MSF teams travel 2 hours by speedboat in Ulang to reach communities displaced by floods
Access to Healthcare

Giving birth amid floodwaters

The challenge of motherhood in South Sudan starts long before delivery. Sexual and reproductive healthcare is not accessible for most women in Ulang County, Upper Nile State. Some communities are entirely isolated for five or more months of the year. The rainy season turns the ground to mud and the floodwaters rise. Even in dry season, the closest health facility is often multiple days’ walk from a mother’s home.

Most women deliver in their own homes, accompanied by a traditional birth attendant. We know of more than 600 deliveries that took place in rural communities around the hospital. These families have little alternative but to hope the delivery goes smoothly. If anything goes wrong and the life of the mother or baby is in danger, a referral will often be impossible. Mobile networks are patchy. Boats and fuel are expensive, unreliable and few in number. Most journeys are long and the presence of armed groups can make movement impossible.

The Médecins Sans Frontières (MSF) hospital in Ulang is the only secondary healthcare facility in a region that is home to more than 100,000 people living in Ulang town and in villages along the Sobat River. One of the services we provide is basic emergency obstetric and newborn care. We also train traditional birth attendants from different locations to help bring mothers to our hospital as soon as they identify that delivery might be going wrong.

Each of the 443 babies delivered at Ulang hospital last year has a story. These are just two:


A new passenger aboard

“One of our staff members approached me saying his relative had been in labour since yesterday. He didn’t know what to do,” said Hakim Abdulahi Ali, project medical referent.

“Our motorboat pushed off the dock less than 20 minutes later. We had all the people and equipment our patient might need. We heard the woman’s village was 40 minutes away. We had no information about the mother or baby. We didn’t know what we might find.

In a village called Pachuey, we found men, women and children shoring up dykes to keep the floodwater out.

We told them we were the MSF team, coming to take the woman in labour. We could see joy on their faces as they rushed to bring her to the boat. The midwife supervisor assessed her quickly as we began the journey.

The 50-minute trip back to the hospital seemed like it was taking forever. Would the mother deliver while we were still on the boat? What could go wrong if she did? What if her labour continued to drag on? That would be worse still. If she needed a caesarean section, the only option would be referral to the MSF hospital in Malakal, an eight-hour journey away by boat.

Then the baby was coming.

We slowed the boat to make the mother more comfortable on her makeshift delivery couch.

At last, we heard the little one’s first cry. The mother’s mother rushed to hold the baby. She was so happy.

We were still underway, cruising and taking care of the mother and baby when she delivered the placenta safely 15 minutes later.

The driver radioed back to base. We had a new passenger on board!”


Twin fighters

“During my morning activities, I started to feel some pain,” our patient told MSF medical activity manager Mananyahleshal Girma Ayelaw.

She was 28 weeks into her fourth pregnancy and she knew something was not going well.

She was relatively lucky. It was only a 30-minute journey from where she was living to the MSF hospital in Ulang.

Even so, she didn’t reach the hospital in time. The pain turned out to be labour, and she delivered twin premature babies on the roadside, on her way to reach us.

“I am glad for this hospital and everyone who struggled with me to help my babies survive,” says the 32-year-old mother, with a smile on her face.

When they arrived, all the medical team rushed to help the two babies, who had come nearly three months early.

These babies still needed weeks of growth before they were ready for the world. We worked with the mother, monitoring them all closely and mimicking the natural environment of the womb. It took a lot of courage and commitment from her, and strength from the babies.

After 24 days of work and determination, the twin fighters Nyaboth & Nyadouth were breastfeeding. The little girls and their mother were all healthy. After a challenging start, they were able to go home and meet their brothers and sisters.