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A salve amid Darfur woes: better midwives

International relief groups are training Darfuri women to ameliorate Sudan's maternal mortality rates – the fifth highest in the world.

By Scott BaldaufStaff writer of The Christian Science Monitor / July 10, 2007

Zamzam Camp, Sudan

Under the blazing noontime sun in this relief camp, Fatima Abdullah Abou does something she couldn't have done before the Darfur conflict began. She takes her patient, a young mother about to give birth, to get medical help at a local clinic manned by doctors for an international medical aid group, Relief International.

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"She was in pain, and she's been trying to give birth for a while, so I came to this clinic to get help," says Mrs. Abou, who has been an untrained village midwife for some 25 years. As she speaks, her young charge is escorted into a waiting van for the six-mile drive to a maternity hospital in nearby Al Fasher.

It's one of the cruel ironies of the Darfur conflict, which has entered its fifth year, that it took a deadly war – that has killed 200,000 civilians, mostly of the region's non-Arab tribes – for many Darfuris to receive the first adequate healthcare of their lives.

Before the conflict, many families lived hours or even days away from hospitals. But now, as 2.5 million people displaced from their homes have migrated to camps like Zamzam, they are benefiting from the healthcare offered by groups like Relief International.

For Darfuri women – who, along with children, make up 80 percent of the displaced – the proximity of international organizations also offers a status-boosting opportunity to bring relief to others as trained midwives.

Sudan suffers the fifth-highest rate of maternal mortality in the world, with 1,700 women out of 100,000 dying while giving birth, according to the United Nations Population Fund (UNFPA). Infant mortality is even more common, with 150 deaths per 1,000 live births.

Despite a recent government push to train more midwives, the vast majority of villages in Darfur still don't have a trained midwife.

But war may be changing that. The training, which had been resisted, is now increasingly being embraced, giving women both financial independence and positions of respect in their communities.

Samia Hassan, a reproductive health officer with UNFPA in Khartoum, says that midwives have become so valuable in Sudanese society that villages that cannot afford to train one have sent their men out to marry midwives from other villages and bring them home.

"Nowadays, people want midwives in their village and there's a waiting list for classes," says Fatima Houssain, dean at the UNFPA-funded Midwifery School of Al Fasher.

In a typical year, the school trains about 30 young girls to become unpaid village midwives or salaried midwives in urban hospitals. This year, enrollment jumped to 82 students, a sign of changing attitudes among the displaced Darfuris who have flooded this oasis town in North Darfur.

"In Darfur, the rate of illiteracy is around 74 percent, so in that kind of society, midwives become role models for young girls," says Ms. Hassan.