Hundreds of thousands of pregnant women and new moms in Sudan have nowhere to go

When Dr. Duria Rayis checked her phone, she saw the desperate pleas of her colleagues who were trying to care for pregnant patients and newborn babies.

Rayis is an obstetrician in Khartoum, Sudan, where violent clashes between the army and rival militias have led to the closure of most of the capital’s hospitals. According to UNFPA, the United Nations’ sexual and reproductive health agency, this has left hundreds of thousands of pregnant women unable to go anywhere.

The few hospitals that remain open are understaffed, under-resourced and, at times, under attack. So health care providers have been using social media to try and coordinate as best they can.

When he looked at Facebook and WhatsApp groups, Rayis saw messages from colleagues who were rushing to find blood for bleeding patients and others trying to find a surgeon who could perform a caesarean section. Others are ready to have a C-section, but don’t have access to anesthesia.

“Everything is getting worse for everyone – especially for pregnant women,” said Dr. Rayis As it happens hosted by Nil Köksal. “This is a nightmare.”

Hundreds died, hundreds of thousands were displaced

It has been more than a month since fighting broke out in Sudan between the army and the paramilitary Rapid Support Force, upending an internationally-backed plan to transition to a civilian-led democracy after a series of military coups.

Despite several cease-fires made by neighboring countries, neither side is willing to lay down their arms.

Sudden violence has changed people’s lives. About 200,000 have fled the country, including health care providers, according to the latest figures from Reuters. Another 700,000 have been internally displaced.

Officials have recorded 676 deaths and more than 5,500 injuries, but the actual death toll is expected to be much higher due to many reports of bodies still lying on the streets and people struggling to bury the dead.

WATCH | Crisis in Sudan:

In Khartoum, more than half of health care facilities were forced to close, according to UNFPA. Others are only part-time operations.

The World Health Organization says only 16 percent of the city’s health care facilities are at full capacity.

And while this crisis affects all Sudanese people, Dr. Rania Hassan, UNFPA team leader in Sudan, said pregnant women and newborns are among the most vulnerable. And, as in any crisis, he says that’s his least priority.

“He has always been left at the bottom of the priority list for political attention [and] political commitment,” Dr. Hassan told the CBC. “Vulnerability is inherent.”

UNFPA estimated at the end of last month that there were 219,000 pregnant women in Khartoum alone – 24,000 of whom were in their prime. Because of the chaotic situation, Hassan said it is difficult to say precisely what the number is right now.

“The hour of birth knows no war,” said Hassan. “When the hour comes, when a woman is in labor, she should be treated with a life-saving level of service.”

‘We lost a baby’

Rayis works at the Saad Abuale maternity hospital in Khartoum, which he says was forced to close after a missile attack. Fortunately, he said no one was hurt, but the hospital had to transfer or release all patients.

He then volunteered at a hospital in the neighborhood of Omdurman. But this too has been closed.

As a doctor, she says it’s hard to understand that so many women and babies don’t care.

“It was like a stab to the heart,” she said.

Sudan had a high maternal mortality rate before the fighting broke out, with 295 maternal deaths per 100,000 live births according to the UN, often due to sepsis, hypertension or bleeding. All these risks are greatly increased by the war.

“To be honest, bro [shortage] resources and medicines that are not new to the Sudanese context in general,” said Hassan. “However, what is happening now is a disaster.”

And it’s not just maternal health care that’s lacking. There are also no resources for newborns, as few hospitals are equipped to care for premature babies.

“We lost babies because the neonatal unit was completely closed,” Rayis said.

Rural hospitals are overwhelmed, midwives are increasing

In rural Sudan, Hassan said most women always rely on midwives to give birth, except in emergencies. Now the midwives have gone up in the city center of the country.

“Midwives, they took, and still continue to take, a huge burden of obstetric care,” Hassan said.

But they also face limited supplies, a lack of clean water, fluctuating power and the constant danger of guns and bombs.

Rayis said patients make long journeys to rural hospitals, traveling more than 100 kilometers to give birth.

“They don’t know what’s going to happen on the streets. They don’t know if they’re going to be bombed or not, they’re not going to stop at any station,” he said.

“Hospitals outside are not prepared for this number. We know that our friends outside have been working very hard because of the patients coming from Khartoum.”

Many health workers have fled, or stopped training altogether, staying at home to protect their families, offering what services they can online. Others risk their own health and lives to work.

“Some stayed five, seven, six days, all in the hospital, they didn’t go home,” said Rayis.

“What doctors do … is beyond imagination. It’s amazing. It’s about being human. I think, from God to our patients.”