Pregnant and displaced: Delivering babies in conflict affected North East Nigeria

Providing integrated emergency primary health care services to living in camps

Kusali Kubwalo
UNICEF Nigeria/2018
20 February 2018

Borno, Nigeria 20 February 2018 – For more than eight years, the conflict in the north east and the resulting humanitarian crisis continues devastating the lives of millions of children, women and their families in the northeast Nigeria.

At least 1.6 million people have been internally displaced, their villages ransacked, their property lost and their lives changed forever. Eighty per cent of the Internally Displaced Persons (IDPs) are living in Borno State, the epi-centre of the crisis, and over half are living outside IDP camps in local communities, making it harder to access them with humanitarian assistance and putting additional pressure on the host communities.

At a health facility in Muna Garage Camp for Internally Displaced persons in Maiduguri, Borno - women quietly await their turn to access reproductive health care at one of the two Primary Health Care (PHC) Clinics fully supported by UNICEF. The clinics provide integrated emergency PHC services 7 days a week to 21,000 IDPs living in the camp and those in the informal camps in the host community around Muna Garage. Women who fall pregnant in the congested camp experience very difficult pregnancies.

It is not easy for these women but we give them the best we can. Pregnant women need space, comfort and a peace of mind but the women in the camp have none of that. It is even worse for them when they have to deliver at night, “says Aisha Mustapha Kolo, the Midwife at clinic A in Muna Garage IDP camp.

Aisha has worked as a Midwife at the UNICEF supported clinic for over a year and says there were 600 births in the camp and ten under five deaths in 2017. Although there were no recorded new born deaths in 2017, most mothers whose newborn babies die at home at night soon after delivery rarely report such cases to the health facility. 

UNICEF Nigeria/2018

At night, there are no health services available in the camp. There have been security incidents in the camps and day services offer protection and safety to the health workers who provide the much- needed services to the IDPs. Women who start labour at night must therefore give birth at home. Others decide to give birth at home due to traditional beliefs. For most in the camp, home is just one grass hut and shared toilets and bathrooms. This means that pregnant women are forced to give birth in a communal toilet or bathroom.

This is my 6th baby. But this pregnancy was the hardest, I was not sure my baby was going to make it. I was lucky, my baby was ready to come during the day and I delivered here at the clinic,” says 39 year -old Hawa Bukhar.

Hauwa and her family found themselves displaced a year ago, after Boko Haram raided their village in Ajiri, Mafa - taking with them cattle and people, mostly young women. She lost everything including four of her children after they got separated. It took her four months to get reunited with all her children and her husband. They were eventually taken to Muna Garage Camp.

“That was the worst four months of my life, I did not know whether my children had been abducted or had been killed,” she says tearing up.

Hauwa’s story is one of the few with a happy ending. So many others have sad stories to tell. In Borno, there are at least 43 new born deaths per every 1,000 live births. This is higher than the national average of 36 deaths per 1,000 live births, according to a recent Multiple Indicator Cluster Survey (MICS) conducted by the Government of Nigeria in 2016/17.

UNICEF Nigeria is supporting the government of Borno State to provide integrated primary health care services in the two clinics located in Muna Garage Camp and in about 50 IDP camps in Borno, Adamawa and Yobe - the three most affected states by the Boko Haram violence. This support includes capacity building for health workers; provision of emergency drugs, medical supplies and equipment; payment of monthly stipends for volunteers working in IDP camps and Newly Liberated Areas. It also includes the treatment of common disease; immunization services, antenatal care, delivery, post-natal care, vitamin A supplementation, distribution of deworming tablets, hygiene promotion and community mobilization; referral services including maintenance of ambulances.