‘I didn’t think I would survive’: A mother’s story on health service delivery

How a pregnant mother in a remote village in South Sudan walked for miles to a health facility with a feeling of resignation and emerged with a healthy child in her arms and a grin on her face

Panom Puok
Nyakuor Gatluak, a mother of seven, stands with Panom Puok in her compound in Maiwut County in Upper Nile State, South Sudan
Nhial Buth/RI
29 August 2022

On a cloudy Tuesday morning, I waded through flood waters across submerged grasslands from Longechuk to Maiwut County in Upper Nile State, a very remote area of South Sudan, heavily affected by conflicts and floods.

When a colleague in the area asked me on arrival the next day to visit midwives at a health facility, I took it as a call for duty. Little did I know that I was coming face to face with the stories of people that keep me motivated to deliver humanitarian services.

As we entered the maternity ward at Wunkir primary healthcare center, a mother lying on a metal bed, flanked by three midwives, caught my attention.

Nyakuor Gatluak, 40, had been at the facility for four days following prolonged labor before she gave birth to a bouncing baby girl weighing 2.6 kilograms. Exhausted, she looked distraught, but was healthy and in high spirits, thanks to the efforts of midwives and Boma health workers.

Panom Puok provides on-job training to health workers in Maiwut County in Upper Nile State.
Nhial Buth/RI
Panom Puok provides on-job training to health workers in Maiwut County in Upper Nile State.
Panom Puok, a health consultant with UNICEF, walks through mud to access health facilities in Maiwut County in Upper Nile State.
Nhial Buth/RI
Panom Puok, a health consultant with UNICEF, walks through mud to access health facilities in Maiwut County in Upper Nile State.

“I am very happy with the midwives who have saved my life and my baby’s life,” Nyakuor, now a mother of seven, said as she breastfed the baby.

She told me that at the early stage of her pregnancy, a Boma Health Worker – who are community based primary health volunteers -- visited her house and advised that she should be visiting the health facility regularly for antenatal care ­-- advice which she carefully followed.

However, when Nyakuor was now about to deliver, the labor pain was so excruciating that by the time she arrived at Wunkir health facility to seek the service of trained midwives, she was already scared and worried about her life and that of the baby.

I was very weak when I first came. I was feeling dizziness and general body weakness. I thought that I will not survive as I was having low blood pressure,

Nyakuor Gatluak
Blocks
Boma health workers pose for a group photo with Panom Puoch, a health consultant with UNICEF, after a meeting on August 11, 2022 in Maiwut County in Upper Nile State, South Sudan.
Nhial Buth/RI
Boma health workers pose for a group photo with Panom Puoch, a health consultant with UNICEF, after a meeting on August 11, 2022 in Maiwut County in Upper Nile State, South Sudan.

Midwives helped to treat her. “I was given some fluids through injection. That injection made me to regain my strength. I was also given some drugs that I swallowed,” she said.

As I stood by her bedside, the enormity of the responsibility I have towards safe delivery of mothers and the health of their children overwhelmed me. Here in Maiwut County, where Nyakuor resides, health systems are now starting to improve, as the State reels out of a series of conflicts that started in 2014. Floods and poor road infrastructure have also limited access to health services.

The Midwives and Boma Health Workers that Nyakuor that helped save her life and that of her daughter are the true heroes.

And it is our job to provide them with support, identify areas of improving health service effectiveness, and to work with them and the local administrators in strengthening health systems to save such lives going forward.

I walked out of the maternity ward with a feeling of satisfaction, with my energy tank refilled. I held meetings with the midwives and the Boma health workers, reviewing their records and refreshing their knowledge by way of on-the-job training.

Later in community meetings that the Boma Health Workers conduct to provide health education to the broader community, the story of Nyakuor walking for hours from her village to the facility feeling resigned to fate, and later emerging safe and happy, was re-told as to the importance of accessing health facilities for safe deliveries.

Days later, before leaving the county, I walked again through the mud to Nyakuor’s house to visit her and the baby. 

I am doing well, and my baby is doing well too. The Boma Health Worker who asked me to visit the health center and midwives who helped me, and my child, are doing good work.

Nyakuor Gatluak

Provision of essential health services in Upper Nile and Jonglei states, as well as the Greater Pibor Administrative Area, is supported by the World Bank through a partnership with UNICEF and the national Ministry of Health. The Boma Health Initiative is supported by funding from the Government of Germany.

Panom Puok is a public health specialist and working as consultant for UNICEF supporting the World Bank Health Project in Upper Nile State.