Southern Sudan's healthcare system is almost non-existent in many areas after a 21-year war with the north, and health workers are regularly forced to work with minimal medical supplies. Alice Tabu, 24, a midwife at a hospital in Lui in Western Equatoria State, talked to IRIN/PlusNews about the challenges of working in such conditions.
"I have worked as a midwife since 2004. My duties include counselling pregnant mothers coming for antenatal clinic visits, treatment, or to deliver [their babies]. I counsel them on primary healthcare, proper nutrition and about HIV/AIDS.
"Some have no problem at all with the requirement for the HIV test [part of prevention of mother-to-child transmission services] but some are reluctant and will ask for more time to consider, and never return to the clinic.
"I even ask them to bring along their husbands to test together, but the majority of men never accompany their spouses to the clinic or for the HIV test.
"The men say: 'If I have HIV, it is already in the body and I don't care; not much can be done to help me out'. I think it is out of ignorance they behave this way.
"Once the HIV results are out, I discuss it with [the mother], explaining what being positive or negative means. But counselling is the easy part; we at the maternity [section] are overworked and facing a big shortage of supplies and, most critically, gloves.
"At times we conduct deliveries without the protection of gloves, when we have none in the maternity ward and the clients don't carry their own, putting us at risk of contracting HIV.
"At times we wear polythene bags in place of gloves. The last time I had my own gloves was when there was a donation from UNFPA [United Nations Population Fund]. Only last December [2008], I conducted a delivery without gloves.
"It was around midnight when I was on duty alone that a woman went into labour. When I went to examine her she was already pushing, so I went ahead, held the baby in my hands, and also cut the umbilical cord without gloves.
"Even after I checked her hospital card and confirmed she had been screened for HIV, hepatitis B and syphilis, and all found negative, I still had doubts and fear deep inside me. I had an HIV test just to make sure I am free from the virus.
"Next time a mother comes to the labour ward without her own set of gloves, I may not assist, lest I risk losing my life in the event she is HIV positive."
wm/kr/ks/he
See also: SUDAN: PMTCT programmes still in their infancy
"I have worked as a midwife since 2004. My duties include counselling pregnant mothers coming for antenatal clinic visits, treatment, or to deliver [their babies]. I counsel them on primary healthcare, proper nutrition and about HIV/AIDS.
"Some have no problem at all with the requirement for the HIV test [part of prevention of mother-to-child transmission services] but some are reluctant and will ask for more time to consider, and never return to the clinic.
"I even ask them to bring along their husbands to test together, but the majority of men never accompany their spouses to the clinic or for the HIV test.
"The men say: 'If I have HIV, it is already in the body and I don't care; not much can be done to help me out'. I think it is out of ignorance they behave this way.
"Once the HIV results are out, I discuss it with [the mother], explaining what being positive or negative means. But counselling is the easy part; we at the maternity [section] are overworked and facing a big shortage of supplies and, most critically, gloves.
"At times we conduct deliveries without the protection of gloves, when we have none in the maternity ward and the clients don't carry their own, putting us at risk of contracting HIV.
"At times we wear polythene bags in place of gloves. The last time I had my own gloves was when there was a donation from UNFPA [United Nations Population Fund]. Only last December [2008], I conducted a delivery without gloves.
"It was around midnight when I was on duty alone that a woman went into labour. When I went to examine her she was already pushing, so I went ahead, held the baby in my hands, and also cut the umbilical cord without gloves.
"Even after I checked her hospital card and confirmed she had been screened for HIV, hepatitis B and syphilis, and all found negative, I still had doubts and fear deep inside me. I had an HIV test just to make sure I am free from the virus.
"Next time a mother comes to the labour ward without her own set of gloves, I may not assist, lest I risk losing my life in the event she is HIV positive."
wm/kr/ks/he
See also: SUDAN: PMTCT programmes still in their infancy
This article was produced by IRIN News while it was part of the United Nations Office for the Coordination of Humanitarian Affairs. Please send queries on copyright or liability to the UN. For more information: https://shop.un.org/rights-permissions
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