2003: Training, the first obstacle
When I started working with MSF as a midwife in 2003, I managed deliveries and newborn care, but I also saw a big need for abortion care. Whenever this need came up, I wanted to be able to help—but I didn’t have that training or experience. It was quite a dilemma for me.
In the country where I am from in East Africa, doctors had always managed that part of health care. But things were changing. When I returned home after my first MSF assignment, I visited the health center where I used to work and saw that the midwives were now managing abortion cases. I felt like I was lagging behind.
In 2004, I learned that MSF had adopted a policy stating that we would provide safe abortion care wherever it was needed to prevent maternal deaths and injuries due to complications from unsafe abortions. I was impressed. I thought, “This is what I am supposed to do.” But I still lacked training.
Few patients were asking for abortion care—abortion is a taboo subject in Central Africa, where I was working, and in many of the places where MSF works. But I knew a lot of women were suffering in silence because I treated them for complications from unsafe abortions, such as septicemia [blood infection] and severe bleeding, which can also lead to severe anemia. I vividly remember one patient who died, leaving five young children behind.