 Awatif, six months
pregnant, is frightened
of giving birth after
the sun goes down.
The Serif camp she
has called home for
the past four years
has no night midwife
available because
of security concerns.
“I’m afraid,” she
said, swathed in
a shawl of sunset
orange, reds and
purples. “I
want a midwife to
be by me in case
something happens.”
Awatif, 27, was married
at the age of ten,
and this is her second
pregnancy in this
camp for internally
displaced persons
outside of Nyala,
the capital of South
Darfur. The camp
midwife helped her
give birth to the
youngest of her four
sons, and she is
hoping for a girl
this time.
The first time her
village was attacked
in Darfur’s
civil war, she said, “They
took all of our cows.
The second time,
they attacked the
people and burned
all our houses.” After
that she fled here
with her family.
In Awatif’s
village, the nearest
health care centre
was a three-hour
walk away. Awatif
relied for her first
three pregnancies
on a traditional
birth attendant,
who in Darfur customarily
ties the hands of
the expectant mother
above her head and
then pulls on the
rope to elongate
the woman’s
body through each
contraction. It is
a difficult and painful
process, especially
if the woman’s
labour continues
for hours on end.
In the camp, a nighttime
complication will
mean Awatif will
have to get from
the camp to the hospital
in Nyala. But donkey
carts are the only
available transport. “It’s
dangerous, and you
have to pay a lot
of money,” she
said.
Maternal mortality
is high in Sudan:
509 women die for
every 100,000 live
births – a
ratio that puts Sudan
130th on a World
Health Organization
ranking of the 181
countries with populations
of 1 million or more.
A woman’s lifetime
risks here are so
great that one in
every 30 Sudanese
women will die of
pregnancy-related
complications: only
71 percent of pregnant
women receive antenatal
care, only 57 percent
of deliveries have
a skilled birth attendant
present, and only
13 percent of women
receive postpartum
care in the first
six weeks following
delivery.
Most people do not
know how to identify
complications, and
men – who make
the decisions about
when a woman can
seek health care – often
do not recognize
the importance of
referring their wives
to emergency care,
or they are too poor
to seek it. UNFPA,
the United Nations
Population Fund,
teaches women and
men in the camps
about the importance
of seeking such care,
and also supports
pooled community
transportation funding
for emergency night
referrals.
A green tent houses
the camp’s
maternal health care
clinic. Straw mats
cover the floor and
the smell of disinfectant
wafts through the
hot air. A simple
sheet separates the ‘operating
theater’ from
the consultation
room, manned by midwife
Amina Mohammed. She
provides ante- and
post-natal care to
IDP women, but wives
must be accompanied
by their husbands
to receive contraception.
“I’m
very proud of what
we’ve done
here,” she
said. “I’d
like to do even more – we’d
like to support every
pregnant woman in
the area.”
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