captioning sponsored by newshour productions, llc >> woodruff: good evening, i'm judy woodruff. on the newshour tonight, the fallout from 'fire and fury'-- president trump's comments on north korea raise alarms in asia and elsewhere and prompt pyongyang to threaten an attack on a u.s. base in guam. then, our series on stopping superbugs continues-- tonight: as farms become breeding grounds for disease, the overuse of antibiotics could spell danger for our food. >> on every grocery store shelf in this country i guarantee you you're going to find drug resistant bacteria on the meats of those shelves. and then, they get in our guts. >> woodruff: plus, pushing the bounds of freedom. we hear from a woman who dared to drive in saudi arabia.

all that and more on tonight's pbs newshour. >> major funding for the pbs newshour has been provided by: ♪ ♪ moving our economy for 160 years. bnsf, the engine that connects us. >> supporting social entrepreneurs and their solutions to the world's most pressing problems--

skollfoundation.org. >> the lemelson foundation. committed to improving lives through invention. in the u.s. and developing countries. on the web at lemelson.org. >> supported by the john d. and catherine t. macarthur foundation. committed to building a more just, verdant and peaceful world. more information at macfound.org >> and with the ongoing support of these institutions: >> this program was made possible by the corporation for public broadcasting. and by contributions to your pbs station from viewers like you. thank you. >> woodruff: the latest flashpoint in the american showdown with north korea, has drawn sharply different responses from president trump and his top national security

aides. it all follows reports that pyongyang can now make nuclear weapons small enough to fit inside a long-range missile. john yang begins our coverage. >> yang: amid the escalating war of words, secretary of state rex tillerson urged calm. >> i think americans should sleep well at night, have no concerns about this particular rhetoric of the last few days. what the president is doing is sending a strong message to north korea in language that kim jong un would understand, because he doesn't seem to >> yang: tillerson spoke on his way to the u.s. territory that's home to the b-1 bombers that have been flying training missions over the korean peninsula, drawing north korea's ire. >> ( translated ): the korean people's army is now carefully examining the operational plan for making an enveloping fire at the areas around guam with a medium-to-long-range strategic ballistic rocket in order to contain the u.s. major military bases on guam.

>> yang: defense secretary jim mattis warned pyongyang to stop "consideration of actions that would lead to the destruction of its people. the volley of tough talk comes amid increased north korean tests of missiles that analysts believe could strike the american mainland. yesterday, president trump delivered a stark warning. >> they will be met with fire and fury and frankly power, the likes of which the world has never seen before. >> yang: in south korea, a government spokesman urged >> ( translated ): these kinds of comments by north korea do not help in the relationship of south and north korea. >> yang: but in japan, the chief cabinet secretary welcomed the american muscle-flexing. >> ( translated ): the united states have said 'all options are on the table.' the japanese government supports this attitude. >> yang: president trump said this morning that he had ordered a modernization of the nation's

nuclear arsenal: "it is now far stronger and more powerful than ever before.... ...hopefully we will never have to use this power, but there while mr. trump did order a review of the country's nuclear capability during his first week in office, it was president barack obama who began a one- trillion dollar modernization of the arsenal. it's barely begun and will take decades to complete. the trump administration has seemed to send a variety of signals about its approach to pyongyang. mr. trump had called on china to pressure its renegade neighbor. but after missile tests last month, he seemed to give up on beijing. >> we'll handle north korea. we're gonna be able to handle them. it will be-- it will be handled. we handle everything. >> yang: last month, c.i.a. director mike pompeo said the solution to north korea's nuclear threat is to oust kim jong un. >> the thing that is most dangerous about it is the character who holds the control over them today. so from the administration's

perspective, the most important thing we can do is separate those two, right? >> yang: amid a "new york times" report that mr. trump's "fire and fury" threat caught his aides by surprise, white house press secretary sarah huckabee sanders said the president and his advisors had discussed "the tone and strength of the message" if not the exact words. republican senator lindsey graham said military action would be "inevitable" if north korea continues on its current path. >> president trump has basically drawn a red line saying he'll never allow north korea to have an i.c.b.m. missile that can hit america with a nuclear weapon on top. but if there's going to be a war, it's going to be in the region, not in america. >> yang: a prospect that is sending a shudder through asia-- and the world. for the pbs newshour, i'm john yang >> woodruff: we'll have more on the north korean nuclear threat, and how the trump white house is responding, after the news summary. also today: north korea said it

released a canadian pastor who's been serving a life sentence there since 2015. the north's state news agency said hyun soo lim was let go on "sick bail," but gave no other details. it comes two months after the death of american student otto warmbier, who'd been in a coma when he was released from north korea. in the day's other news, there's word f.b.i. agents have searched a home of former trump campaign chairman paul manafort and seized documents and other materials. "the washington post" first reported the pre-dawn raid and said it happened in july. a manafort spokesman confirmed the search and said manafort has "consistently cooperated with law enforcement and other serious inquiries and did so on this occasion as well." allegations of election fraud set off deadly clashes in kenya today. early results from yesterday's vote showed president uhuru kenyatta with a strong lead.

but challenger raila odinga claimed hackers infiltrated an election database. protesters in nairobi and elsewhere burned tires and set up roadblocks. at least three people were killed. odinga urged calm, but said he doesn't "control the people." >> democratic elections are based on the basic principle, the sovereign are the people. it's not a show for those who stand for election or those who run it. >> woodruff: the kenyan election commission defended its system and denied interference "before, during or after" the vote. the united nations says up to 50 migrants were deliberately drowned off the coast of yemen today. the u.n.'s migration agency said a smuggler forced more than 120 people into the water when he saw authorities on the shore. the migrants were from somalia and ethiopia; their average age was around 16.

the death toll from yesterday's powerful earthquake in southwest china has risen to at least 19. it hit near a national park that's one of the country's top tourist attractions. nearly 250 people were injured. rescue crews worked around the clock to pull victims from under heaps of debris and collapsed rock. but they were slowed by unsafe conditions. >> ( translated ): as you can see on both sides of the valley there are mud and rock slides everywhere so our rescue's been cut short. all we can do is stay here and observe until there's a change for the better, once that's happened we'll go in there and begin the rescue. >> woodruff: a second strong earthquake in far northwest china this morning left dozens of people injured and damaged more than 1,000 homes. the u.s. has imposed sanctions on eight more people in venezuela, amid that country's deepening crisis. they target current and former government officials, for their role in the creation of president nicolas maduro's new,

all-powerful constitutional assembly. one of the sanctioned individuals is the brother of late venezuelan president hugo chavez. there was yet another attack targeting security forces in france today. a man rammed his car into a group of soldiers in a paris suburb, injuring six of them. after an hours-long manhunt, police cornered the suspect on a nearby highway, opened fire and wounded him. the man's motivation was unclear, but officials say they're looking at it as a potential terror attack. >> ( translated ): we know it was a deliberate act, it was not an accident. what i can say is that the anti- terrorism section of the paris prosecutor's office is in charge of the case. this shows that today the threat remains extremely high and that our security forces, our military forces are still being targeted. >> woodruff: later, heavily armed and masked police searched a building believed to be linked to the attacker. president trump appeared to bristle today, over comments by the senate's top republican,

on health care. majority leader mitch mcconnell said monday that mr. trump had excessive expectations" about how quickly lawmakers could act. but in a tweet, the president said he disagreed, adding: "after 7 years of hearing repeal & replace, why not done?" and, on wall street today, stocks were lower, as investors weighed tensions between the u.s. and north korea. the dow jones industrial average lost 36 points to close at 22,048. the nasdaq fell 18. and the s&p 500 dropped a fraction of a point. still to come on the newshour: why tamping down the north korean nuclear threat is so difficult. steps the u.s. is taking to upgrade its own nuclear arsenal. how livestock breed antibiotic- resistant superbugs, and much more.

>> woodruff: returning to our top story tonight, the threats and counter threats between pyongyang and washington. joining me now for how regional powers are reacting to all this: abraham denmark a former deputy assistant secretary of defense for east asia. and mike chinoy, a former senior asia correspondent for cnn, he's visited north korea 17 times and is now a senior fellow at the university of southern california's u.s.-china institute. and we welcome both of you to the "newshour". abraham denmark, let me start with you. given what has happened in the last 24, 48 hours, how do you size up the situation now between the u.s. and north korea? >> i think we're at a bit of an inflection point, both kim jong un and president trump have elevated the tension in terms of rhetoric between the two sides, yet the policies the two sides have been on have not radically changed. kim jong un and north korea have been conducted missile tests at

a regular pace, and the onground policies the u.s. have been doing have been fairly consistent. the real change is the change in the rhetoric with kim jong un putting out very strong statements as well as president trump making his very strong statements. so the question now is what happens after these statements have been made. >> woodruff: that's what i want to ask you about. quickly, you followed the east asia region closely. how is all this being received there? >> there's a great deal of concern amongst our allies. there's concern the messaging out of the trump administration has been fairly chaotic, and different senior officials are speaking about different policy positions, so there's a lot of question about where the united states really is when it comes to north korea. there is also broader and deeper concerns about how the united states is going to handle a north korea that's making very steady progress in developing a robust, credible nuclear capability that is able to reach the united states?

>> woodruff: mike chinoy, again, this is an area you follow so closely, we talk about how many times you visited the north korean mainland. how do you see this situation right now? >> i think what the north koreans are doing has been quite predictable. they believed for many years now that the best way to guarantee their security is to have a nuclear and missile capability that would deter the united states, and this dates back a long, long time. it was reinforced in the early 2,000s when the north koreans saw the u.s. invade iraq and topple saddam hussein who didn't have nukes. they saw muammar gadhafi overthrown, he voluntarily abandoned his nuclear program. so the north is really committed to this. they've just accelerated, i think, in the last couple of years the pace at which they're doing it. i think one of the big questions is how the north koreans are going to respond to the very confusing signals coming from

washington. secretary of state tillerson has mentioned talks but president trump is talking in very, very forceful and extreme language, so i think there is a risk because i don't think the north is going to change its approach of a misunderstanding leading to some kind of conflict. >> woodruff: why do you believe there is a risk of a misunderstanding? >> well, the north koreans are going to respond to threats from the united states with full speed ahead because that's just their style. this is not a system or regime or leadership that's going to bow to that kind of external pressure, and if they fear that the very strong language from president trump means the u.s. might, in fact, be considering some kind of preemptive strike, when it's possible they will calculate that they need to strike first. but i think there is one other point that gets lost in all of the inflammatory headlines which is the north korean position continues to be that they will

not give up their nuclear or missile capabilities unless the u.s. abandons what pyongyang calls washington's "hostile policy." and if you parse the north korean rhetoric, there might be an opening for negotiations, but that depends on the extreme level of confusions and the signals in washington are clarified in way that suggests the u.s. are interested in talks and that the not at all clear. >> reporter: as we're sitting here talking, i'm told by the producer the wires report north korea say they will have a plan to attack gaum by the middle of august and go on to call what president trump has been saying, in their words, is a load of nonsense, and they're saying only absolute force can work with president trump. abe denmark, what does this tell you about what the united states is dealing with and what our

allies in the region are dealing with? >> dealing with a country, north korea, that has a very clear idea of what it wants to do. it sees the development of a nuclear capability as essential to the preservation of its regime and it's willing to bear significant costs in the pursuit of that in terms of diplomatic isolation, severe economic sanctions. they're continuing to make progress on that. the question is how do we get them off that path in. terms of the threats they have been making about gaum, there is actually quite a few steps they have and other options they have between where we are now with the elevated rhetoric, and actually conducting strikes against the united states. >> woodruff: what do you mean? e've seen in the past north korea doing several things -- attacks against south korea on the d.m.z., sinking a ship in the yellow sea several years ago, which in the past they were able to demonstrate to their own people that they're strong, that they're able to attack south korea but did not escalate into a war.

the question now is what options is north korea considering beyond the threatening rhetoric about gaum and how will the united states and our allies respond to that. >> woodruff: mike chinoy, the question one hears from a number of people is are the north koreans suicidal in their attitude? because one assumes, if they were to take any sort of military strike tore the kind we're discussing here right now, the threat against gaum, something in the region, that there would be a return strike that would hit directly at the leadership of the north korean government. >> i don't think the north koreans are suicidal, and i think you have to be very careful in assessing north korean rhetoric because, if you look at the history, going back a long, long time, the north koreans are masters of incendiary rhetoric. brinksmanship is the cornerstone of the way they approach the rest of the world.

these kinds of threats keep their adversaries off balance. they feel it gives them the initiative, but i don't think you can always take it literally. i recall, for example, in the spring of 1994 when tensions were high over the north's then nascent nuclear program. north korean officials they would turn seoul, south korean capital, into a sea of fire. four months later after president carter visited north korea, there was an agreement of the first ever summit between the north and south but didn't happen because the north korean leader died. -- don't assume their rhetoric means they will do everything they threaten to do. >> woodruff: we can't narrate what the trump administration is

going to do, but if you're in their shoes, do you respond with escalated rhetoric or do you try to calm things down? >> i think you do two things. try to calm things down. president eisenhower would practice this. when cru chef 's rhetoric would get strorntion he would counter with softer rhetoric. we have extremely strong alliances in japan and south korea. there is a great deal we can koto indicate we have a great ability and will to act. also send a message to the allies that we're there for them, reliable and capable. >> woodruff: abraham denmark, mike chinoy, we thank you both.

>> woodruff: as we reported earlier, the president said this morning that he ordered the modernization of the american nuclear weapons. that decades-long, one-trillion dollar project was actually begun under barack obama last year, the newshour broadcast a series about that process, which we called "aging arsenal." in one report, special correspondent jamie mcintyre, with the support of the pulitzer center on crisis reporting, looked at the debate over the wisdom of updating america's three-pronged nuclear arsenal. he interviewed the top military commander in charge of america's nukes, who has since retired. here's an excerpt of that story, explaining what the nuclear triad is, and why it exists. >> turn, punch it, seven away. >> reporter: missiles, bombers, subs, america's nuclear triad, a three-pronged approach to deterrence that dates back to the 1960s, when the former

soviet union was the enemy, mad, mutual assured destruction, the strategy, and thermonuclear war seemed a real possibility. >> the real key here, as you look at the combination of the triad, is making the adversary's problem very complex, very costly, so that restraint is a better option. >> reporter: u.s. strategic commander cecil haney is the four-star admiral in charge of america's nuclear arsenal. he says the triad endures because it's still the surest way to guarantee that, even if hit with a first strike, plenty of u.s. nuclear weapons would survive, enough to allow haney to present the president a full range of options. it's a strategy based on redundancy, having backups for backups. but to critics, maintaining and rebuilding all three legs of the triad in the 21st century amounts to expensive overkill, among those critics, former defense secretary william perry.

>> well, you can have belts and suspenders, and then belts and suspenders for the belts and the and suspenders. and that is what we are getting into here. >> reporter: perry says the current strategy is based on the folly of winning a nuclear conflict, the kind of cold war thinking caricatured in the classic movie "dr. strangelove"" >> mr. president, i'm not saying we wouldn't get our hair mussed. but i do say no more than 10 to 20 million killed, tops, depending on the breaks. >> the whole sort of "dr. strangelove" rationale that went with how you use nuclear weapons, which was endemic to the cold war, i don't think is in place today. if we regard nuclear weapons, the role of nuclear weapons today, as preventing the use of nuclear the weapons against us, then all of that goes away. >> reporter: the united states is at the point where, to maintain the safety and reliability of its aging nuclear arsenal, largely designed in the 1950s and '60s, almost everything needs an upgrade. there are plans for new

submarines and stealth bombers, along with upgraded bombs and missiles to go with them. add in the possibility of next generation land-based intercontinental ballistic missiles, i.c.b.m.'s, and the price tag comes to an eye- popping $1 trillion over 30 years. each leg of the triad has its advantages. submarines are stealthy, virtually undetectable, and therefore nearly invulnerable. bombers are slow enough to be recalled at the last minute. it's the third leg, the intercontinental ballistic missiles, on hair-trigger alert, that are under the microscope. we're flying over the missile field that essentially surrounds minot air force base, 150 i.c.b.m.'s buried in silos underground spread across 8,500 square miles of north dakota. it's just one of three missile fields that cover five states, montana, wyoming, nebraska,

colorado, and north dakota, 450 i.c.b.m.'s altogether. were it not for the security fence, this silo would be barely visible in the snow. but the locals know where it is, and so do america's enemies. for now, the debate over the triad is purely academic. the latest pentagon budget funds plans to begin rebuilding all three legs, and no one in congress is mounting any serious opposition. for the pbs newshour, i'm jamie mcintyre. >> woodruff: you can watch our full series on the aging u.s. nuclear arsenal on our website. pbs.org/newshour. >> woodruff: stay with us, coming up on the newshour, a new book from a woman who dared to drive in saudi arabia. but first, our special series,

"stopping superbugs." this week science correspondent miles o'brien and economics correspondent paul solman tag- team again for a look at how the use of antibiotics in livestock can lead to unhealthy, even dangerous, outcomes. miles begins at a missouri pig farm as part of our weekly science series, "leading edge." >> reporter: pig farmer russ kremer is up early, tending to his herd, talking to the animals. >> i have the ability to interact with pigs. i think that they are the smartest most social animals. i tell people that if you like kids, you love pigs. >> reporter: he is the fifth generation in the kremer clan to farm this plot of land in frankenstein, missouri. he introduced me to the newest residents. >> everything that we do on this farm as far as feeding, and as

far as production, as far as genetics it all has to do with keeping them healthy. >> reporter: russ kremer is obsessed with keeping his pigs healthy because he knows first hand that his own health depends on it. 30 years ago, the farmer from frankenstein created a monster after he adopted industrial farming techniques to increase his pig production. >> my pigs were unhealthy. i would go through my pigpens three times a day, injecting them with antibiotics to cure some sort of chronic diseases that i had on my place. in fact i was actually growing superbugs in this farm i didn't know it. >> reporter: how he found out nearly killed him. he was gored in the leg by a boar and the wound became infected. his doctor told him not to worry-- antibiotics were the cure, but it wasn't that simple. >> we tried two different tetracycline, we tried streptomycin, we tried

erythromycin, amoxicillin, seven different antibiotics in total to no avail. >> reporter: so he checked the reports from his veterinarian to see what infections his pigs had and what antibiotics worked for them. >> it came back, resistant, resistant, resistant, resistant and finally, "aha." there was one antibiotic at that time that had some effect on that disease. they treated me and thank god there were this new generation drug. and so that transformed my life. >> reporter: molecular microbiologist lance price also grew up on a farm, a cattle ranch. he watched firsthand, as the neighboring dairy went from a small-scale family operation to an high-density, industrial- scale farm. they are called "concentrated animal feeding operations." lance price says they are fertile breeding grounds for disease. >> you pack them together, snout

to tail in the case of pigs, and beak to feather in the case of chickens and turkeys, they're gonna share bacteria, right? so we've engineered a system that makes them sick. rather than change that system, we actually just add low doses of antibiotics to try to prevent infections. >> reporter: price and his team at george washington university conduct large epidemiological studies of meat that is sold in grocery stores. they culture the bacteria found on the meat and test to see how they react to disks saturated with antibiotics. he is hunting for superbugs. >> if they're susceptible that is not resistant to the antibiotic, they will be inhibited. they won't grow near the disk. but when they grow right up to the disk, like all of these? that means that that bacteria is resistant to all those antibiotics. you don't want to get infected with one of these. and these are bacteria that we actually isolated from the food supply. >> reporter: he sequences the

genomes of e. coli from food and from people, comparing them to a database of 7,000 distinct types of the bacteria. >> we're trying to figure out," hey did this urinary tract infection come from the e.coli from animals or from food?" >> reporter: price there is a strong case linking the use of antibiotics in livestock to the spread of drug resistant bacteria in humans. >> so on every grocery store shelf in this country i guarantee you you're going to find drug resistant bacteria on the meats of those shelves. and then, they get in our guts, you know, when we consume the animals, or the meat from those animals. most of the time that's a dead end, right? you know, we will eventually get rid of those bacteria, we'll shed them away. but sometimes, they'll take hold. >> reporter: in the 1950s, farmers discovered feeding livestock steady, low doses of antibiotics made them grow faster. but this so called" subtherapeutic" use of these

precious drugs raised concern in the medical community and the government. in 1977, the u.s. food and drug administration proposed a ban on subtherapeutic uses of penicillin and tetracycline in animal production. but the rule was never enacted. and the problem worsened. in 1989, human and livestock usage of antibiotics was about equal. today, agriculture accounts for about three-quarters of all the antibiotics used in the united states. >> we have to stop now. we have to stop abusing them now so that we can slow this problem down. >> reporter: mae wu is a senior attorney at the natural resources defense council. >> using antibiotics and misusing them just to make animals get fatter or so you can cram more together and have more stressful conditions and feed them worse diets is the worst way to be using these incredibly important drugs. >> reporter: in 2010, the

n.r.d.c. sued the f.d.a. to force it adopt its own rule. instead, it released new regulations limiting the use of medically important antimicrobial drugs in animals to when it is "necessary for assuring animal health" and wi"" veterinary oversight and or consultation." liz wagstrom is the chief veterinarian at the national pork producers council. >> the pork industry believes that the most judicious uses of antibiotics are those for treatment control and prevention of diseases. >> reporter: wagstrom says the pork industry will follow the f.d.a. regulations, but she says pork producers will continue to use antibiotics as a routine disease prevention tool even if there are no illnesses detected in their livestock. >> it is a judicious and responsible use of antibiotics

to go ahead and prophylactically treat some of those animals when we know they're exposed, we know that it's a specific disease and we're going to use that antibiotic for a defined duration of use. >> reporter: this is a huge loophole, as my colleague paul solman discovered in his conversation with johns hopkins university environmental health scientist ellen silbergeld. >> what has been stated as the recommendations, not enforceable policy, by the f.d.a. is that agriculture should not use antibiotics for growth promotion any more, but they are still permitted to use the exact same amounts of antibiotics in feeds for prevention. so i think the category of prevention now has blown up. >> reporter: no need to worry about this at russ kremer's farm in frankenstein, missouri. his pigs do not spend their life confined indoors cheek to jowl. they have much more space, easy

access to pastures, even a wooded area kremer calls his pig park. he is trying to mimic what pigs would find in nature. >> this is the best place in america to raise pigs in my mind. >> reporter: right here? >> right here. >> reporter: he rarely uses antibiotics at all and then, only if an animal is sick. antibiotics saved russ kramer's life 30 years ago. today he's doing all he can to return the favor. >> they're life savers and like we have to like ingrained into people's mind, in society's mind is we have to do everything we can to preserve them. it's the most important, the most critical health issue in the world and i'm here to do whatever i can. >> reporter: after i got back from frankenstein, i sat down with paul solman to share some anecdotes from russ kremer's bucolic pig farm. so russ kremer was ahead of his time, but the market has kind of caught up to what he is doing.

it's still a small piece of the big pie. just a few thousand are raised in the way russ does. so the question is, is it scalable? >> well in chickens, producers claim that 30% of the market or something like that, the chickens are raised antibiotics- free. so that's where we're going next actually. that's out next story. for the pbs news hour, economics correspondent paul solman. >> reporter: and i am the science correspondent miles o'brien. >> woodruff: now, one woman's mission to bring healthcare to other women in need. fred de sam lazaro reports, part of our ongoing series, agents for change. >> she had an easy delivery last night. >> reporter: it was a pretty typical day at the edna adan

hospital. three babies had just been born; a half-dozen high-risk women were in labor. several others were being treated for life-threatening illnesses. at the center of it all: the hospital's founder and namesake: edna adan. >> these are the kind of women i built the hospital for. but a woman who is anemic. a woman who has had previous complications, a woman who has a scar, a woman who has lost babies before-- these are the >> reporter: what is especially remarkable is where this is all taking place in hargeisa, the capital of somaliland, an enclave that declared its independence three decades ago from the war-torn somalia but is not recognized by the rest of the world. the region suffers from some of the world's highest rates of infant and maternal mortality. adan was born here 79 years ago, the daughter of a prominent physician. at 17, she won a scholarship to study in england, becoming a midwife.

she returned to somalia, marrying a politician who would become prime minister, seen with him here and next to president lyndon johnson at a white house reception. she fled somalia's civil war in the 1980s. when edna adan returned to her native hargeisa, the city lay in ruin from years of war. she was given a plot of land that had been used as a burial ground and on it built a foundation for rebuilding the city's healthcare system. >> most doctors had fled, some had been killed in the war. >> reporter: adan had worked for the u.n. while in exile and used her savings-- and a fundraising campaign-- to build what had been a lifelong dream: a non- profit hospital and nursing school designed to specifically address the health needs of women. in 2002, she opened the 45-bed hospital, which has since doubled in size and grown to include an outpatient clinic and two surgical theaters. >> we've delivered 20,000 babies

in the last 15 years. we have the lowest maternal mortality rate. a quaters of the national rate and that's still too many many of those women should not have died. but they bring them too late. >> reporter: another factor in the high rate of maternal death and various complications in labor is female genital mutilation. nearly 95% of young girls in this country are thought to be subjected to genital cutting. adan has become an outspoken critic of the practice. >> my mission now is to talk to fathers. i am blue in the face talking to mothers, but the influence lies >> reporter: but it's the mothers who are taking the daughters to have this done, right? >> if a father says no and puts his foot down, there will be a chance that some of these girls will be saved. space your child. happy. clean. >> reporter: she has also become

a vocal advocate for family planning in this conservative islamic society. adan planned to counsel this patient who was rushed here by her husband the previous night, hemorrhaging badly after she miscarried what would have been her seventh baby. >> the first advice we will tell her before she goes home is not to get pregnant. >> reporter: is she equipped to make that decision? >> that decision we usually do with the husband. it's someone who almost lost a wife. he brought her here. his wife is alive. he doesn't want to go through that again. >> reporter: the hospital does offer limited family planning services, most frequently implantable contraceptives for women. as edan adan's reputation has grown, so too has its mission.

the hospital now treats men and it brings in physicians and surgeons from the u.s. and other countries who volunteer to do specialized procedures, treating patients with cleft palate, and hydrocephalus among other things, all free of charge. >> you see they're totally conjoined. >> reporter: sometimes, all the hospital can offer is compassion. this pair of eight month old twins, conjoined at the heart were discharged from another hospital soon after they were born. >> they're not going to find oxygen anywhere else. so whatever we can do palliatively, we will do. but surgery is totally out of the question. >> reporter: so it's palliative care until nature takes its course. >> god makes that decision. i don't want to be the one that switches it off. >> reporter: in a region where roads are poor to non existent, getting to the hargeisa hospital can be daunting. so adan has a team of midwives and nurses to treat women and children in the vast rural areas of somaliland.

khadan abdilahi was in the first class of midwives to graduate. we watched as she helped vaccinate newborn babies at a small clinic in abdi iidan. and then teach a prenatal class on nutrition for these pregnant women at a refugee camp. >> edna is a role model for myself. >> reporter: a role model for you? >> exactly. >> reporter: 30-year-old dr. shukri mohamed dahir was also trained as a nurse and midwife by edna adan. she went on to become a physician and surgeon and is now back practicing at the adan hospital. she says initially, patients weren't sure about the idea of a woman in that job. >> when i was dealing with an emergency case, they used to s"" oh you are a female and you're going to operate? maybe she will die. and still that idea exists. but it's not as strong as when i

graduated. >> reporter: although she's groomed new doctors and midwives, edna adan, nearing 80, has not chosen a successor. >> i have 1,000 students, 800 graduates from various courses, thousands of people whose lives i've touched and they're all my children. and i'm still looking for someone who is crazy enough to say i'll look after them for you the way you did. >> reporter: if only for that reason, edna adan says she has no plans to slow down anytime soon. for the pbs newshour, i'm fred de sam lazaro in hargeisa, somaliland. >> woodruff: fred's reporting is part of the under-told stories project at the university of st. thomas in minnesota. and we'll be back shortly with another addition to our newshour bookshelf-- a memoir from the leader of the movement

supporting women's right to drive in saudi arabia. but first, take a moment to hear brown.ur local pbs station.

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>> woodruff: continuing our week of books, we take an intimate look at the fight for women's rights in saudi arabia. jeffrey brown has the latest addition to the newshour bookshelf. >> brown: in may 2011, manal al sharif drove a car. that is remarkable only because it happened in saudi arabia where women are banned from driving, and many other activities that most of us would consider normal, daily life. she was arrested and spent nine days in prison before international outcry helped gain her release. she's continued her activism for women's rights, now living outside her native country ,and she's written her story in the new book "daring to drive: a saudi woman's awakening." welcome to you. >> brown: i want to ask you first about this idea of an awakening because you write about yourself in your early life very much apart of the system.

when a group of women drove in 1990, and kind of a public protest, you scorned them. >> yes. >> brown: but something happened to you. >> because we got the wrong story, they didn't have a voice. we heard about them, we didn't hear from them. didn't drive until today, until the moment of truth came to me in 2011 when i started my own campaign and i got to know their story. they're my inspiration. >> brown: what did you awaken too? what did you see in the system there? you write, you refer to it as" the guardianship system." >> yes. the guardianship system, or the male guardianship system is the one, the source of all evil when it comes to women's rights in my country. where i am 38, mother of two, and an engineer, but i'm still a minor. i'm legally minor. i need permission from a man to do anything in my life. and that man can be my father, my husband, and it could even be my own son if he is an adult. >> brown: all of this, it affects all parts of daily life. >> yes. every single part of your life. >> brown: is there any space where you feel freedom? or freedom to act or move?

>> well, things been loosened. one of them for example, going to school. now we don't have to get permission to go to school or open a bank account. imagine the things i had to get permission to do before. >> brown: so, driving became the symbol, right? why driving? >> driving, for me, nothing will emancipate women in my country like driving. because it gives them a sense of independence. it gives them a sense of liberty and freedom. and that breaks all the things that's been learned and brainwashed. we have to be obedience to these unjust laws, and we're weak and we cannot make decisions on our own. this will give independence for women, this what i believe, at least. >> brown: what is it that keeps the system in place? the system of the gender relations and the power >> two things, men, prejudice, women, submissive. these two things need to be changed to change the system.

>> brown: how is that changing? how strong is the movement? i mean i've seen recently, and in recent weeks there's been some arrests of women for various kinds of behavior. true, true. so we have-- i have my own there's been arrests for some of the leaders of this movement, which is good by the way. that means they're recognizing that it's influential and it's making an impact. the millennial generation, the internet native generation women, are changing the rules of the game in saudi arabia. they're outspoken, they're fearless, they're courageous, and they really don't submit to the rules my generation submitted too. and i do believe, women have the key to change if they believe that if they break the wall of fear, if they challenge these unjust laws. and i've been told always respect the law. and i always say respect the line from suffrages i say, "i will respect laws that respect me." >> brown: you're quoting suffragettes, and you clearly studied your history, women's history. what is it that for you, caused

that change i mean of learning all this history and wanting to become part of it? >> do you know when i saw, i've always been an activist and i didn't know. i've never read about other feminists or activists, but when you face so much backlash, so much hardship, so much pain, you would seek i would say, you would seek relief, in places, in history that happened to the same people, doing the same things that you're doing. so i started watching movies about the women's right movement, i mean the movement to get the women to vote in the u.s. i watched suffragettes, i i read rosa parks book. and i was amazed by the similarities between my story and them, i'm like i found my and i'm studying how they changed the system, with non violence, the civil disobedience, non violence struggle. and it's amazing to me when i was watching these things. the civil right's movement itself, remove the black people, put saudi women. this is exactly the situation in saudi arabia today.

>> you go through the book through many experiences that you had of being in prison, having to leave the country, having to leave your own children behind from your former marriage. do you have regrets now? or what is your life like now? >> jeff, i do have a lot of regrets in my life, i think we are all as humans, have regrets. but speaking up, i've never regretted that, because if i didn't speak out, i'd lose myself. >> brown: alright the book is "daring to drive: a saudi woman's awakening." manal al sharif, thank you very much. >> thank you. >> woodruff: and that's the newshour for tonight. i'm judy woodruff. for all of us at the pbs newshour, thank you and see you soon. >> major funding for the pbs newshour has been provided by: >> supported by the rockefeller foundation. promoting the well-being of humanity around the world by building resilience and inclusive economies. more at

rockefellerfoundation.org >> and with the ongoing support of these institutions and individuals. >> this program was made possible by the corporation for public broadcasting. and by contributions to your pbs station from viewers like you. thank you. captioning sponsored by newshour productions, llc captioned by media access group at wgbh access.wgbh.org

aerials of clouds cloaking snowy peaks when we think of alaska, we are all on a journey together, an odyssean voyage of outward adventure and inner reflection, reaching toward the world's edge; to that shadowy sea where the sun is hidden and the clouds are born; where the earth's subterranean heart beats; where living