The maternity rooms are strangely quiet, considering that at points through the night up to five women have been in some stage of painful labour.
Story and photos by LuAnne Cadd
Only the sound of occasional talk between midwives and their patients breaks the stillness. This is the norm in Medair’s 24-hour maternity facility for refugees from Sudan, located across the border in South Sudan.
Blue Nile women
Birthing a baby is painful, but for these women, life itself has been particularly hard. Like their silent labour, they don’t speak much about what they have gone through, what they have lost.
Every person in the refugee camp, except those born here, fled aerial bombardments and shelling by the Sudanese government beginning in mid-2011, leaving behind their homes, animals, gardens, shops…everything.
They traded their beautiful Blue Nile of Sudan, with its fertile soil and ever-flowing river, to settle on dusty, barren ground that didn’t belong to them, in a place that would soon become a separate country, near people who were struggling themselves to feed their families.
The refugees eventually formed four separate camps in Maban County, now totalling nearly 140,000 souls. It’s the largest single concentration of displaced people in South Sudan, living in limbo with a collective desire to just live in peace.
Medair began work in Maban County in July 2012, providing assistance to refugees and the surrounding host communities. Currently Medair is the primary partner for WASH, health, and nutrition services in Yusuf Batil, the second largest refugee camp in the area.
In January of 2016, the 24-hour maternity facility opened with only five night deliveries that month. The numbers increased rapidly over the following months with a high of 111 total births a few months later at the small facility, 81 of those delivered at night.
'Now we have many more women who give birth here as opposed to giving birth at home, which is a good thing,' says Jacinta Knell, an Australian midwife who serves with Medair as their Reproductive Health Manager in Maban.
'A few weeks back, five babies were born in one hour. The midwives and assistants were running back and forth among all of them'. Jacinta Knell
'There’s always going to be a certain percentage of women who can give birth at home with no worries whatsoever. But they need to know when things are going wrong, and that’s why we encourage them to give birth with a skilled birth attendant. 'The majority of pregnant women in the camp now come to the Medair facility to deliver their babies.
Jacinta remembers a recent especially crazy night for the two midwives on duty. 'A few weeks back, five babies were born in one hour. They were delivering on the floor, lying on a plastic sheet. The midwives and assistants were running back and forth among all of them. Since I started here, the most we’ve had in one night was seven. Sometimes it’s just one, but it’s a rare thing to have no births overnight.'
Midwives Jacinta and South Sudanese Patricia Masudio are working this overnight shift. Patricia, an experienced midwife since 2004, has no idea how many babies she has helped deliver – it’s just too many to count. She began working for Medair in Maban in April 2016 and feels strongly that Medair is different from other NGOs.
'Not all the agencies have the Medair values – the hope, the faith, the compassion,' Patricia says. 'These are the most important values in our daily lives. We are here to also give hope to the communities we are serving. If there’s no hope or faith, then why am I here?
'Medair is different. You see the love among the team. It keeps you strong because you know that you’re not alone. There are challenges, but with the challenges, you put them before God and with the team, you share and you let things go and continue.'
Even with 12 years of experience as a midwife, Patricia still finds joy in helping women bring new life into the world. 'When you see the baby come out peacefully like this on the mother’s abdomen, and with this first soft cry, you say, ‘Wow! This is life!’ The joy is not only for the mother but it’s for us, the midwives too. It is a blessing. I am very grateful.'
'I’m very happy because, the midwives took good care of me until I gave birth to my baby.
I felt safe in the clinic.' Amal
She has worked in maternity wards in South Sudan, including her own community, where women cry and make loud noise, a normal response to such incredible pain, she says. In the refugee camp, this is different.
'They are in pain, but they are very strong. I only received one first-time mother just last week where at the last moment when the baby was coming out, she really opened up her big round eyes and yelled loudly, and then the baby was out. And that was the first time I’ve heard any of these pregnant women make a noise. You can see pain on their faces, but you will never hear them scream. It’s crazy. It’s unique. We really admire them the way they take it.'
Amal, a new mother
It’s Amal Bashir’s first pregnancy, which at age 20 is unusually late in life for her culture. A husband is typically provided for a girl following her first menstrual cycle at age 13 or 14 and pregnancy quickly follows. Amal married at a young age as well before fleeing Sudan with her family, yet this is her first child.
For hours following her 3:40 pm arrival, Amal slowly paces the room and courtyard, or sits and lies on the bed as darkness falls and solar-powered lights dimly illuminate the ward. Her face repeatedly contorts in obvious agony with each contraction, yet not even a moan passes her lips.
Jacinta, Patricia, and the birthing attendant all help as she gets closer to delivery: holding her up as she tries to walk back and forth in the delivery area; wiping the beads of sweat off her face as she pushes; giving words of encouragement and instruction.
When the baby girl finally arrives at 9:20 pm and Jacinta places the newborn on Amal’s chest, her utter exhaustion hides any joy she might be feeling.
'When you see the baby come out peacefully... and with this first soft cry, you say, ‘Wow! This is life!’ The joy is not only for the mother but it’s for us, the midwives too.'
A community of mothers
In the morning her father, mother, and a handful of aunts show up to welcome the new life. Grandma holds her third grandchild. She explains that Amal is her second-born, and she was fortunate to come to the camp in 2012 with her husband and all five of her children. Not all the refugee women can say this.
Amal says she feels ‘okay’ compared to last night. 'I’m very happy because even though my mother wasn’t here, the midwives took good care of me until I gave birth to my baby. I felt safe in the clinic.'
Her mother has experienced what it’s like to give birth without medical facilities. 'In Blue Nile, all my children were born at home. The delivery in the hospital is very good because the midwives are there to take care of my daughter. She is here in safe hands. I think that here is better than home.'
Although Amal was the only one to give birth this night, other women arrived, some by donkey cart, with various issues. One would need a Caesarian, so received a referral to the hospital in Bunj, taken there in the Medair ambulance.
A young woman is only 12 weeks along and in pain and bleeding. Patricia broke the news that she would likely lose her baby. Another woman in active labour through the night gave birth in the morning just as the new midwives’ shift began.
This is Jacinta’s second time to be working in South Sudan. She is taking time off from her job in Australia to live in one of the most isolated and unstable countries in the world, live in a small room with another Medair staff member, take bucket showers, and dream of chocolate.
'I grew up with parents who were strong Christians and very missionary-minded. They always encouraged us to be looking outward,' she explains. 'They introduced us to a lot of different organisations and MAF was one of those, so I’ve known about them for a long time.'
Her first encounter with MAF was in another South Sudan town in 2011 while working for Médecins Sans Frontières (MSF). 'When I finished my assignment, I flew out with MAF. I was so excited, like a giddy little school girl, to be flying with an organisation I had heard so much about. To be able to fly with MAF and be served by them was an amazing thing for me.'
MAF has flown for Medair since their work began in Maban and continues to serve Medair through monthly flights, bringing in supplies for the team and the primary care clinic that includes the 24-hour maternity facility.
A Cessna Caravan can help save lives that are just beginning in South Sudan.
In July this year, MAF pilot Sam Johnston flew in much-needed cargo for the team in MAF 6; an important flight for him as well as Medair as it was his first day flying as pilot-in–command in the South Sudan programme, having transitioned from working in Arnhem Land a few months earlier.
‘I don’t remember much about it,’ he admitted later, ‘the whole day was a bit of a blur!’ Nonetheless it was a great opportunity for him to kick off his flying career in a new programme by serving one of MAF’s most long-standing and valuable partners.
'I was so excited, like a giddy little school girl, to be able to fly with MAF and be served by them was an amazing thing for me.' Jacinta Knell