Women and girls displaced by Sudan’s war face severe barriers to reproductive healthcare in Darfur, with limited medical facilities and shortages of essential supplies putting mothers and newborns at heightened risk, the United Nations Population Fund (UNFPA) said earlier this week.
Fabrizia Falcione, UNFPA’s Sudan country representative, said after returning from Tawila in Darfur that more than 700,000 displaced people were sheltering in the sprawling camp, with new families arriving daily and setting up makeshift shelters across the desert.
The scale of displacement has placed enormous pressure on the area’s already limited health infrastructure.
Falcione said only one hospital in the camp was able to provide comprehensive emergency obstetric care, including Caesarean sections, leaving pregnant women with few options when complications arose during childbirth.
The priority, she said, was to bring reproductive healthcare closer to women rather than forcing them to travel long distances across difficult terrain to reach hospitals.
“Healthcare must be decentralized,” Falcione said, calling for an expansion of mobile services capable of reaching communities in remote and hard-to-access areas.
She also urged greater support for community midwives, saying trained and properly equipped midwives could address about 90% of women’s medical needs before, during and immediately after childbirth.
Critical medical shortages
UNFPA is also seeking to increase supplies of reproductive health commodities in Darfur, where some facilities in Tawila and Central and North Darfur were running short of oxytocin.
The drug is commonly used to prevent or control severe bleeding after childbirth, a potentially fatal complication of delivery.
Falcione said reproductive health supplies were often overlooked when humanitarian funding was allocated, despite their importance in preventing maternal deaths.
UNFPA has recently received USD1.8 million for reproductive health supplies, most of which will be directed to Darfur, she said.
However, funding remains insufficient to meet the scale of need.
The agency has been forced to close some services in order to maintain operations in areas considered to have higher levels of need, Falcione said.
Dangerous journeys
Access to healthcare is made more difficult by the poor road network around Tawila.
Falcione said her own journey to the camp took nine hours, with only about one hour spent on paved roads. The remainder of the journey involved mountain tracks largely designed for donkeys and camels.
For pregnant women, the journey can be even more difficult. Many displaced women have no money to pay for transport, leaving some with little choice but to walk long distances or travel on wooden stretchers carried by men.
Falcione said improving access to healthcare therefore required more than increasing the number of medical facilities. Services also needed to be brought closer to communities through mobile clinics and decentralized care.
UN access to Tawila has improved from a permit perspective, she said, with several U.N. agencies and non-governmental organisations already operating in the area and providing basic emergency obstetric services.
Supporting women-led organisations
UNFPA is also working with UN Women to strengthen women-led organisations and enable them to act as partners in humanitarian response efforts.
Falcione said local organisations could play an important role in reaching women and girls in communities where conventional humanitarian services were difficult to deliver.
Sudan has been engulfed in conflict since April 2023, when fighting erupted between the army and the paramilitary Rapid Support Forces. The war has displaced millions of people and severely disrupted healthcare services across the country.
For women in Darfur, the combination of displacement, insecurity, poor infrastructure and shortages of reproductive health supplies has created additional risks during pregnancy and childbirth.
Falcione said the immediate focus should be on decentralising reproductive healthcare, strengthening community-based services and ensuring essential medicines reach facilities before stocks run out.
Without sustained funding, she warned, humanitarian agencies will continue to face difficult choices over which services and communities they can afford to support.
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