For many pregnant refugee women in the Democratic Republic of the Congo (DRC), childbirth is literally a matter of life or death.

Living in isolated settlements or in camps without maternal health facilities means they are unable to access the care they need to give birth safely and keep their babies alive. Every year an estimated 96,000 newborns die from preventable causes.

Dr Charles Dago, UNHCR Senior Regional Public Health Officer based in Kinshasa, DRC, has seen these challenging conditions firsthand. Here he explains what needs to be done to save the lives of newborns.

Where do you see the most urgent need for refugee health services in the DRC today?

Delivering any kind of healthcare in the DRC is an enormous challenge: so many areas are affected by chronic crisis. The needs are huge, resources are limited and many of the local health services are either not functioning or are very weak.

Dr Charles Dago has seen firsthand the challenging conditions facing refugee women and their newborns in the DRC. © C. Dago

Even the better-equipped health centres like this one in Inke camp lack essential medicines. © UNHCR

Can you describe these local health facilities?

They are in very poor shape. At the basic level, you have health posts, mostly made of mud, lacking the most basic equipment and run by one or two nurses who need training. Even the simplest hygiene is not there. This is important for neonatal health because most deaths occur at the time of delivery. In the regional hospitals, there is often no electricity, which can have serious consequences for newborns and mothers.

What else makes pregnancy and childbirth more dangerous in this region?

Many of the refugees arriving are acutely malnourished. This can lead to premature and low birthweight babies. It can also cause anaemia, which increases the risk of post-partum haemorrhage. That’s why it’s so important to have proper antenatal care, to check for anaemia, provide iron supplements during the pregnancy and ensure that women get enough food.

Malaria is also a problem – it’s the number one disease here. It can weaken the mother’s immunity and affect the health of the foetus. Unfortunately, many of the infectious diseases are present in this region. Last year we had cases of Ebola but, luckily, it didn’t spread to the camps.

How can we improve maternity services and neonatal survival? 

First, you need to ensure that a mother can deliver in good conditions. There are basic skills that are important for the staff to have, including low-cost practices like resuscitation and cord care. We need to spread the message of the importance of antenatal care, and of neonatal practices that are safe and effective. There is also equipment that is very important to have but is not present in most of the health facilities now.

What can Australians do to help reduce the newborn death toll in the DRC?

The donations of Australians at this critical time can help UNHCR upgrade, supply and support the local health facilities, giving more mothers and babies access to life-saving maternal, neonatal and child health services.

You can provide life-saving healthcare to newborns in the DRC

After months living in an isolated refugee settlement, Florence, 22, was transferred to a health centre where her birth was supervised by midwives. © UNHCR/Sebastian Rich

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