Encouraging Expectant Mothers in Dadaab to Take Advantage of Obstetric Care

This is one of a series of features UNFPA is producing about the life in the camps where hundreds of thousands of people have sought refuge from war and famine in the Horn of Africa. The stories document the lives, the loss, the hopes and the fears of some of the most disenfranchised people in the world today.

DADAAB, Kenya — Amid the whistling wind and the rising dust, Hibo Yasin, scours the expansive Dadaab refugee complex, looking for expectant and lactating mothers. As she moves around the camp, Hibo receives warm greetings from mothers. She waves back at them briefly, stopping on occasion to inquire about how they have been and whether they have been attending the clinic.

Hibo’s works as a community health worker involves convincing many of the expectant mothers to attend antenatal clinics and linking those about to deliver with obstetric care. “I monitor those who are about to give birth and ensure they go to the maternity clinic to deliver. When they do follow my advice, it is an inspiration to carry on,” says Hibo.

Barefoot, tired and emaciated

At the registration centre for new arrivals in Dadaab, one can find many barefoot, tired and emaciated expectant mothers. Some are too weak to make it through the long wait for the registration process, and many of them just have days to deliver but do not know where to seek help.

“Knowledge is very low, and many of them do not even know a clinic exists. It is not easy to convince them but at least now, many of them realize the need to deliver in a hospital,” explains Hibo.

Dadaab is today home to some 470,000 people with 80 per cent of them from Somalia, a country where the healthcare system has collapsed, due to the world’s longest running conflict. Somalia has been described as one of the most dangerous countries for a woman to get pregnant. The usual risks of pregnancy are exacerbated by stress, malnutrition, female genital mutilation/cutting and frequent and early childbearing. Hospital deliveries are rare.

‘Mama Taxis’ to the rescue

But through an initiative of the United Nations High Commission for Refugees and aid organizations working in the camp, expectant mothers in labour are able to access maternity services quickly. There are taxis, known locally as ‘Mama Taxis’ who can be called to quickly ferry a mother to the nearby maternal clinic.

At the Hagadera clinic run by the UNFPA’s implementing partner, the International Rescue Committee, Sophia Abdi, a 32-year-old mother of three sits patiently on her bed. She has been here at the clinic for the last three days. Tired but upbeat about what tomorrow holds for her and her unborn child, she says she is happy. Back in her country Somalia, she had lost two children while giving birth.

“If I were in Somalia, I would simply go to a traditional birth attendant and my chances of living would have been very slim. But here, I know I will get help and even if something bad comes up, they will be able to treat it,” says Sophia.

Community health workers encourage mothers to seek help

UNFPA through its partners is distributing reproductive health care kits and contraceptives to women in Dadaab.
Community health workers like Hibo have been crucial in boosting the uptake of reproductive health services among women in the camp, says Dr. Beldina Gikundi of the International rescue Committee.

“Many of these women arrive here in very bad shape, and the expectant ones needs very close attention. The challenge is that many of them still believe in home deliveries.” Even though these services are available, the high number of Somali refugees and the high fertility rates in Dadaab puts pressure on the few facilities available. Today, only MSF(Doctors Without Borders) and IRC have maternal facilities in Dadaab . Together, they can care for only 210 at any given time. Aid workers, however, say the demand for these services have gone up 110 percent.

“We are seeing an increased number of women seeking reproductive health and maternity services in the past months and health facilities can hardly cope. Contraceptive use is very low yet fertility rates are high putting pressure on facilities, and we are promoting the use of contraceptives within the camps,” says Dr. Gikundi of IRC.

— Kenneth Odiwuor for UNFPA