News

I was more worried about stopping my midwifery training than being hit by bullets

19 February 2018
Displaced by the conflict in South Sudan, Nyomon Lilian hopes to return to Kajo Keji and use her midwifery skills to the benefit of women there. © UNFPA South Sudan/Arlene Alano

JUBA, South Sudan – The tragedy that Nyomon Lilian witnessed the day she decided to become a midwife is one she will never forget.

Just a few years ago, she watched as her neighbour bled heavily after giving birth in her hometown of Kajo Keji, in Equatoria region. The woman who was attending her had no training in how to deal with such complications.

Watching my neighbour die during childbirth emboldened me to make the decision to enrol in midwifery [school].

The new mother was rushed to hospital – but it was too late. She died, leaving behind five small children.

“Watching my neighbour die during childbirth emboldened me to make the decision to enrol in midwifery [school],” said Ms. Nyomon, 25. “The woman assisting her had no knowledge of what to do.”

Nor was this life-changing moment the first time she had observed a woman die in childbirth. “I’ve seen it with my own eyes,” she said, “women dying because of bleeding.”

This tragedy is all too common in South Sudan, which has one of the highest maternal mortality ratios in the world.

For every 100,000 live births, around 789 women die from pregnancy-related causes, according to recent UN statistics. Figures from the 2006 South Sudan household survey show an even more dire situation, however – 2,054 deaths for every 100,000 live births.

Becoming a midwife in a war zone

When Ms. Nyomon heard a radio announcement about a midwifery scholarship programme supported by UNFPA’s Strengthening Midwifery Services Project, she applied for it that day – and was accepted. Together with 58 classmates, she was enrolled at the midwifery school in Kajo Keji.

But early in 2017 their studies were forced to a halt by the conflict engulfing the country. Fighting broke out in Kajo Keji and most of the town’s residents fled into the bush.

Although Ms. Nyomon and her classmates had no patients left to treat, and they feared for their lives, they stayed behind because they did not want to leave their school. They were the last people remaining.

We heard gunshots in the school. I took my uniform, and left behind my books and everything else.

But things took a turn for the worse.

“We heard gunshots in the school,” she said. “I took my uniform, and left behind my books and everything else.”

She also left behind her home.

Yet what worried her more than being hit by bullets was the thought that she might not be able to continue her education. “I was really sad,” she said.

Planning for a better future

I feel a lot better now that we’re back in school.

Together with her classmates, she sought refuge in Uganda. There they remained until the midwifery classes were relocated to Juba, South Sudan’s capital. This was a welcomed development: “I feel a lot better now that we’re back in school,” she said.

Now in her second year of the midwifery programme, she has started to assist in the maternity clinic in Juba. She recently observed and assisted in her first delivery – an experience she describes as thrilling.

Ms. Nyomon is learning about the main causes of maternal death, and believes that more women would be spared if they knew to seek skilled care. “People do not know about haemorrhaging,” she said. “Mothers are also not aware that they need to eat well and treat illnesses like malaria when they are pregnant.”

She now encourages mothers living in remote towns to get antenatal check-ups, especially if they are experiencing unusual symptoms during pregnancy.

When the fighting subsides, she hopes to return to Kajo Keji and use her midwifery skills to the benefit of women there. Her aspiration is to ensure that mothers in her hometown live to see their children grow up.

~ Arlene Alano