In the barren desert of eastern Chad, advanced medical care can be hard to come by, making a well-trained traditional birth attendant a powerful resource in preventing unnecessary deaths of women and children.
International Medical Corps has worked in Chad since 2004, following the arrival of refugees from Darfur. Reproductive health is a crucial component of International Medical Corps’ primary health care interventions in Chad, which cover five refugee camps as well as one site for the internally displaced. The program addresses several areas of concern, such as safe motherhood, family planning, treatment of sexually transmitted infections, and prevention of mother-to-child-transmission of HIV/AIDS. In addition, International Medical Corps’ reproductive health program monitors the growth and nutritional health of children younger than five and provides nutritional support for pregnant and lactating women.
In addition to direct services, International Medical Corps also trains and builds the capacity of traditional birth attendants (TBAs) by pairing them with trained midwives. In the absence of a midwife, doctor, or other qualified health worker, trained TBAs are essential to ensuring clean deliveries for Chadian and refugee mothers and their babies.
The impact that a trained TBA can have on the health of women and children in her community is reflected in the story of Fatime, a woman who was having trouble delivering her third child. But unlike so many tragic stories that go untold in the developing world, Fatime had a TBA trained by International Medical Corps, Khadija, with her who knew that she had to be taken to the closest health facility.
Khadija took Fatime 10 km away to Kounungu, a camp of more than 18,000 refugees where International Medical Corps provides health services to camp residents and the host community. Fatime was examined by an International Medical Corps midwife who found that there was malpresentation of the fetus — a common issue during delivery where the baby is not aligned for an easy exit from the birth canal. Fatime was immediately referred to the Guereda Hospital, the district referral hospital supported by International Medical Corps some 23 kilometers away, where she was given an emergency caesarian section. She gave birth to a healthy baby boy — a child who very likely might have died in childbirth, without the trained TBA who saw the warning signs and made sure Fatime got the care she needed for her life, and the life of her child.