International Rescue Committee (IRC)

A new nation gives birth to life-saving obstetric care

Ripping up clouds of red dust, the International Rescue Committee ambulance flies along the potholed roads leading to the South Sudanese town of Aweil. Inside, 19-year-old Arek Mawien lies on a stretcher grimacing in pain as she struggles to give birth to her first baby. 

“She came into our health center yesterday and has been in labor for 24 hours,” explains Joseph Remi, the IRC’s health manager in the isolated village of Malualkon, where Arek lives. “She can’t push the baby out, so we need to take her to a hospital immediately for a caesarian section.”
The ambulance skillfully avoids the many obstacles in its way: fallen trees, goats and cows, and large pools of muddy water from a torrential downpour the night before. After a few hours, the four-wheel-drive arrives at the gates to the hospital. Arek is rushed into surgery and, 40 minutes later, emerges as the exhausted but proud mother of a healthy seven-pound (3.2-kilo) daughter.
“I’m naming her Ajok,” she says later that evening, as she recovers. “I’m so happy everything went well.” 
But without the help of trained health care professionals, Arek probably would have died. 
Obstructed labor, often caused by chronic malnutrition or untreated childhood infections, is one of many conditions that claim the lives of pregnant women in South Sudan. More than 2,000 out of every 100,000 pregnant women in the new nation die during childbirth, many from excessive bleeding or infection. Indeed, South Sudan suffers the highest rate of maternal mortality on the globe, according to the World Health Organization. By comparison, the risk of pregnancy-related death for a woman in South Sudan is 100 times greater than for a woman in the United States.
“Maternal mortality is the health indicator with the greatest disparity between underdeveloped and developed countries,” says Susan Purdin, the IRC the IRC’s South Sudan director. “It’s worse than infectious diseases, car accidents, infant mortality, Aids or any other cause of death you can think of.”
Sudan’s decades-long civil war has left South Sudan, which became an independent state last year, without a functioning health system or trained personnel. In response, the IRC is supporting 30 health facilities nationwide and has trained over 2,500 community health workers and other healthcare staff.
“We build maternal facilities in remote rural areas and staff them with trained midwives who provide basic but quality obstetric care,” says Purdin. “As a result, we have seen an increasing number of women coming to the health facility for delivery instead of giving birth at home. A delivery in a health facility with a skilled health worker is crucial to saving the lives of mothers and babies.”
Traditional birth attendants, usually the only source of maternal health care services in rural areas, are playing an important role in convincing pregnant mothers to leave their homes to deliver their babies. 
“Before, pregnant women didn’t know the importance of the health facility,” says Arek Akot, one of hundreds of traditional birth attendants who have received IRC training in clean delivery practices and how to identify the most common birth complications.
“We tell them that they will get vaccinations and deliver safely there,” she says. “And if there is bleeding, they can get IV fluids to recover. Now, nobody in the village thinks that we are bringing them to a bad place. They know that health facilities are important.”
Watch Arek's story and learn more about IRC health services that are saving lives in South Sudan:

South Sudan at One: Safer deliveries for the nation’s new mothers from International Rescue Committee on Vimeo.

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