After more than three years of relentless conflict, the situation in Yemen remains fragile and unpredictable, with humanitarian conditions, access to humanitarian aid and general security seriously declining. The 45 % of health facilities that are still functional face severe shortages in medicine, equipment and staff. An estimated 14.8 million people lack access to basic healthcare – around half of the population.
Women, in particular pregnant women, and their new-borns are a high-risk group and require special medical attention. According to the United Nations Population Fund (UNFPA), one in five women of child-bearing age is likely to be pregnant. Without access to reproductive health services, these women face an increased risk of life-threatening complications.
A matter of life and death
Fatima Khamisi had to experience these problems first-hand. The 30-year-old mother of two lives together with her family in a small house in the Mostabaa’ District, Hajjah Governorate. The living conditions in Hajjah are difficult and she and her husband are struggling to provide for their family. With the highest number of internally displaced people, Hajjah is bearing a heavy burden, given the already limited and overstretched medical services. Health facilities in general are far away and hard to reach. When Fatima was pregnant with her second child, complications started to show in the seventh month: “I didn’t know what to do. The pain was so severe, I could barely get out of bed each day”, she says.
Despite the pain, Fatima didn’t seek medical help until her ninth month of pregnancy. Women in Yemen traditionally prefer to deliver at home and, if ever, often only turn to a health facility in case of pain or complications. This is due to the sometimes long distances in order to get to health facilities and to high costs for transportation. Also, it is culturally not always accepted for the women to be treated by strangers, particularly men.
With financial support from their neighbour, she and her husband decided to go on the long and expensive journey to the district’s main health facility. After more than three hours, they arrived, but to their despair, the hospital’s only gynaecologist was not available that day, so they had to leave without proper medical assistance.
Given the shortage of doctors and functioning health facilities, these situations happen very frequently. Also, a large majority of all births in Yemen take place at home, often without skilled birth attendants present. The limited availability of midwives in the districts, long distances, and a lack of awareness of the importance of the role of midwives are usually the reasons. This is particularly critical, and often life-threating, in case of complications during pregnancy or delivery, and also after delivery.
Yemeni Red Crescent (YRCS) Reproductive Health Services
Fatima and her husband didn’t know what to do. On top of the excruciating pain, she felt that she would deliver soon and was afraid of losing her child. A man in front of the hospital saw the desperate family and advised them to seek medical help at the YRCS health facility nearby. He had heard that their service is very good and free of charge. With little to lose and in severe pain, Fatima went to the YRCS facility.
After a thorough consultation by the Gynaecologist, she was immediately diagnosed with anaemia and a severe cervix stenosis, a condition that increases the risk of pregnancy loss and premature birth. The doctor and medical staff took care of Fatima and seven hours later, she gave birth to a healthy boy.
With funding from the British Red Cross, the German Red Cross is supporting the YRCS with the Emergency Obstetrics Care Unit of the YRCS Health Facility in Hajjah since May 2016. This project targets women with gynecological needs and in particular pregnant women, including antenatal care, assistance during delivery as well as postnatal care. This includes two comprehensive antenatal consultations as well as a postnatal check-up within three days after delivery. Furthermore, assistance is provided to children (mainly the youngest ones), particularly regarding nutrition and feeding support.
Fatima is relieved and thankful
Fatima’s biggest fear was not being able to give birth naturally – and ultimately, losing her child. She is very happy that her journey brought her to the Hajjah health facility and now, one month after her difficult experience, she is happy back home with her husband and her two healthy children.
Photos: Yahya Arhab/IFRK, Oana Bara/DRK