of Bardera has a new maternity unit. This unit was opened on December 13, 2008. Present at the opening occasion of this unit, was the head of Bardera Council of Elders, Hussein Ali Bihi. This unit has a staff of three people. One of the most liked midwives in Bardera, Fadumo Mohamed Elmi and her assistant Nimo Ibrahim Afyare will be the two people running West Bardera Maternity Unit.

Midwife Fadumo Mohamed Elmi has served Bardera for decades. East Bardera Mothers and Children's Hospital is pleased to have her onboard at this stage. One of the best things that will happen now is that, both midwives, Markabo Bilal Kulow and Fadumo Mohamed Elmi will train new midwives, so that the region will always have a fresh helping hands. East Bardera Mothers and Children's Hospital and the new Bardera Poytechnic College, combined with the experience of Markabo and Fadumo, women in Bardera region will have better health services.

Most services and businesses in Bardera are located on the eastside of town but the population on the western side of Bardera has been on the rise for two decades now. East Bardera Mothers and Children's Hospital director, Fardowsa Abdinur Hashi and her staff have always given their best for health services directed at the residents on the west side of Bardera. The two Units, one on the east and the new west-side unit will have close cooperations in terms of scheduled work, supplies, and joint-trainings.

Fardowsa spoke about the importance of people of this side of Bardera doing their part, in terms of informing their neighbors and friends about the services available at West Bardera Maternity Unit
West Bardera Maternity Unit
-Introduction:The city of Bardera, Gedo, Somalia, is a place where women and children get basic medical services. West Bardera Maternity Unit, established on December 13, 2008, offers basic women’s and children’s health services including prenatal, child delivery services, post-partum and child...

. Supplements for pregnant girls and women, the help available to them up to the birthing process and beyond. Just as the rest of maternity hospitals in the region, this unit is lacking some the basic equipments such as ultra sound.

Staff at EBMCH

The medical team at East Bardera Mothers and Children's Hospital numbers six in total. There is the head nurse who is also the Director of East Bardera Mothers and Children's Hospital.http://www.somalisupportsecretariat.info/events/stories/seho.htm Other staff includes an additional nurse, a midwife, an assistant midwife, a junior pharmacist, and an assistant pharmacist.

Nurse Fardowsa serves as the Assistant Head Nurse at East Bardera Mothers and Children's Hospital. She has held this position since October 2007. Markabo Bilal Kulow, the head midwfie, has served the Bardera community for over 10 years as a midwife.

The staff at EBMCH is hard at work in finding solutions to one deadly occurrence in Somalia during each dry season: the deadly watery diarrhea or Acute Watery Diarrhea (AWD). Communities across Somalia suffer from this annual occurrence. The East Bardera Hospital is planning to establish a permanent treatment center for this disease and other communicable diseases
Infectious disease
Infectious diseases, also known as communicable diseases, contagious diseases or transmissible diseases comprise clinically evident illness resulting from the infection, presence and growth of pathogenic biological agents in an individual host organism...

 such as Tuberculosis
Tuberculosis
Tuberculosis, MTB, or TB is a common, and in many cases lethal, infectious disease caused by various strains of mycobacteria, usually Mycobacterium tuberculosis. Tuberculosis usually attacks the lungs but can also affect other parts of the body...

 and HIV AIDS
AIDS
Acquired immune deficiency syndrome or acquired immunodeficiency syndrome is a disease of the human immune system caused by the human immunodeficiency virus...

.

The hospital currently gets many of its medical supplies from the United States and Canada; the majority of medications at larger Somali markets such as Mogadishu and Kismayo are often unreliable and sometimes dangerous for consumption.

Bardera Polytechnic College Trains More Medical Staff

Newly established Bardera Poytechnic College is focusing among other things, training more medical staff for the local health centers. And East Bardera Mothers's Children's Hospital is among the first to receive new supply of trained medical personal. As the population of Bardera increases, and more services is needed, it's essential to have a place that trains additional staff.

Current staff from EBMCH have had their medical training outside of Bardera. EBMCH and Bardera Polytechnic have already established working relations. The Dean (Hormuud) of Bardera Polytechnic, Mohamed Abdudullahi Barre, is a friend and a supporter of East Bardera Mothers and Children's Hospital. Mohamed was a longtime English Language Instructor, who worked at various education centers in Bardera District. There are at least 20 new medical students for the first patch of students at Bardera Polytechnic. These students will fill different fields such puplic health sciences, nursing and junior pharmacy, and these future leaders will have two years of training, each.

Community Education Against FGM And Other Health Information Sessions

Staff at East Bardera Hospital have initially taken up the task of going to Bardera city neighborhoods where they give basic health education in which the community will benefit in the long term. One issue which has affected many women and young girls is female genital mutilation (FGM). Since the last twenty five years or so, there has been slow but growing attention being given to this subject. Educated women and their families are aware of the health problems faced by women who have gone through this terrible procedure and they choose not to take their daughters to these mutilating practitioners.

Some of the problems resulting from FGM include birthing problems, unusual infections, and numerous other complications. Nurses at EBMCH regularly hold sessions dealing with FGM at all community outings. Neighborhood Level community health information sessions include:
  1. The need for every woman to take care of her health by visiting clinics often and ask about specific treatments
  2. Getting supplements and proper nutrition during and after pregnancy
  3. Taking part in women's health oriented organizations' meetings


Nurses at East Bardera tell women: Healthy women raise healthy children. This statement often results other women and men supporting female family members where they are afforded financial and other forms of help such as family members accepting medical advice given to mothers and young women when they bring such information home.

Pharmacy at the East Bardera Maternity Hospital

From the beginning, it was evident that some of the illnesses pregnant women face in Bardera could have been prevented with safe supplements and with basic prenatal care. Supplies and medicine at the East Bardera Maternity hospital were purchased according to the needs of women and children. As there is no major hospital serving in this community of over 100,000 people, patients of all sorts, ordinary folks, walk-in patients with variety of illnesses and men and women of all ages come to the pharmacy of East Bardera Mothers and children's Hospital to fill out their prescriptions.

Before the establishment of EBMCH in 2006, any sick person in Bardera and surrounding areas would go to private pharmacies for treatment. And most of the drugs available in Bardera were not reliable in most part due to lack safety enforcement and the unknown origins of these medicines. East Bardera Hospital Pharmacy operates as a non-profit, hence, the need to obtain and give out unreliable drugs is out of the question. This obviously proved wonderful for the population of Bardera who seek medical treatment at East Bardera Maternity Hospital and its different departments such as maternity, children's services and department of pharmacy.

The pharmacy is supplied with medicine from Canada and US. Most of these drugs are non-prescription in nature. EBMCH hospital pharmacy is staffed with junior pharmacist and her assistant. As you can see from the pharmacy shelves, there is no whole lot of supplies here. But one of the greatest things at East Bardera Mothers and Children's Hospital is the quality of medicines. All of these medicines have been purchased from safe markets. Aside from supplements and pain killers, stomach worm drugs are some of the most effective drugs available at the East Bardera Maternity Hospital. This was reported by patients and communitywide individuals as a feedback to the hospital services in general, and as an anecdotic fact given to the pharmacy staff by patients who previously received drugs or treatment from the hospital.

Community participation in strengthening EBMCH

The EBMCH staff encourages visitors from North America
North America
North America is a continent wholly within the Northern Hemisphere and almost wholly within the Western Hemisphere. It is also considered a northern subcontinent of the Americas...

 and Europe
Europe
Europe is, by convention, one of the world's seven continents. Comprising the westernmost peninsula of Eurasia, Europe is generally 'divided' from Asia to its east by the watershed divides of the Ural and Caucasus Mountains, the Ural River, the Caspian and Black Seas, and the waterways connecting...

 to bring well-preserved over-the-counter medicines
Over-the-counter drug
Over-the-counter drugs are medicines that may be sold directly to a consumer without a prescription from a healthcare professional, as compared to prescription drugs, which may be sold only to consumers possessing a valid prescription...

 and donate them to the EBMCH's Pharmacy
Pharmacy
Pharmacy is the health profession that links the health sciences with the chemical sciences and it is charged with ensuring the safe and effective use of pharmaceutical drugs...

 Department. They have requested medications that have a long shelf-life
Shelf life
Shelf life is the length of time that food, drink, medicine, chemicals, and many other perishable items are given before they are considered unsuitable for sale, use, or consumption...

because non-air-conditioned room temperatures are too high for many medicines and creates a condition for expedited expiration for these medicines.

Future expansions for Bardera Maternity Hospital include construction for a new facility 1.2 km east of the Bardera Arc, which is planned to start in October 2009 and acquiring at least two ambulances. Both activities need the support of the community, especially, Diaspora friends of the hospital and anonymous donors and instituitions.

External links

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