After two years of war, only a few health facilities are still functioning in the Darfur region of Sudan, depriving pregnant women of timely access to medical care.
When women do seek medical care, they must undertake harrowing journeys through the war-torn region. Because of insecurity, checkpoints, and a lack of affordable transportation, many are forced to undertake day-long treks by foot or donkey, often resulting in delivery complications, miscarriages, or death.
Since last year, Doctors Without Borders/Médecins Sans Frontières (MSF) teams have been working in Zalingei Teaching Hospital and Murnei Hospital, providing maternity care and other services in West and Central Darfur.
Many women living in remote areas of Darfur give birth at home, relying on traditional methods. Due to the scarcity of health care facilities, pregnant women often seek health care only after experiencing complications, which creates great risks for women and their newborns.
According to the World Health Organization (WHO), more than 70 percent of health facilities in conflict-affected areas such as Darfur are barely operational or completely closed, leaving millions without access to critical care amid one of the worst humanitarian crises in recent history.
“One mother gave birth at home and couldn’t remove the placenta,” said Wendemagegn Tefera Benty, project medical referent at Zalingei Teaching Hospital in Central Darfur. “Then she was bleeding, so they rushed her to the hospital. The family had to carry her and after one day of walking, when they reached it, she had already passed away because of the bleeding.”
How a mother’s health affects her baby
The ongoing war in Sudan has had a profound impact on the health of pregnant women and their babies, particularly regarding preterm deliveries. The war has left many people unemployed and has disrupted access to food and clean water, and as a result, many pregnant women arrive at hospitals malnourished. This also affects the health of their babies, who are often born preterm and malnourished due to the mother’s malnutrition. These babies are frequently admitted to observation units to ensure their survival and well-being.
"The biggest difficulty is how to manage to bring food to my children,” said a maternity patient at Murnei Hospital in West Darfur. “I was working a lot when I was pregnant and that is maybe why my baby was born weak. Access to health care was also difficult, but MSF helped.”
The MSF-supported Zalingei Teaching Hospital is the only referral hospital available for secondary health care for an estimated 500,000 people. There is no other health facility managing deliveries in the area. In the operating theater at Zalingei, MSF teams perform over 40 emergency cesarean sections per month.
Consequences of complications
“Most of the complications we receive are caused by post-home delivery and anemia during pregnancy,” said Virginie Mukamiza, midwife activity manager at Zalingei Teaching Hospital. Many pregnant women also seek medical care when they have postpartum bleeding or sepsis.
Afaf Omar Yahya experienced severe abdominal pain when her pregnancy was about to come to term. Due to the lack of transportation in Darfur, she had no choice but to travel for hours on a donkey to reach Zalingei Teaching Hospital. Upon her arrival, the doctor informed her she had suffered a miscarriage, and she needed to undergo an emergency cesarean section. “Losing the baby was the greatest heartbreak for me,” Afaf said while recovering in the maternity ward.
Women from across Darfur share similar experiences, and the situation shows no signs of improvement.
Dwindling access to health care amid war
“Most health facilities in Darfur are now mere empty buildings,” said Osanatu Sento Bangura, MSF midwife activity manager at Murnei Hospital. “There’s no staff, no medications, nothing at all."
"Before the war, people had access at least to primary health care centers near their homes," Bangura added. "Now they have to rely on big hospitals that are far away. Many of these situations could be prevented with prenatal consultations and adequate referral systems from primary care facilities, but most of them have been either out of service since the onset of the war or rely on humanitarian aid, which is widely unavailable, to deliver services."
Twelve days after she gave birth at home, Sameera visited the Romalia mobile clinic, located in a remote area of West Darfur, for check-ups for her and the baby. She arrived with a high fever and infected wounds on her arm. She had experienced terrible abdominal pain after her delivery, and her brother gave her an injection to bring down her fever, injuring her arm in the process. The wound left her in pain and unable to hold her baby properly. After conducting several tests, MSF teams at the clinic discovered the infection in her arm. They promptly disinfected and dressed the wound and prescribed treatment.
MSF reiterates our call to drastically scale-up the provision of lifesaving humanitarian aid and access to health care in Darfur. Warring parties must grant unhindered access for aid delivery and ease the obstacles that are preventing the civilian population from accessing health care. The full engagement of donors must be ensured to increase sustained funding for boosting the humanitarian response.
