South Sudan: 'We've Been Through More Difficult Times; We Shall Overcome This' - Midwife at COVID-19 Frontline

Torit — “In a profession that has historically always placed patients’ needs first, the degree of sacrifice being demanded of us now is unprecedented,” says midwife Justine Mangwi.

With the first cases of the new coronavirus disease (COVID-19) having been confirmed in South Sudan in early April, he is concerned about protecting mothers and their newborns from being infected both in their communities and in the health facility.

Expectant mothers are already expressing a preference to deliver at home instead of at a hospital as they are aware of the risk of contracting COVID-19 when they leave their homes. This worries him, as home delivery increases the risk of maternal death or injury.

“I tell them that switching their birth plan could be dangerous. A home birth environment is just as susceptible to the spread of the coronavirus,” Mr. Mangwi points out. “Pandemic or no pandemic, the hospital has a team and the equipment available to save lives in case of pregnancy or childbirth complications.”

The midwife has a reason to be concerned. South Sudan has a maternal mortality ratio of 789 deaths per 100,000 live births – one of the highest in the world. One of the contributing factors to the country’s high maternal death rate is low skilled birth attendance. Only 15 percent of women deliver with the assistance of a trained birth attendant, such as a midwife.

Until early April, South Sudan had remained COVID-19 free. The virus now adds to the many already existing factors that could cause pregnancy and childbirth complications.

UNFPA, the United Nations Population Fund, is working with the Ministry of Health to put in place measures to ensure that maternal health and other sexual and reproductive health services are safeguarded to prevent deaths and illnesses, especially among pregnant and breastfeeding women and their newborns.

Measures are also being put in place to protect frontline health workers, including midwives. The plan includes recruiting additional midwives to support the anticipated surge in demand for health care.

Mr. Mangwi is one of 26 midwives who have been deployed by UNFPA to various hospitals under the Strengthening Midwifery Services Project to provide sexual and reproductive health services, as well as mentor midwifery students at Health Science Institutes. The project, supported by the governments of Canada and Sweden, seeks to fill the huge need for skilled health personnel.

At independence from Sudan in 2011, the country had only eight qualified midwives. Since the launch of the midwifery project in 2012, the number of trained midwives has grown to more than 800 today.

Mr. Mangwi has been preparing for his critical role in the COVID-19 response. He has completed online training courses and is participating in virtual meetings on the World Health Organization (WHO) protocols on COVID-19 for health workers. At Torit Hospital, where he works, he is part of the Rapid Response Team taking on the role of a risk communicator.

Yet, more needs to be done. The government should provide vital equipment, such as ventilators, for the hospitals as well as personal protective equipment for the frontline health workers. Those at the frontline will be more motivated and confident when they have the skills they need and feel that they are supported, he asserts.

“This situation calls for everyone to show commitment to help prevent our country from being wiped out by this merciless pandemic. Now, it is the turn of health workers to fight the coronavirus war for our country,” he says.

Mr. Mangwi maintains a mindset of resilience as he stands ready to serve at the frontlines of the COVID-19 response. “We have been through difficult times and I believe we shall overcome this. I pray each day for good health and a long life so I can tell some of my stories to my children.”

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