News

Midwives without borders: Empowerment & action in humanitarian crisis… beyond the clinic walls

5 May 2019

From serving the women of their own country… to serving the world. Two young African midwifery leaders – from Burkina Faso and Chad – passionately apply their skills and energy to improve the lives of vulnerable women and girls affected by natural disaster and humanitarian crisis in Mozambique. Members of UNFPA’s humanitarian surge team in Sofala, Mozambique, both young women were deployed to bolster UNFPA Mozambique’s response to Cyclone Idai which affected 1.85 million people in central Mozambique, causing more than 600 deaths and damaging houses and health facilities.

Sabine Nana (of Burkina Faso) trains newly recruited maternal and child health nurses (midwives) in lifesaving skills in labour and delivery and also helps set up temporary maternity & sexual and reproductive health (SRH) units at the worst-affected health facilities in areas devastated by the cyclone. An experienced humanitarian, she began her career with the Ministry of Health in Burkina Faso and then went on to serve with Medecins Sans Frontieres in the Rohingya refugee camps in Bangladesh, as well as in the DRC, Haiti, and Mauritania. An expert in sexual and reproductive health and rights (SRHR), maternal and newborn health, and sexual and gender-based violence (SGBV), she is now serving as SRH technical specialist and UNFPA’s lead trainer on Clinical Management of Rape.

The dynamic, determined, energetic, and ever-positive Sabine says of her humanitarian surge experience in Mozambique:

“I arrived a few weeks after Cyclone Idai struck. The earth had begun to dry but the people’s tears continued to fall. People have lost their loved ones, their property, and their memories. Women, children, and adolescents live in a precarious situation of lack of access to quality health services. I am, therefore, committed to this response to help prevent unwanted pregnancies, to help women gain access to a health center and skilled birth attendants, and to have medical treatment and psychosocial support in case of violence. As a midwife, I am really proud to run those community activities in remote areas of Nhamantanda, Buzi, and Dondo, which were devastated by the cyclone.”


Bandua SRH unit – severely damaged by Cyclone Idai ©UNFPA Mozambique/Sabine Nana

In the morning, Sabine starts her field visits to Bandua and Buzi district, 400 km from the capital city, Beira. She leaves early in the morning with a dedicated team to erect SRH tents and accommodation for the midwife who lost her house but keeps working in a roofless health center. Floods removed all medical equipment and medicines. UNFPA’s objective is to reach remote areas, install and equip tents (to be used as temporary maternity & SRH clinics), provide medicines through specialized reproductive health (RH) kits, and deploy a trained and skilled midwife in this temporary SRH tent. The “typical” day in Beira look like a surge training simulation (very intense and tough!), but the difference is that, in Beira, it’s not a simulation; we are responding to a real emergency. UNFPA invested a lot to train and prepare surge team members and this helps a lot to integrate and adapt ourselves to any emergency situation, Sabine reflects. 

“My everyday motivation is based on the teamwork,” says Sabine. “I am lucky to have an amazing supervisor and a nice smiling head of program. I have support from others and I give what I have to help others. The work is still a lot, and there is still a long way to go, but we will succeed together.”

When asked what inspired her to become a midwife, Sabine recounts: “When I was a little girl, my mother used to spend the whole day and night in the health facility with a woman in labour. And when she came back home, she was always happy and she said “the mother and the baby are healthy”. She worked too hard because she was alone doing deliveries for a big village where family planning use was not common. When I finished my studies, I wanted to work as a midwife… especially to improve the use of family planning. It was a way for me to help my mom have fewer deliveries to do, a way to help young girls escape unwanted pregnancy and continue their studies….”

“But finally, I found that being a midwife is more than that. After every single delivery, I am so happy to make the announcement to the family and enjoy how they celebrate this. I realize that helping a mother give birth and stay alive is a great mission for me and, doing this in an emergency setting is even more gratifying and helpful for the affected population. At least I know I am not a burden, I am useful for the society and this keeps me more engaged and inspired as a midwife.” 


Felicite (far right) with colleagues during an SGBV training in the field in cyclone-affected area ©UNFPA Mozambique/Alexandre Muianga

Felicite Ramadji (of Chad) is the embodiment of resilience and compassion. Her gentle, soft-spoken nature and kind smile have a way of making people feel at ease. The loss of her aunt during childbirth as she was growing up inspired her to become a midwife. She wanted to help her family and the many, many women in her community in Chad who were dying from complications related to pregnancy and childbirth. 

After working in a hospital in Chad for a year, she was recruited by the International Rescue Committee, and began working with Sudanese refugees. She later went on to work in the DRC and in northern Cameroon (Boko Haram-affected areas) with the IRC and with Doctors of the World in the DRC. In the course of her work, she saw many women suffering sexual and gender-based violence (SGBV) due to cultural and gender norms, lack of awareness of women’s rights, and lack of education. She knew she had to do something to help end this injustice. So she trained as a social worker and began working as a GBV focal point and protection coordinator for humanitarian agencies. 

It was not easy for Felicite to convince her family to let her leave home, but she promised to one day return to help her own community & the women of her country who, she laments, are so marginalized. Violence against women is systematic, she says, and women don’t receive support, the community tolerates the situation & has a tendency to blame the victim. She wants to learn from other countries (that are more advanced) & apply what she learns to help uplift and empower the women in her own country.

Here in Mozambique, Felicite mobilizes & sensitizes communities to protect women’s and girls’ dignity, well-being, & rights, and to prevent sexual & gender-based violence. She is a key member of the SGBV surge team in Beira, working in collaboration with the Mozambican government and partners, to ensure access to timely and high-quality life-saving Sexual and Reproductive Health and Rights (SRHR), including those outlined in the global inter-agency Minimum Initial Service Package (MISP) for Reproductive Health in Emergencies that includes the availability of comprehensive services for pregnancy-related complications and sexual and gender-based violence, as well as HIV/STI prevention and treatment. She also supports implementation in the field of UNFPA-supported Women-Safe Spaces (WSS) and distribution of dignity kits, along with education and awareness raising at the community level on SRH and GBV issues.  


Felicite distributing dignity kits in UNFPA’s Women Friendly Spaces tent at Samora Machel accommodation center, Mozambique ©UNFPA Mozambique/Natalia da Luz

“When we [UNFPA] distribute the dignity kits,” she says, “you see the smiles and women are very, very happy to receive this gift. Something has changed in their lives. Because they lost most of their possessions, even sometimes their ID cards and precious items, due to the disaster. Thinking about the past and what they are facing now makes them sometimes angry and sometimes sad, because they lost so much. But when UNFPA goes to the field to see them, they’re so happy that these dignity kits can help them to take care of themselves. It even helps them to manage their menstruation. When everything is lost, it’s not easy to manage menstruation… if you have nothing to put on. It makes you stressed & worried. But when you receive a donation, it makes you smile and it reassures you that you don’t have to isolate yourself.”

Felicite’s passion and commitment to her work and her deeply held conviction that women deserve to be free from violence, fear, and abuse stems partly from her own experience as a survivor of gender-based violence herself. Working in this field has permitted her to recover from her own case, she reflects. She likes to help others, to listen to women/survivors. And after, when the survivor begins to recover and starts to smile and stops crying, she rejoices… not because it’s her job, but because she is able to give comfort, hope, and a smile to someone who was in her same situation.

Erin Anastasi, Sabine Nana, Felicite Ramadji