SANA'A, Yemen -- Often heard throughout the global pandemic is that essential workers cannot work from home. But the world's worst humanitarian crisis calls for extraordinary measures. In a country ravaged by conflict, where only half of health facilities are operable and only one in five of those remaining offer maternal care, midwives are carving out space in their homes for makeshift maternity clinics. There they provide basic antenatal care, delivery and post-natal care, referring cases with complications to health facilities equipped to handle emergency obstetric care.
In 2020, UNFPA trained community midwives in villages and remote rural areas and established 170 home clinics by covering the costs of renovation, equipment like ultrasound machines, medicines and reproductive health supplies. A solar suitcase provides lighting, mobile phone charging and electronic fetal monitoring.
Filling in maternal care gaps
Not only have the clinics filled gaps in maternal and reproductive health care, they have also been effective where male providers face limitations in providing services to women because of cultural and religious practices.
Since opening her home clinic more than a year ago in the economically depressed neighborhood of Sawan, Rahma has helped more than 120 women. In addition to midwifery, she provides check-ups, family planning, minor surgery and first aid. Her schedule is booked with expectant mothers giving birth during Ramadan (13 April - 12 May), a time that should be joyous but is subdued by both stress because of unrelenting hostilities and economic unease due to a typical increase in the costs of food and goods. "I feel sorrow and sadness when thinking about these women -- their financial and health condition is very bad," she said. "During Ramadan, the prices rise crazy, which makes the lives of these women more difficult."
Rising prices, rising pressures
One woman whose due date falls within the Muslim holy month is Halima, 38. Rahma delivered Halima's first child, Khaled, now 6, and has followed Halima's second pregnancy since the beginning.
"The war is raging every day, which will have a bad effect on our lives," Halima explained. "My husband is unemployed with no income, prices doubled crazily, and services such as domestic gas and fuel were cut off. As expenses for necessities climb, "I will have to bear a lot of costs. It is a heavy load."
Before Rahma's clinic opened, Halima's cousin and her cousin's baby died during childbirth because the family couldn't afford to take her to a private medical centre. Even though Rahma's services are free, Halima worries about how to pay for rent, transportation and medicines. Rahma, too, is concerned about spiraling conditions.
"There are cases that come to my clinic with symptoms of malnutrition that may cause great harm -- even death -- to them and to their fetuses," Rahma said. "People are no longer able to provide for their daily sustenance. I think there is a famine coming and that women and children are the most vulnerable."
UNFPA appealed for $100 million to provide reproductive health care and women's protection services in Yemen through the end of 2021. To date, only 13 percent of this appeal has been received.
Despite the dire situation, Halima allows herself to imagine better times: "I hope that when I give birth, the war has ended and peace will begin. I hope to see my children grow up in front of my eyes."