Desperate, and in immense discomfort, Asia knew she had to make the long journey to the SOS Mother and Child Hospital in Mogadishu if she wanted to survive.
A dangerous place to give birth
Asia, like most women in Somalia, has delivered all her babies at home without professional help. She has never attended an antenatal clinic or been visited by a midwife. Instead, she relies on a traditional birth attendant. These attendants have often had many children themselves, but have little or no medical training. When complications arise, there is little they can do. Today, Somalia is one of the most dangerous places in the world to give birth - 1,000 out of every 100,000 women die in the process.
Twins born days and miles apart
Frightened and in agony, Asia travelled 55 miles to reach the SOS Mother and Child Hospital in Mogadishu. “She was writhing in pain when she arrived,” remembers Dr Abdullahi Mohamed Said, who was on duty that day. “We took her to the labour ward where we discovered that she was haemorrhaging, had an infected septic placenta and finally, that she was still pregnant.”
Unbeknown to her, Asia had been pregnant with twins – something she would’ve known had she had access to antenatal care. But Asia, like 73% of pregnant women in Somalia had never had an antenatal visit.
Within an hour of her arrival at the hospital, Asia had given birth to a second, healthy, baby boy.
“We can’t save everyone”
Not all cases have a happy ending like Asia’s. “The same day that Asia came into the hospital, another lady, Amal, came in,” says Dr Said. “She was a mother of five and had come to deliver her sixth child. She had travelled for more than 60 miles to see us.” Amal had been in labour for eight days. The doctors quickly established that her baby had died in the womb.
“When Amal went into labour at home the traditional birth attendant discovered that the baby was breach. Its arm was coming out first, instead of the head,” recounts the doctor who looked after Amal. “The attendant didn’t know what to do, so she and all the other women in the village prayed and chanted, hoping that the baby would come out.”
Several minutes after undergoing an emergency caesarean section, Amal slipped into a coma and sadly also lost her life.
“Such stories are heart-breaking,” says Dr Said. “We try, but we can’t save everyone – the problem is that the women arrive far too late.” There is a real need for increased education around pregnancy and birth across Somalia, as well as improved access to professional medical care, but the country is still reeling from the effects of decades of conflict which completely decimated the country’s health infrastructure.
The SOS Mother and Child Hospital deals with between 20-30 emergency cases like Asia’s and Amal’s every single day. The hospital also runs a busy maternity ward with over 100 beds, offers dedicated paediatric and antenatal care as well as out-patient services, including a child immunisation programme.
It is the only facility of its kind for miles around and offers its services for free. It has, quite literally, been a life-saver for thousands of pregnant women, new mothers and children under-five from the poorest communities in Somalia. Despite being stretched at the seams, the staff at the hospital never turn anyone away.
In 2014, the Mother and Child Hospital provided emergency obstetric and new-born care to over 5,500 women and carried out 743 caesareans. In just eight months between January and August 2015, the hospital’s outpatient centre treated nearly 26,000 children and 15,500 mothers.
Maternal care is only one aspect of the work we do in Somalia. Find out more about our work there.