Pioneer midwife in South Darfur still passionate about maternal health at 78
By Sven G. Simonsen
Nyala, South Darfur, January 2014: In her 48 years as a midwife, Fatima Ali has delivered thousands of girls and boys. More than that, she opened South Darfur’s first and only midwifery school which has trained 1,500 midwives.
“’This is a gift to the women of Nyala’ – that was what I said when I put down the first bucket of concrete,” Fatima, now 78 years old, recalls.
Her story begins in 1950 in North Darfur, when Fatima was selected to be trained as a nurse at the age of 14. After several years of training and work, Fatima arrived in Nyala in 1972. “At that time, there were only eight midwives in the entire state,” she says.
First line of defence
In her first year, Fatima secured the approval of Sudan’s President to establish a midwifery school. And she turned to the locals to have it built. “The school was built by the citizens themselves. Every Friday people came to build. There were carpenters, bricklayers, and some cooked food for the workers. The school was ready in eight weeks,” she recalls.
Fifteen midwives graduated in the first year; in 2013, the number had risen to 102. The goal in South Darfur is to have one midwife per 2,000 inhabitants. At present the state has 977 midwives, equal to 56 per cent of the goal.
Infant and child mortality have been significantly reduced in Sudan over the last decade, but maternal and new-born mortality rates are still high, with great disparities across states and localities.
South Darfur and East Darfur states have the highest maternal mortality ratio in the country; out of 100,000 live births, 335 led to the death of the mother. Of all deliveries in these two states, only 12 per cent are in hospitals, and only half of these births are attended by skilled health care workers.
UNICEF is a long-time supporter of midwifery education in Darfur. Building two additional wards at the school, we enabled a doubling of the number of students here. We also support the training of midwifery trainers, day-to-day operation of the school, the cost of training and provision of midwifery kits for the graduates.
In 2014, UNICEF launched a major investment in midwifery training in South and East Darfur, as part of a project funded by the European Commission. The project will improve access to skilled birth attendants in the two states through the training of 300 midwives, 120 nurses and 16 health visitors.
Knowledge is key
Although much work remains to be done, Fatima has seen and contributed to great improvements in Darfur over the years. Most fundamentally, perhaps, ordinary people’s attitude towards trained midwives has changed, and certain myths and misconceptions around childbirth have been dispelled. The traditional involvement of the community in child birth remains, however. When women come to hospital to deliver, they are usually accompanied by family, extended family, and neighbors. To Fatima and the new generation of midwifes, they are all an audience for their messages: “We use that opportunity to advocate for hospital delivery and antenatal care,” Fatima says. “Knowledge is key.”