In Rebuilding Sudan, Birth Often Brings Suffering and Death

Bang Akok at Rumbek Hospital with her baby girl and her aunt, Agoen Matheu. The baby's twin died before delivery. (Emily Wax -- The Washington Post)

Fleeing the Fighting

A year ago, Ahmed Abdallah, 21, married Fadna Abdulla Rhaman, a pretty woman of 25. They lived in a compound of huts about 37 miles east of Nyala, the capital of South Darfur.

Rhaman quickly learned she was with child. Her new husband and their families celebrated. They slaughtered a cow and held the customary feast of celebration for a first pregnancy. But when Rhaman was eight months pregnant, her belly swelling with life, their village was attacked -- either by African rebels or Arab militiamen, allegedly armed by the government to stop the uprising.

"People came on horses at 4 in the morning, rebels or government, we aren't sure," said Khadija Ishak Hamad, Rhaman's mother, who sat in a dank shelter patched together from leaves, rags and sticks in a sweltering camp for those who fled. "My daughter was not well enough to run. I knew she was in pain."

In the late stages of her pregnancy, Rhaman spent her days resting, as most pregnant women do around the world. So when the family had to flee, Rhaman found it almost impossible to keep up. They had little water and had to walk for two days in the sun, with sand whipping up behind them.

"The biggest problem was that we were in the bush and lacked food," Hamad said. "At one point, we had to run to the mountains when we heard more gunfire. I carried her for a while."

During the journey, the family was worried Rhaman might give birth, because she was bleeding and kept passing out. But after several days, they made it to a crowded camp in Nyala where more than 80,000 people were living after being displaced by fighting. Rhaman gave birth soon after, helped along by women without formal training.

Afterward, she held her baby girl, wrapped in a torn pink blanket and named Abdallia, or "Servant of God" in Arabic.

"My wife was so happy," her husband recalled. "We thought everything would be fine. We thought she might need a better meal of meat. But we had nothing."

Rhaman knew she was weak because she couldn't breast-feed and felt dizzy. But her sister, who gave birth last year, fed the baby and the entire family squeezed into one hut, cuddling her. The men came by to praise the miracle. Her husband held the child. Another neighbor came over to offer a small bowl of dates and porridge.

But during the night, Rhaman began bleeding heavily. The next morning, her husband took her to a clinic in the camp. The lines were long. They waited all day. They were told to come back the next day. By then, she had died.

Attempts at Education

"You only see tiny babies here," said Sisa, the Kenyan nurse, looking over the ward crowded with women and newborns at Rumbek Hospital. "So many are in their 10th or 11th pregnancies. No wonder so many women and their babies are dying."

Lately, the nurses in Rumbek have been feeling frustrated by the high number of deaths. Last year, 3,000 village midwives were trained and 1,100 students were recruited for training across the country, with the support of the government and the rebel group that controls southern Sudan.

"We desperately need help," Sisa said. "During the war, you knew why there were so many maternal and infant deaths. But now, we can't have this many people dying."

Recently, she started making lists of health tips to hand out to pregnant women who visit. But she has had to read them aloud in most cases, because few of the mothers can read.