As displacements soar, Juba’s burdened clinics improvise to keep childbirth safe

JUBA, South Sudan – Since the July outbreak of in violence in South Sudan, UN-protected camps in the capital have seen a spike in displaced people seeking shelter. The surge has compounded demands at the camps’ already heavily burdened health facilities. Despite these challenges, health workers are finding ways to keep childbirth safe and to provide essential reproductive health services to those in need.

In two protection sites in Juba alone, the number of displaced people has swelled to over 37,000, according to the UN Refugee Agency (UNHCR), up from 28,000 before the crisis.

“The increase of population in the camps also increased the number of medical cases we manage,” said Dr. Meroni Abraham, medical coordinator of a UNFPA-supported International Medical Corps clinic.

Dr. Meroni said health facilities now deliver up to 120 babies per month, or four babies per day, in the two sites.

The cramped conditions have forced medical staff to improvise.

Converting medical departments

In one of the camps' clinics, Dr. Meroni said, “we used to have a maternity department, but we had to convert it into an emergency surgical unit to accommodate the wounded, aside from Caesarean section deliveries.”

Women in labour and those recovering from childbirth have to be accommodated in another area of the facility, where female patients are admitted for other medical conditions.

When the facility gets too crowded, some women are referred to the clinic in the nearby protection site, which now operates 24 hours a day to assist night-time childbirths.

Both facilities are also providing comprehensive reproductive health care to the community, including antenatal care, safe deliveries, post-natal care, post-abortion care, clinical management of rape, family planning counselling, HIV testing and treatment, and even community-based activities.

The health facilities are stocked with UNFPA-provided supplies, including emergency reproductive health kits. The provisions include medicines and supplies to assist in normal and complicated childbirth, antibiotics for the treatment of sexually transmitted infections, contraceptives, and post-rape treatment supplies. 

Midwives trusted, effective

The two clinics also employ 12 UNFPA-funded midwives, almost all of whom are displaced themselves.

Their ability to relate to the women they serve has helped them gain the trust of the community – as has their effectiveness in providing care.

“It is very rare to see home deliveries in this place, because women have seen the advantages of giving birth in the clinic. They have seen complications being managed here,” Dr. Meroni explained.

Still, the medical team says more needs to be done.

“Since we are in a heightened crisis, we work with whatever we have now, but one action we are prioritizing is to find more space so we can segregate post-natal mothers from other patients,” said Connie Maina, a nurse-midwife supervisor in one of the health facilities.

Dr. Meroni said they are also working to have a 24-hour surgical team available for the camps so they can also perform C-sections and other emergency operations at night.

– Arlene Alano