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In the heart of the Central African Republic (CAR) and northern Nigeria, women are facing an increasingly perilous journey to motherhood, with alarming rates of maternal and infant mortality. A recent investigation reveals the dire circumstances surrounding childbirth in these regions, as ongoing conflicts and significant cuts to international aid exacerbate an already critical situation.
A Grim Reality for Mothers and Infants
At the only dedicated paediatric hospital in the CAR, a newborn girl’s life hangs in the balance. Brought in after a harrowing two-hour journey on a motorcycle, she struggles against birth asphyxia. Dr Emmaus Johann, a medical student working alongside seasoned professionals, grimly observes the tragedy unfolding before him. “There was no ambulance; the only one was busy with another child,” he reflects, as the baby’s family watches helplessly. This hospital serves a nation of five million, grappling with some of the highest maternal and infant mortality rates globally—829 women die for every 100,000 live births, a stark contrast to the UK, where the figure is just 9.
The situation has worsened significantly in recent years, with the United Nations and various humanitarian organisations sounding the alarm over stalled progress in maternal health. A combination of unprecedented aid cuts, primarily initiated by the reallocation of funds towards military expenditures in the US and Europe, has led to a deterioration of health services. The loss of essential funding has precipitated a crisis, as health facilities close their doors and staff are laid off, leaving women without access to critical reproductive health services.
The Impact of Conflict and Aid Cuts
In Birao, a town plagued by conflict and now hosting an influx of refugees from neighbouring Sudan, the local hospital is overwhelmed. Dr Kango Semplice, who oversees the emergency department, laments the sudden funding cuts that have left them without resources to provide adequate care. “We have had no funding since last year,” he states, emphasising that the prioritisation of limited resources means only the most treatable cases receive care, resulting in preventable deaths for both mothers and infants.
Monica Ferro, head of the United Nations Population Fund (UNFPA) in London, underscores the urgency of this crisis. “When maternity wards close, mortality rates rise. It’s as simple as that,” she insists. “No woman should die from childbirth.” The current upheaval in CAR, coupled with escalating conflicts worldwide, has created a perfect storm of humanitarian need.
In Nigeria, the situation mirrors that of the CAR. With over 29 per cent of all estimated global maternal deaths occurring in the country, the data paints a bleak picture. In 2023 alone, Nigeria recorded 75,000 maternal deaths, equating to one death every seven minutes. The healthcare system is severely strained, with just one doctor available for every 9,000 patients, leading to a reliance on poorly equipped primary care centres that often lack basic supplies.
Desperate Choices and Heartbreaking Consequences
Blessing, a mother from Nigeria, recalls the traumatic experiences of her sister, who lost her life after an agonising three-day labour, unable to afford the necessary hospital care. “I was terrified I might face the same fate,” she admits, having endured complications during her pregnancy. The facility manager at her local health centre reveals that they are often left with only a fraction of the resources needed to care for the influx of women seeking assistance.
Asina, another Nigerian mother, shares her story of loss, having lost a baby just two days before. The emotional toll of the healthcare crisis is evident, with women expressing dread over the prospect of future pregnancies. Hawwa, who has already lost six of her thirteen children, voices her fears, stating, “I always fear the one I’m carrying will die.”
In both CAR and Nigeria, the impact of these crises is compounded by external factors such as climate change and ongoing conflict, which continually displace families and strain already fragile health systems.
Why it Matters
The maternal health crisis unfolding in the Central African Republic and Nigeria is not just a local issue; it reflects a broader global challenge that requires immediate attention. As funding for vital health services dwindles and conflicts escalate, the consequences are devastating, with mothers and infants paying the ultimate price. Addressing this crisis is essential not only for the health of women and children in these countries but also for global efforts to improve maternal health outcomes everywhere. Without urgent action, the successes achieved in reducing maternal mortality over the past decades risk being reversed, putting countless lives in jeopardy.