DARFUR WOMEN FEAR NIGHTTIME LABOR WITHOUT MIDWIFE SUPPORT
SERIF, South Darfur, Sudan- Awatif, in the sixth month of her pregnancy, is frightened of giving birth after the sun goes down. The camp she has called home for the past four years of her life has no midwife available overnight.
“I’m afraid,” said the 27-year-old mother. “I’m worried – I don’t know what will happen. I want a midwife to be by me in case something happens.”
Nighttime emergency obstetric cases are a problem in South Darfur’s camps for displaced persons because of a lack of trained personnel and after-hours transport.
“The problem is security,” says Dr. Widad M/Ahmed Hamad, Sexual and Reproductive Health Program Officer for UNFPA, the United Nations Population Fund. “We have difficulty making a referral at night for emergency cases.”
Awatif is hoping for a girl to join her four surviving boys. Her youngest son was born with the assistance of the camp midwife. When she lived in the village, it was a three-hour walk to the nearest health care center where she could see a doctor or midwife. Instead, Awatif relied on the services of a traditional birth attendant.
Now Awatif is worried about what will happen if she develops complications overnight, when only donkey carts are available for transport to the hospital in Nyala. “It’s dangerous and you have to pay a lot of money,” says Awatif.
Since the conflict began in the Darfur region of Sudan in 2003, over 200,000 people have been killed and more than two million have been displaced. Violence against civilians, much of it targeted against women, has been an ongoing consequence of the conflict. The situation for pregnant women fleeing the conflict was dire. “Women lost their kids.” “They lost their husbands.” “While they were running from one village to another, they had serious problems – miscarriage, bleeding.” Thousands of women have been raped. With their villages destroyed, many women have lived for years on the run, in informal settlements or in internal refugee camps throughout Darfur.
Maternal mortality rates are high in Sudan. Nationally, 509 women die for every 100,000 live births, but the difficult conditions in Darfur put women at higher risk. Throughout Sudan, only 71 percent of pregnant women receive antenatal care and only 13 percent receive postpartum care during the first six weeks following delivery. In addition, only 57 percent of deliveries are attended by a skilled birth attendant.
“It’s difficult to access services, the coverage of midwives is low and most live far away from hospitals,” she says. “Most people aren’t even aware about how to identify complications, and men as heads of households aren’t aware of the importance of referring their wives, or they are too poor and don’t have the means.”
UNFPA has initiated educational sessions at the camps to teach both women and men about the importance of seeking maternal health care from trained medical personnel. UNFPA also supports community-based transportation funds to cover emergency night referrals.
Read more about the crisis in Darfur in these related features:
Violence Plagues Darfur Women Searching for Firewood and Fodder
Responding to Sexual Violence in Darfur