Caring for the next generation

A pregnant woman having her tummy checked by doctor in the health centre in Um Labassa camp. [Paul Jeffrey]

As the camps in Darfur, Sudan continue to grow, CAFOD is training birth attendants to care for pregnant women and help deliver healthy babies

"There was no one around in the village to help when my pregnant sister told me, 'I want to deliver.'

I assisted the delivery and after that I became a birth attendant," recalls Hawa, a traditional birth attendant now called 'grandmother.'

In the rural areas and camps of Darfur most babies are born at home, with mothers sometimes being assisted by a midwife, and more often by a traditional birth attendant, who may or may not have any prior training.

Hawa was forced to flee her original village in West Darfur three years ago due to the conflict in the region.

She now lives in a camp for displaced persons in Kubum, South Darfur where she continues to work, assisting three or four mothers to deliver their babies each week.

"I am very old, I have helped women to give birth and I am now helping their children to give birth," explains Hawa. "The work is in the heart. God is the only guidance I have had."

Stark reality

The stark reality of the basic conditions in which many women give birth becomes clear as Hawa explains that the only equipment she has used in the past is a razor blade (and not necessarily a new one), wash cloths and hot water.

Due to her age, Hawa had not received any training in midwifery, or any prior education. She only speaks her mother tongue of Fur.

Many traditional birth attendants, especially older ones, are also illiterate and have never received any formal training.

Even younger traditional birth attendants typically only receive three months of training and have a similarly limited range of equipment, extending to include a pair of scissors and maybe a pair of clamping forceps as well.

Ante-natal care

CAFOD has been working through ACT/Caritas, a network of faith-based and Sudanese agencies responding to the crisis in Darfur.

ACT/Caritas has set up mother and child health care services in all its health care centres across South and West Darfur.

The centres offer ante, intra and post-natal services, health education, safe delivery facilities and assistance carried out by trained midwives.

Record keeping was introduced in the clinics two years ago even though birth registration is not widely practiced outside of towns in Darfur.

Reporting was limited, but nevertheless, the results revealed an alarming rate of infant and maternal mortality.

Reports also indicate that despite the large number of consultations, there are very few deliveries in the clinics with the vast majority of women, around 85 percent, still preferring to give birth at home.

In Darfurian culture, women typically will only go to a hospital to deliver if there is a complication with the birth.

Training midwives

At the town clinic in Kubum, funded by CAFOD, Hadilla is pregnant with her fourth child and is visiting the midwife for a check up.

"When it is time to deliver, I will call for the midwife to come to see me in my home and if there are no complications, I will stay at home to deliver.

"Thanks be to God, my three other children were easy deliveries and there was no need to go to hospital."

Prompted by data from the reports, the programme last year trained and equipped 82 midwives and traditional birth attendants who are working in camps and rural areas in South and West Darfur to improve services and support the clean, safe delivery of babies.

"The training taught me the importance of cleanliness during delivery so as to prevent disease. Since the training I have changed the way I work.

"Now, I wash my hands, use gloves, only use a new razor and new cloths and to sterilise the equipment," says Hawa.

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related resources

Darfur & Chad (612.50 kB) 14-slide powerpoint including notes for teachers, giving all the background to the conflict in Sudan - accompanies the launch of CAFOD's Darfur & Chad Appeal in May 2007

Darfur prayer: Five years on (25.50 kB) A prayer and reflection written by The Catholic Bishop of El Obeid, Antonio Menegazzo - whose diocese includes Darfur - to mark the fifth anniversary of the conflict in the region