Midwife Nuriat Koku Mtumbi remembers the day in March well: "It was raining heavily and Adimu* had delivered her baby on her way to our facility. "She was shielding herself under a tree" when she gave birth, Ms. Mtumbi recalled.
Adiumu was in excruciating pain, and bleeding heavily. She could barely move, "but her mother managed to get her here," Ms. Mtumbi said. The newborn was struggling to breathe.
"I worked quickly, drawing on what I had learned during my training," Ms. Mtumbi said, "and managed to save both Adimu and her baby. I couldn't have done this before; I simply didn't have the skills or equipment."
Ms. Mtumbi's health facility - Nyangokolwa Dispensary in the Bariadi District - is one of 40 health facilities renovated by UNFPA between 2017 and 2019, with funding from the Korea International Cooperation Agency. The facilities have also received equipment and staff training.
Such efforts are critical for saving the lives and health of women and girls who experience complications of pregnancy and childbirth.
Preventing obstetric fistula
May 23 is the International Day to End Obstetric Fistula, which calls global attention to one of the most devastating childbirth injuries: Obstetric fistula is a hole between the birth canal and bladder and/or rectum, caused by prolonged, obstructed labour without access to timely, high-quality medical treatment.
This condition is almost entirely preventable, yet it persists among the most vulnerable and marginalized women and girls.
Ms. Mtumbi has seen the life-shattering impact of obstetric fistula on women in the community: "Women suffer chronic incontinence; they are shamed and shunned by their community, and sometimes even divorced."
The risks of experiencing such injuries, or even dying in childbirth, were higher before the facility was renovated in 2018.
Then, many pregnant women had to make the long journey to Somanda Hospital some 20 kilometres away. Some didn't make it, others faced injuries like fistula.
But since Nyangokolwa Dispensary was renovated, the number of pregnant women delivering there has skyrocketed. There are now more than 80 deliveries per month; the number previously hovered around 30.
Ms. Mtumbi says she is proud that women have confidence in the facility - something she shares.
Preparing for COVID-19
The COVID-19 pandemic has not yet reached the Nyangoolwa community, but the health facility is already implementing infection and prevention control measures.
New patient flow systems are in place at antenatal and postnatal clinics to ensure physical distancing. No more than three to five clients attend group education sessions, and they sit at least one metre apart.
UNFPA is set to support additional infection prevention and control training, and is procuring personal protective equipment and essential supplies for health facilities in priority regions.
* Name changed for privacy