Mexico’s Popocatepetl volcano rumbled to life again this week, belching out towering clouds of ash that forced 11 villages to cancel school sessions.

The residents weren’t the only ones keeping a close eye on the towering peak. Every time there is a sigh, tic or heave in Popocatepetl, there are dozens of scientists, a network of sensors and cameras, and a roomful of powerful equipment watching its every move.

The 5,426-meter volcano, known affectionately as “El Popo,” has been spewing toxic fumes, ash and lumps of incandescent rock persistently for almost 30 years, since it awakened from a long slumber in 1994.

The volcano is 72 kilometers southeast of Mexico City, but looms much closer to the eastern fringes of the metropolitan area of 22 million people. The city also faces threats from earthquakes and sinking soil, but the volcano is the most visible potential danger — and the most closely watched. A severe eruption could cut off air traffic, or smother the city in clouds of choking ash.

Ringed around its summit are six cameras, a thermal imaging device and 12 seismological monitoring stations that operate 24 hours a day, all reporting back to an equipment-filled command center in Mexico City.

A total of 13 scientists from a multidisciplinary team take turns staffing the command center around the clock. Being able to warn of an impending ash cloud is key, because people can take precautions. Unlike earthquakes, warning times can be longer for the volcano and in general the peak is more predictable.

On a recent day, researcher Paulino Alonso made the rounds, checking the readings at the command center run by Mexico’s National Disaster Prevention Center, known by its initials as Cenapred. It is a complex task that involves seismographs that measure the volcano’s internal trembling, which could indicate hot rock and gas moving up the vents in the peak.

Monitoring gases in nearby springs and at the peak — and wind patterns that help determine where the ash could be blown — also play a role.

The forces inside are so great that they can temporarily deform the peak, so cameras and sensors must monitor the very shape of the volcano.

How do you explain all of this to 25 million non-experts living within a 62-mile (100-kilometer) radius who have grown so used to living near the volcano?

Authorities came up with the simple idea of a volcano “stoplight” with three colors: green for safety, yellow for alert and red for danger.

For most of the years since the stoplight was introduced, it has been stuck at some stage of “yellow.” The mountain sometimes quiets down, but not for long. It seldom shoots up molten lava: instead it’s more the “explosive” type, showering out hot rocks that tumble down its flanks and emitting bursts of gas and ash.

The center also has monitors in other states; Mexico is a country all too familiar with natural disasters.

For example, Mexico’s earthquake early alert system is also based at the command center. Because the city’s soil is so soft — it was built on a former lake bed — a quake hundreds of miles away on the Pacific coast can cause huge destruction in the capital, as happened in 1985 and 2017.

A system of seismic monitors along the coast sends messages that race faster than the quake’s shock waves. Once the sirens start blaring, it can give Mexico City residents up to half a minute to get to safety, usually on the streets outside.
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The World Health Organization on Saturday launched a global network to help swiftly detect the threat from infectious diseases, like COVID-19, and share the information to prevent their spread.

The International Pathogen Surveillance Network (IPSN) will provide a platform for connecting countries and regions, improving systems for collecting and analyzing samples, the agency said.

The network aims to help ensure infectious disease threats are swiftly identified and tracked and the information shared and acted on to prevent catastrophes like the COVID pandemic.

The network will rely on pathogen genomics to analyze the genetic code of viruses, bacteria and other disease-causing organisms to understand how infectious and deadly they are and how they spread.

The data gathered will feed into a broader disease surveillance system used to identify and track diseases, in a bid to contain outbreaks and to develop treatments and vaccines.

‘Ambitious’ goals

WHO chief Tedros Adhanom Ghebreyesus hailed the “ambitious” goals of the new network, saying it could “play a vital role in health security.”

“As was so clearly demonstrated to us during the COVID-19 pandemic, the world is stronger when it stands together to fight shared health threats,” he said.

The IPSN, announced a day before the annual meeting of WHO member states begins in Geneva, will have a secretariat within the WHO’s Hub for Pandemic and Epidemic Intelligence.

It is the latest of several initiatives launched since COVID that aim to bolster the world’s ability to prevent and more effectively respond to pandemic threats.

The network will bring together experts on genomics and data analytics, drawn from governments, academia, the private sector and elsewhere.

“All share a common goal: to detect and respond to disease threats before they become epidemics and pandemics, and to optimize routine disease surveillance,” the agency said.

COVID highlighted the critical role pathogen genomics plays when responding to pandemic threats, with the WHO noting that without the rapid sequencing of the SARS CoV-2 virus, vaccines would not have been as effective and would not have become available as quickly.

New and more transmissible variants of the virus would also not have been identified as quickly.

“Genomics lies at the heart of effective epidemic and pandemic preparedness and response,” the agency said, adding that it was also vital for surveillance of a range of diseases, from influenza to HIV.

Many countries lack effective systems

While the pandemic spurred countries to scale up their genomics capacity, the agency warned that many still lack effective systems for collecting and analyzing samples.

The IPSN would help address such challenges, Tedros said, since it could “give every country access to pathogen genomic sequencing and analytics as part of its public health system.”
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The U.S. space agency NASA announced Friday it has awarded the Jeff Bezos-owned aerospace company Blue Origin a contract to build a second lunar lander for the Artemis V moon mission, aiming to land a crew on the moon by 2029.

At a Washington news conference, NASA Administrator Bill Nelson said under the $3.4 billion contract, Blue Origin will design, develop, test and verify its Blue Moon lander to meet NASA’s human landing system requirements for recurring astronaut expeditions to the lunar surface, including docking with Gateway, a space station where crews will transfer in lunar orbit. 

Two years ago, Blue Origin made a bid on the contract NASA awarded to the Elon Musk-owned company SpaceX to build NASA’s initial human landing system to be used in the agency’s Artemis III and Artemis IV missions. In a release, the agency said it also directed SpaceX to evolve its design to meet the requirements for sustainable exploration on the moon.

Under its contract, Blue Origin will build a lander that meets the same sustainable requirements, including capabilities for a larger crew, longer missions and the delivery of more mass to the moon. NASA officials said the program is an important step toward their goal to establish “a regular cadence” of missions to the moon. 

And, NASA said, that competitive approach, using multiple providers, drives innovation, brings down costs and invests in commercial capabilities that will foster “a lunar economy.”

Nelson said Friday, “We are in a golden age of human spaceflight, which is made possible by NASA’s commercial and international partnerships. Together, we are making an investment in the infrastructure that will pave the way to land the first astronauts on Mars.”

The agency said the Artemis V project is the next step between extended lunar exploration capabilities and establishing a base on the moon to support recurring complex missions that would lead, eventually, to moon-to-Mars exploration.

Some information for this report was provided by Reuters. 
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More than half of the world’s large lakes and reservoirs have shrunk since the early 1990s, chiefly because of climate change, intensifying concerns about water for agriculture, hydropower and human consumption, a study published Thursday found.

An international team of researchers reported that some of the world’s most important water sources — from the Caspian Sea between Europe and Asia to South America’s Lake Titicaca — lost water at a cumulative rate of about 22 gigatonnes per year for nearly three decades. That’s about 17 times the volume of Lake Mead, the largest reservoir in the United States.

Fangfang Yao, a surface hydrologist at the University of Virginia who led the study in the journal Science, said 56% of the decline in natural lakes was driven by climate warming and human consumption, with warming “the larger share of that.”

Climate scientists generally think that the world’s arid areas will become drier under climate change and wet areas will get wetter, but the study found significant water loss even in humid regions. “This should not be overlooked,” Yao said.

Scientists assessed almost 2,000 large lakes using satellite measurements combined with climate and hydrological models.

They found that unsustainable human use, changes in rainfall and runoff, sedimentation, and rising temperatures have driven lake levels down globally, with 53% of lakes showing a decline from 1992 to 2020.

Nearly 2 billion people who live in drying lake basins are directly affected, and many regions have faced water shortages in recent years.

Scientists and campaigners have long said it is necessary to prevent global warming beyond 1.5 degrees Celsius (2.7 degrees Fahrenheit) to avoid the most catastrophic consequences of climate change. The world has already warmed about 1.1C (1.9F).

Thursday’s study found unsustainable human use dried up lakes such as the Aral Sea in Central Asia and the Dead Sea in the Middle East, while lakes in Afghanistan, Egypt and Mongolia were hit by rising temperatures, which can increase water loss to the atmosphere.

Water levels rose in a quarter of the lakes, often as a result of dam construction in remote areas such as the Inner Tibetan Plateau.
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Mexican authorities said Thursday that they were trying to locate several hundred people, including U.S. nationals, potentially at risk of developing fungal meningitis after medical treatment near the border.

The announcement came a day after the United States warned that suspected fungal infections had led to severe illness and even death among U.S. residents returning from the Mexican city of Matamoros.

Around 400 people were being traced, including roughly 80 from the United States, according to the health minister of Tamaulipas state, home to Matamoros, which sits across the border from Brownsville, Texas.

“They’re going to be located to rule out that they are infected,” Vicente Joel Hernandez told AFP.

Two clinics, River Side Surgical Center and Clinica K-3, have been closed following the death of an American and the infection of seven other people, he said.

According to the U.S. government, the affected travelers had medical or surgical procedures, including liposuction, that involved injecting anesthetic into the area around the spinal column.

The U.S. Centers for Disease Control and Prevention advised canceling any procedure that involves an epidural injection in Matamoros until the problem is resolved.

It urged anyone experiencing symptoms of fungal meningitis after having such an injection in the city to go to a hospital emergency department immediately.

The symptoms include fever, headache, stiff neck, nausea, vomiting, confusion and sensitivity to light, it said, adding that fungal meningitis infections are not contagious or transmitted person-to-person.

Mexico is one of the world’s top medical tourism destinations, largely due to U.S. residents crossing the border for everything from dental work to cosmetic surgery and cancer treatment.
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Drug overdose deaths in the U.S. went up slightly last year after two big leaps during the pandemic. 

Officials with the Centers for Disease Control and Prevention say the numbers plateaued for most of last year. Experts aren’t sure whether that means the deadliest drug overdose epidemic in U.S. history is finally reaching a peak, or whether it’ll look like previous plateaus that were followed by new surges in deaths. 

“The fact that it does seem to be flattening out, at least at a national level, is encouraging,” said Katherine Keyes, a Columbia University epidemiology professor whose research focuses on drug use. “But these numbers are still extraordinarily high. We shouldn’t suggest the crisis is in any way over.” 

An estimated 109,680 overdose deaths occurred last year, according to numbers posted Wednesday by the CDC. That’s about 2% more than the 107,622 U.S. overdose deaths in 2021, but nothing like the 30% increase seen in 2020, and 15% increase in 2021. 

While the overall national number was relatively static between 2021 and 2022, there were dramatic changes in a number of states: 23 reported fewer overdose deaths, one — Iowa — saw no change, and the rest continued to increase. 

Eight states — Florida, Indiana, Kentucky, Maryland, Michigan, Ohio, Pennsylvania and West Virginia — reported sizable overdose death decreases of about 100 or more compared with the previous calendar year. 

Some of these states had some of the highest overdose death rates during the epidemic, which Keyes said might be a sign that years of concentrated work to address the problem is paying off. State officials cited various factors for the decline, like social media and health education campaigns to warn the public about the dangers of drug use; expanded addiction treatment — including telehealth — and wider distribution of the overdose-reversing medication naloxone. 

Plus, the stigma that kept drug users from seeking help — and some doctors and police officers from helping them — is waning, said Dr. Joseph Kanter, the state health officer for Louisiana, where overdose deaths fell 4% last year. 

“We’re catching up and the tide’s turning — slowly,” said Kanter, whose state has one of the nation’s highest overdose death rates. 

Beginning in the mid-1990s, abuse of prescription opioid painkillers was to blame for deaths before a gradual turn to heroin, which in 2015 caused more deaths than prescription painkillers or other drugs. A year later, the more lethal fentanyl and its close cousins became the biggest drug killer. 

Last year, most overdose deaths continued to be linked to fentanyl and other synthetic opioids. About 75,000, up 4% from the year before. There also was an 11% increase in deaths involving cocaine and a 3% increase in deaths involving meth and other stimulants. 

Overdose deaths are often attributed to more than one drug; some people take multiple drugs and officials say inexpensive fentanyl is increasingly cut into other drugs, often without the buyers’ knowledge. 

Research from Dr. Daniel Ciccarone, a drug policy expert at the University of California, San Francisco, suggests “there appears to be some substitution going on,” with a number of people who use illicit drugs turning to methamphetamines or other options to try to stay away from fentanyl and fentanyl-tainted drugs. 

Ciccarone said he believes overdose deaths finally will trend down. He cited improvements in innovations in counseling and addiction treatment, better availability of naloxone and legal actions that led to more than $50 billion in proposed and finalized settlements — money that should be available to bolster overdose prevention. 

“We’ve thrown a lot at this 20-year opioid overdose problem,” he said. “We should be bending the curve downward.” 

But he also voiced some caution, saying “we have been here before.” 

Consider 2018, when overdose deaths dropped 4% from the previous year, to about 67,000. After those numbers came out, then-President Donald Trump declared “we are curbing the opioid epidemic.” 

But overdose deaths then rose to a record 71,000 in 2019, then soared during the COVID-19 pandemic to 92,000 in 2020 and 107,000 in 2021. 

Lockdowns and other pandemic-era restrictions isolated people with drug addictions and made treatment harder to get, experts said. 

Keyes believes that 2022’s numbers didn’t get any worse partly because isolation eased as the pandemic ebbed. But there may be issues ahead, others say, like increased detection of veterinary tranquilizer xylazine in the illicit drug supply and proposals to scale back things like prescribing addiction medications through telehealth. 

“What the past 20 years of this overdose crisis has taught us is that this really is a moving target,” Keyes said. “And when you think you’ve got a handle on it, sometimes the problem can shift in new and different ways.” 
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“I remember my wife, Dora, coming home one day and telling me she had a problem while driving,” said Bill Collier, a marketing professional living near Harrisburg, Pennsylvania. “She said she stopped at an intersection and suddenly couldn’t remember where she was going.” 

That was in August of 2015. Then things got worse. Within months, Collier said Dora began experiencing nervous breakdowns and hallucinations on a nightly basis. 

“She freaked out at me, at the world, at God — you name it,” he told VOA. “Most nights we both ended up in tears because we didn’t know what was going on or why it was happening.” 

It wasn’t until nearly six years later, in February 2021, that Dora, now 57, was finally diagnosed with Alzheimer’s disease, a progressive mental deterioration most commonly suffered by the elderly, but which can also strike middle-aged people. The disease, the sixth leading cause of death in the United States and the only one in the top 10 without a cure or potentially reversible treatment, causes brain cell connections and the cells themselves to degenerate and die.

The eventual result is the destruction of memory and other important mental functions. 

“The day we got the diagnosis felt like getting a death sentence,” Collier said. “Dora is still alive, but it’s been the eight toughest years of my life. Alzheimer’s is like a slow motion, everyday horror movie with a senseless plot that haunts my thoughts each hour I’m awake.” 

Diagnosing the disease

“Alzheimer’s disease is a public health crisis, and it’s growing at a rapid rate,” explained Ruby Dehkharghani, director of public policy at the Alzheimer’s Foundation of America (AFA).

According to the Alzheimer’s Association, 6.5 million Americans live with the disease, including roughly one in nine senior citizens. The Centers for Disease Control and Prevention (CDC) projects that number to more than double to 13.8 million people by 2060.

Family members of those with Alzheimer’s say one major problem is how long it can take to diagnose the issue and begin treatment.

“On one hand, it’s hard to get doctors and health care systems to take family members seriously during the early, undiagnosed stages of Alzheimer’s,” Collier said. “On the other hand, you have patients themselves avoiding getting tested and lying to the doctor because they don’t want to admit what amounts to a horrible truth.” 

This is what Krista Patrick-Brown, a school principal in New Orleans, Louisiana, experienced with her father.

“My dad was diagnosed in the fall of 2020, when it was obvious to the rest of us that something was going on and he needed to be tested,” Patrick-Brown told VOA. 

It was only when the family gained access to his medical records at the time of diagnosis that they learned he had expressed concern to his doctor three years earlier because he was struggling to perform his job. 

“I think he was scared to tell anyone, or maybe the realization that it could be something serious made him avoid learning more,” she continued. “Either way, he didn’t follow up until it was unavoidable, and I can’t help but imagine how starting his medicine years earlier might have slowed his deterioration.” 

Drugs have recently been developed that can slow but not stop the progression of Alzheimer’s, if administered in the early stages of the disease. Such treatments are expensive and can have side effects. While drugmakers race to develop and test what is hoped will be more effective treatments, there is no indication that a cure is on the horizon. 

“The current medications for Alzheimer’s have very, very modest benefits,” said Colleen Kenny, a nurse who works with dementia patients at a hospital outside of Chicago. “Families should temper their expectations for how well they should work.” 

A nightmare 

Patrick-Brown said her father’s loss of independence has been one of the more difficult aspects of the disease for him.

She said they tried to encourage him to stop driving on his own, for example, but he resisted. Once her father’s doctor reported his diagnosis to the state, he had to either pass a driver’s test or forfeit his license. 

“It was awful. He spent weeks trying to study for the test, but he couldn’t process the information,” Patrick-Brown remembered. “His anxiety increased and he didn’t seem to even completely grasp why he was being asked to take the test in the first place.” 

“I think that’s when our roles flipped indefinitely,” she said. “From then on, my father would always be child-like to me and my brother, and we are now his parents.” 

It’s common for patients with dementia — of which Alzheimer’s is the most common type — to exhibit behaviors found in younger children, such as mood swings, tantrums, irrationality, forgetfulness, vocabulary problems, fear, and extreme dependence on family members.

“They get angry, sensitive, and irrational,” said Margarita Hernandez, an aide for Alzheimer’s patients in Commack, New York, “but of course it’s not their fault. They didn’t choose this. They are innocent and we need to respond by giving them love, attention, and help.”

Life of a caregiver

Dehkharghani of the AFA notes that Alzheimer’s patients aren’t the only ones severely impacted by the disease.

“Many of the things that make it challenging for the person living with Alzheimer’s are what also make it challenging for family members providing care,” she said. “Caregivers will be expected to provide greater assistance to their loved ones as the disease progresses, and they’ll carry the emotional impact of watching their personalities change. It’s not something someone should be expected to do alone.”

Alexandra Magiera, who works in education in Chicago, Illinois, and is a volunteer for the Alzheimer’s Association, said she was just 15 years old when her mother, Lizzie, was diagnosed with the disease.

For Lizzie, it started with what appeared to be small things such as confusion about where she was supposed to be, but Magiera said it quickly got worse. 

“A year later she had trouble remembering my name, and a few years after that she no longer knew who I was,” she said. “That, plus there were times she was getting angry and combative. It was all heartbreaking.”

When Magiera left for college, the responsibility of caregiver for her mother fell even more squarely on her father’s shoulders.

“She was the love of my dad’s life and he cared for her as best as he could,” she said, “but the physical and emotional demand was too much and eventually he had to place her in a nursing home. I know it was one of the hardest decisions he ever had to make.”

During the last two years of Lizzie’s life, Magiera’s dad couldn’t stand it anymore.

“He told a friend, ‘I’m bringing Lizzie home; I miss her too much,’ and that’s what he did,” Magiera said. “I think he relished every moment he was able to spend with her.”

Moving forward

According to the CDC, more than 11 million Americans care for a loved one with Alzheimer’s. For many, it’s not possible to be the sole caregiver.

“I hate to say it, but unfortunately money is key,” explained Kenny. “In-home health aides aren’t often covered by insurance, and a decent nursing home for my father, who had dementia, cost $7,000 per month. There aren’t easy solutions.”

Magiera said her father had been retired for 20 years, but after her mother died in 2011, he had to go back to work to help pay for his wife’s medical bills.

“I can’t even imagine what would have happened if he hadn’t been on such solid financial footing to start,” Magiera said. 

The heartbreak this disease has caused so many Americans and their families has stirred Washington to action.

When the National Plan to Address Alzheimer’s Disease was released in 2011, initial funding totaled approximately $500 million a year, far below the $2 billion goal that leading scientists had estimated was necessary to find a treatment or cure by 2025. More recently, however, politicians have worked together to increase federal research investment to more than $3.4 billion last year.

“It’s encouraging to see such a bipartisan effort, but we’re not across the finish line yet,” said Dehkharghani. “There are still so many unanswered scientific questions when it comes to Alzheimer’s, but researchers are working very hard to discover answers and to hopefully find the breakthrough that will lead to the treatment and cure we’re all hoping for.”

In the meantime, things have been learned to stave off the effects of Alzheimer’s, including cardiovascular exercise, maintaining a healthy blood pressure, continuing a consistent level of socialization and, of course, early diagnosis.

“I sometimes wonder what we’d be doing right now if my wife had early treatment,” Collier told VOA. “Would we be traveling the world? Would we be checking items off her bucket list?”

“Instead, I go to her senior living facility every day,” he continued, “because I want the nurses to know this woman who has been reduced to shuffling and mumbling is still my Dora — she’s a Navy veteran and a very accomplished woman, and I want them to know her story.” 
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Countries can reduce plastic pollution by 80% by 2040 using existing technologies and by making major policy changes, the United Nations Environment Programme (UNEP) said in a new report on Monday.

The Kenya-based U.N. body released its analysis of policy options to tackle the plastic waste crisis two weeks before countries convene in Paris for a second round of negotiations to craft a global treaty aimed at eliminating plastic waste.

The report focuses on three main market shifts needed to create a “circular” economy that keeps produced items in circulation as long as possible: reuse, recycling and reorientation of packaging from plastic to alternative materials.

“If we follow this road map, including in negotiations on the plastic pollution deal, we can deliver major economic, social and environmental wins,” said Inger Andersen, UNEP executive director.

The treaty negotiations, known as INC2, will be May 29 to June 2 and are expected to result in key inputs for the first treaty draft, which needs to be done before the third round of negotiations in Kenya in November.

UNEP estimates that government promotion of reuse options such as refillable bottle systems or deposit return schemes could reduce 30% of plastic waste by 2040.

It also says that recycling could achieve an additional 20% by that year if “it becomes a more stable and profitable venture” and fossil fuel subsidies are removed, and that the replacement of products such as plastics wraps and bags with compostable materials could yield an additional 17% reduction.

Countries have different approaches to tackling plastic waste. Some major plastic-producing countries such as the United States and Saudi Arabia prefer a system of national strategies.

A “High Ambition Coalition,” comprising Norway, Rwanda, New Zealand, the European Union and others, have called for top-down approach where global targets are set to reduce virgin plastic production and eliminate fossil fuel subsidies, among other measures.

Some campaigners said the UNEP blueprint fell short of tackling the root of the pollution problem.

“A treaty that does not cap and reduce plastic production will fail to deliver what the people need, justice demands and the planet requires,” said Angel Pago, director of Greenpeace’s plastics campaign.
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Edna Adan Ismail, a nurse-midwife, hospital founder, and health care advocate who for decades has combated female genital mutilation and strived to improve women’s health care in East Africa, was named Tuesday as winner of the 2023 Templeton Prize, one of the world’s largest annual individual awards.

“Rooted in her Muslim faith, she receives this year’s award in recognition of her extraordinary efforts to harness the power of the sciences to affirm the dignity of women and help them to flourish physically and spiritually,” said the announcement.

Among her achievements: the founding of a hospital and university which have significantly reduced maternal mortality in Somaliland.

The Templeton Prize, valued at nearly $1.4 million, was established in 1973 by philanthropist Sir John Templeton. It honors those “who harness the power of the sciences to explore the deepest questions of the universe and humankind’s place and purpose within it.”

Ismail, the first African woman to win the prize, “has used the teachings of her faith, family, and scientific education to improve the health and opportunities of some of the world’s most vulnerable women and girls,” said Heather Templeton Dill, president of the John Templeton Foundation.

Ismail, 85, said she would donate some of her prize money to the U.S.-based Friends of Edna Maternity Hospital, for use in purchasing new equipment, hiring educators and “training the next generation of health care workers that East Africa so desperately needs.”

Ismail was born in 1937 in Hargeisa, the capital of what was then British Somaliland. Her father was a doctor; thanks to his influence, she was covertly tutored alongside her brothers until she was 15. A scholarship exam, normally reserved for boys, qualified her to study in Britain, where she received an education in nursing and midwifery.

She returned to her homeland as its first medically trained nurse-midwife. According to the prize announcement, she was the first woman to drive a car in her country and the first appointed to a position of political authority as director of the Ministry of Health.

She later joined the World Health Organization, serving as regional technical officer for maternal and child health from 1987-91 and WHO representative to Djibouti from 1991-97.

She left her international career to return home with a dream of building a hospital. After newly re-formed Somaliland declared its independence in 1991 — though it remains unrecognized by foreign powers — its government offered her a tract of land previously used as a garbage dump.

She sold her assets to build the hospital and raised more funds worldwide after a profile of her appeared in The New York Times. The Edna Adan Maternity Hospital opened in 2002.

While Somaliland’s health care system was in disarray, the hospital made great strides, dramatically reducing the maternal mortality. Its education program became Edna Adan University in 2010; it has trained more than 4,000 students to become doctors, nurses and other types of health professionals. More than 30,000 babies have been delivered at the hospital, where 80% of the staff and 70% of the students are women.

Despite its lack of international recognition, Somaliland remains self-governing in its territory in northern Somalia.

Ismail is an outspoken critic of female genital mutilation, a painful and sometimes life-threatening practice performed in some Muslim and non-Muslim societies. When she was 8, her mother subjected her to FGM without the knowledge of her father, who was outraged.

As a practicing midwife early in her career, she was confronted with grievous complications during childbirth from the FGM scarring. After attending a 1976 conference in Sudan at which participants from Muslim countries that practiced FGM spoke about its effects, she was inspired to raise the issue at home.

As a director in Somalia’s health ministry, Ismail began to speak out on FGM — initially shocking her audience and attracting threats, but also building widespread interest. She encouraged women to come forward and men to stand up for them.

“Islam forbids female circumcision,” Ismail said in a video filmed for the Templeton Prize. “Every day I’m reliving and remembering, I’m recalling that pain that happened to me when I was 7 or 8 years old. The wounds may heal but the pain never leaves you.”

While progress has been made, FGM is still practiced in several countries; cases have come to light in Britain, the United States and elsewhere. Ismail’s fight to end FGM continues through her international advocacy and at her hospital.
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