Refugee women in CAR face childbirth risks amid US funding cuts

Lead

When labour pains struck Sudanese refugee Maude Ahmad Fadala, there was no clinic nearby, no transport and no money to reach a hospital. Hours later, weakened by illness and stranded on a dirt road in northern Central African Republic, she gave birth with only her sister by her side.

The agony began shortly after sunset at the Korsi refugee camp near the Sudanese border. Fadala, who had fled Sudan's war, was suffering from typhoid when labour started. With no functioning maternal health services in the camp and no money for transportation, she began the journey to the district hospital on foot. But the distance proved too great.

Forced to stop repeatedly as contractions intensified, she eventually collapsed by the roadside and gave birth without medical assistance.

“I didn’t know about the baby. I don't know what a nurse does to make a newborn cry,” Fadala said, as reported by Africa News. “My baby and I were sick.”

Her experience illustrates the growing dangers facing thousands of displaced women in one of the world's most fragile health systems.

Coverage Comparison

Two news outlets—Africa News and Al Jazeera—have reported on the situation, each emphasizing different facets of the crisis. Africa News focused on the personal story of Fadala, highlighting the humanitarian toll and the broader context of CAR's weakened public services. Al Jazeera framed the issue as a funding crisis, stressing that cuts to US assistance are increasing risks for pregnant women and straining health facilities that were already struggling.

Both outlets agree on the core facts: the influx of refugees from Darfur, the high maternal mortality rate in CAR, and the impact of funding reductions. However, Al Jazeera placed greater emphasis on the systemic pressures on health facilities, reporting that "some facilities have already cut back on overnight staffing and outreach activities," while Africa News underscored the individual suffering and poverty.

Key Claims

• A Personal Ordeal: Sudan's Maude Ahmad Fadala gave birth on a dirt road without medical assistance, as detailed by Africa News. This account is a single-source report but is presented as a firsthand narrative.

• Maternal Mortality Crisis: Both outlets report that CAR has one of the highest maternal mortality rates in the world. The United Nations notes that women in CAR are 40 times more likely to die during pregnancy or childbirth than women in the United States, with 829 maternal deaths per 100,000 births, according to Africa News.

• Conflict and Weak Services: Years of instability and conflict have weakened public services, particularly outside major cities. Poverty is widespread, with one in three people living on less than two dollars a day, as reported by Africa News.

• US Funding Cuts: The US government ended all funding agreements with the UN agency responsible for sexual and reproductive health programmes, which has led to the loss of jobs for four UNFPA-supported midwives in the region. This is a multi-source claim, corroborated by both Africa News and Al Jazeera.

• Refugee Influx: Tens of thousands of people have fled fighting in Sudan's Darfur region into CAR's remote Vakaga province, stretching the few functioning facilities to breaking point. Some facilities have already reduced overnight staffing and outreach activities, according to Al Jazeera.

• Health Risks: Refugee women face multiple risks, including malnutrition, malaria, and untreated infections. Many report never having seen a midwife before reaching CAR, as per Al Jazeera.

Perspectives

Humanitarian agencies warn that the funding cuts are worsening an already critical situation. The loss of US support for UNFPA programmes has direct consequences, such as the termination of midwives and reduced services. Aid workers on the ground describe a scenario where more women will deliver at home without skilled help, increasing the risk of preventable deaths.

From the perspective of the affected women, the crisis is immediate and personal. Fadala's story illustrates the dire circumstances many refugees face: lack of transportation, no access to clinics, and the physical toll of illness during pregnancy. Her words highlight a lack of knowledge about childbirth and the absence of medical care.

The situation reflects broader challenges in CAR, where decades of conflict have eroded health infrastructure. The arrival of tens of thousands of refugees has overwhelmed what little capacity exists, as both outlets note.

While the reports do not include direct responses from US officials or UNFPA, the implication is clear: international funding is essential for maintaining even basic maternal health services in this remote region. The cuts have not only reduced staffing but also undermined outreach activities, leaving pregnant women with fewer options.

As the crisis unfolds, the international community's response will be critical in determining whether more women like Fadala face childbirth alone or with the assistance they urgently need.