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A midwife in DRC: "The roads are like nothing I have ever seen"

US midwife Claire takes a bumpy ride to a remote healthcare centre in the Democratic Republic of Congo

Tomorrow, I'm waking up early to head out on my weekly mouvement.

A major part of my job is overseeing the sexual and reproductive health activities at the four health clinics that this project supports, and this is how I do so…

A bumpy ride

All four health centres are on hillsides on the outskirts of towns here. It's fun to get out of Walikale, too!

Tomorrow, I'll grab my water and sunscreen and hop in the Land Cruiser for a bumpy ride to one of the facilities. There’s an outreach team that comes as well, so we don’t have trouble filling space in the cars.

I would never have the courage to brave the roads in our area while I was in labour, but women do it regularly.

We drive in caravans of two or three Land Cruisers, in part to avoid getting stuck in the mud.

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An MSF land cruiser negotiates a flooded road in the DRC
An MSF land cruiser negotiates a flooded road in the DRC

The roads here are like nothing I have ever seen. On one drive, we drive through a river. I have no idea how our drivers manage to drive over them every day without ruining the cars on a regular basis.

I've told our drivers a couple of times now how much respect I have for them.

The health centres

One of our local staff midwives is assigned to the outreach team. She goes on mouvements more often than I do and she keeps me up-to-date on the needs of the health centres since I can't be there every day. She’s got a lot of experience and is definitely someone I rely on.

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Nyasi health center in DRC
Nyasi health center in DRC

I time my visits to correspond to the day the clinic holds prenatal visits. This is so I can check in with the sexual and reproductive health care provider at each health centre. This is usually a nurse.

Each health centre reserves one day a week for initial prenatal visits, a second day for prenatal follow-up visits, and a third day for postpartum and family planning care. There is also a birth centre for low-risk women within each facility, and the teams follow strict criteria for transferring women to the hospital in Walikale.

Personally, I would never have the courage to brave the roads in our area while I was in labour, but women do it regularly.

The waiting home

Luckily, my project is building a Maison d'Accueil, a “waiting home” where pregnant women can stay until it's time to give birth. This will be adjacent to the hospital.

I'll be giving a brief presentation to the staff of the health centre we’re visiting tomorrow, so everyone in the community has the same information about the new facility. I'm really excited about it becoming a reality for women here!

While I'm at the health centre, I’ll also review any cases of sexual or gender-based violence that have been treated by the team. Finally, I make sure they have all the supplies they need. 

When I get home, it's usually late afternoon and I'm exhausted.

After a break, I keep advocating for my patients and discuss the needs at the health centre we visited with my supervisor, our fearless medical team leader.

Then, it’s time to grab a beer and watch the sunset.