KHARTOUM, Sudan – Lubna still remembers the sound of shelling in Khartoum, the capital city of Sudan, six months ago. The 34-year old was, at the time, mother to six children and pregnant. “I was wondering how I can guarantee the safety of my unborn child, my six children and my own safety,” she recently recalled to UNFPA, the UN sexual and reproductive health agency. “Who will give me a helping hand in these terrible circumstances? I did not know what to do.” 

Her family was among some 3 million people  forced to abandon their homes in Khartoum following the outbreak of violence on 15 April 2023 between the Sudanese Armed Forces and the Rapid Support Forces. Since the fighting started in mid-April, nearly 6 million people have fled their homes, seeking refuge elsewhere within Sudan or in neighboring countries. 

Among the 4.55 million people internally displaced across Sudan, an estimated 1,092,000 are women and girls of reproductive age, and an estimated 108,740 are currently pregnant and in need of timely access to lifesaving and essential reproductive health services.

Needs continue to grow

Since the outbreak of the conflict, UNFPA deployed mobile clinics to displacement sites across the country, responding to the reproductive health and protection needs of women and girls affected by the conflict. Thousands of services – including prenatal care, STI testing and treatment, cervical cancer screenings,  postpartum care and newborn care – have been provided to both internally displaced and vulnerable host communities.

The clinics are operated by a medical doctor, lab technician, midwives and a pharmacist. Four such clinics have been deployed in West Darfur, Blue Nile and White Nile. UNFPA is additionally deploying temporary clinics in the states of Kassala, Gedaref, Aj Jazira, South Darfur, Northern, River Nile and Red Sea, where large numbers of displaced people are staying. 

Yet the humanitarian needs are only growing. 

The only medical supplies entering the country today are provided by aid organizations, which are unable to keep up with demand. And as the economic situation deteriorates, access to essential and life-saving health and protection services is falling as well. 

Moreover, protection risks – including threats of sexual violence, harassment, abuse and exploitation – are on the rise. Gender-based violence has been reported both in areas where active combat is taking place and in areas hosting displaced people.

Safe childbirth amid chaos

For Lubna, as for so many others, the outbreak of violence was only the start of an ongoing ordeal.

It was not until late June that the family was able to flee Khartoum – Lubna’s husband, Omar, had spent weeks scraping together enough money for transport. The journey itself required an arduous 15-hours  of travel to Kosti, in White Nile State. Lubna, by then, was seven months pregnant. 

When they finally reached the city of Kosti, the family was directed to an area known as the Ezzedine gathering site for displaced people. In the weeks that followed, they made their home in a school serving as a shelter.

Living in this temporary refuge has been challenging, but one thing Lubna did not have to worry about was reproductive health care. Immediately upon arrival, Lubna received medical attention at a UNFPA-supported mobile clinic, including an examination, medication and also psychosocial support. Thereafter, she was able to receive routine care.

"Lubna had frequent pregnancy checks at the clinic,” said Aisha, a midwife at the mobile clinic. Lubna also received a clean delivery kit, containing sterile supplies to facilitate a safe birth. The kits are disseminated in humanitarian contexts in case women end up delivering at home or in a poorly equipped facility.

Fortunately, Lubna was able to deliver at the mobile clinic. On 12 September, at 10:00 in the morning, Lubna gave birth to a healthy baby girl. 

For staff at the mobile clinic, Lubna’s safe delivery was especially heartwarming – a happy story amid the chaos of conflict. “Lubna was one of the first registered patients at the reproductive health mobile clinic,” said Dr. Ruaa, who works in the clinic. “We hope that all pregnant women in the gathering site give birth safely.” 

Needs are mounting

UNFPA is working closely with partners – including Canada, the Central Emergency Response Fund, the European Commission, the European Union Humanitarian Aid,  the Netherlands, Sweden, the United Kingdom and the United States of America – to scale up the reproductive health care available to conflict-affected populations. 

But the needs continue to mount.

"We are proud that we were able to help Lubna and provide life-saving services to hundreds of women and girls through this mobile clinic,” said Mohamed Lemine, UNFPA’s representative in Sudan. “But we should also consider other situations where there are needs but we do not have the means to provide the same services due either access constraints or a shortage of funding."