November 30, 2023
Dr Paul Mushombe Nibhumba: Testimonial from Doctors of the World Medical Coordinator in Mali
Chad is a landlocked country in the Sahel region of north Africa that is largely made up of arid and desert landscapes. Although it is the continent’s 5th largest nation in terms of its geographic area, the people of Chad face a variety of health issues. These issues are exacerbated by the fact that many live in rural areas with little to no access to healthcare. Compared to the United States, where the average life expectancy is 79, the average life expectancy in Chad is just 54 years for women and 52 for men.
In 2015, our Doctors of the World teams provided 1,711 medically supervised births and over 44,170 obstetric consultations for expectant mothers. Some of the leading causes of death for women in Chad are complications related to pregnancy and childbirth. Since 2009, Doctors of the World has been working in the Kanem region, where pregnant women and newborns receive very little medical care, especially in rural areas. Women often have to walk several hours to reach a health center or to see one of the few doctors in the country. As a result, many women die during childbirth without having received any medical attention. For every 100,000 women, 1,100 die during childbirth and only 4.8% of women use any form of contraception.
Lack of access to healthcare is one of the most challenging health issues confronting the people of Chad. Many women and children do not seek medical care or treatment due to the long distances they have to travel. To address this, our teams equipped local communities with horse carts in order to transport patients more quickly and efficiently. Using the carts greatly reduces the time and effort required to reach a center, enabling women and children to seek care more frequently.
Giving birth in Chad can be extremely risky. Caesarians are rare, and labor can often be obstructed or prolonged due to malnutrition. The difficult labor process can leave women with cases of obstetric fistula that can dramatically impact their wellbeing. These complications can lead to chronic incontinence, which severely impacts women’s personal lives and can result in them being ostracized from the local community. In order to reduce the dangerous consequences of prolonged and ill-equipped labors, our team has recruited and trained midwives in addition to refurbishing the birthing rooms inside rural health centers. We also provide women suffering from obstetric fistula with medical care and psychosocial support.
Since 2015, Doctors of the World has also worked with Action Against Hunger on advocacy in the health districts of Mao, Mondo, and in Mao City. We have worked in over 47 health centers and in Mao’s regional hospital, where we raise awareness among young adolescents about health related issues such as maternal health, the prevention of HIV, the transmission risk between mother and child and the importance of vaccinating new-born babies against disease. Throughout the region we also organize family planning activities and information sessions.