Shakila Parvin has been a UNFPA-trained midwife in the refugee camps of Cox’s Bazar since 2019. In Bangladesh, obstetric care during delivery by medically trained providers, which contributes to reducing maternal and neonatal mortality, has increased from 21 per cent in 2011 to 53 per cent in 2017 - 2018.
COX’S BAZAR, Bangladesh – It was the end of July 2021 when non-stop rains caused major flooding in the Rohingya refugee camps throughout Cox’s Bazar. The roads were submerged by floodwaters so it was tough for the other midwives and me to reach the UNFPA-supported health-care facility in the camp.
Once we reached the facility, we saw that the maternity ward, pharmacy, storage area and other areas were submerged by water. Medical equipment and medicines were destroyed and machinery and furniture were damaged. It was very difficult for us to provide services to the patients during those days.
On one particular day, 27 July, a patient arrived in labour. Within 30 minutes, this mother, who had hypertension, delivered her first twin then started bleeding badly. We immediately consulted the doctor and made a plan for an emergency Caesarean-section to get the second twin out.
All this time, the rains had not stopped – water throughout the facility was knee-high. Without electricity, it became difficult to perform obstetric care, and the patient’s condition was worsening. Luckily we were able to give her a blood transfusion to stabilize her. Then a midwife accompanied her in a UNFPA vehicle to another hospital so she could have her second twin.
Ensuring maternal health at any time in any situation is my first and foremost responsibility. Pregnant women can become desperate when they need help especially during natural disasters. I keep myself prepared and try to keep my mental state strong to ensure things go smoothly even during any unexpected situations, like a delivery room flooding.
During the July floods, I was acting midwife supervisor. I provided instruction and information to 11 midwives so they could continue providing health services through a mobile medical team deployed during emergency situations or inside the facility.
**Access to care paramount **
We can't prevent climate change just as we can't prevent natural disasters. But we can reduce the damage of natural disasters. Climate change has definitely impacted my job. The number of extreme weather events is increasing – floods, droughts, tidal waves and cyclones make it harder for expectant and new mothers to access care, whether it is regular checkups or emergency services. Delays in seeking health services puts the mother and fetus or baby at risk.
Childbirth can be the happiest time for a mother, but every year many women die as a result of complications during and following pregnancy and childbirth. Most of these complications can be prevented by antenatal and postnatal check-ups and facility-based delivery.
As a midwife I can make a significant contribution in this regard as I provide services to a mother from preconception to 42 days after delivery so if any abnormality develops, I can detect it and make a plan for managing or treating the problem as early as possible.
By ensuring these services I can contribute to reducing maternal and child mortality rates, which is one of the most fulfilling parts of my job. When I see a mother’s happiness at her healthy baby, my life feels meaningful.