16 November 2016

The testimony of Central African MSF Assistant Midwife Bouhari in the highly insecure PK5 district of Bangui.

I have been working in the Gbaya Ndombia maternity since it opened at the beginning of 2016. As an assistant midwife, I am part of a team that looks after the mothers-to-be while they’re in labour. I also care for the babies after their birth. I clean the newborn, check his breathing, swaddle and dress him before handing him over to mum.

It’s a very special moment for the woman and her child, and it’s a pleasure for me to take part in it.

 Assistant midwife Bouhari at the Gbaya Ndombia Maternity Clinic in Bangui. Photo: Sandra Smiley/MSF

I have wanted to be a midwife since primary school. My neighbour was a midwife, and I really admired her. After becoming an assistant midwife, I actually registered at the university here in Bangui to study and deepen my knowledge. But since the crisis of 2013, I can no longer get to the campus.

I am a Muslim woman, and I worry about leaving this neighbourhood, PK5. People can see that I am a part of this community from the way I act and the way I dress. When I leave PK5, I feel threatened, and so I do not do it very often, for fear of being harassed or becoming the target of aggression.

The university is 4 km away, so not very far at all! But the fear and the stress that I feel are enough to stop me from going. The other women in this neighbourhood have the same problem: they have a hard time leaving here in order to get quality healthcare. That’s why MSF opened this facility here in Gbaya Ndombia.

The night of Sunday 30 October, I was at home with my children. We heard noises, shooting all around us at about 5pm. After the shooting stopped, there was silence. My mother called me to tell me that one of my little sisters had fainted, and she wanted me to bring her to the maternity clinic. There were no cars, no motorcycles in the streets, and on top of that the armed men were really agitated, so it wasn’t easy to get around.

Around 18h30, when we arrived at the maternity clinic, my sister was taken into care straight away by the MSF medical team here of midwives and assistant midwives. As for me, I put on my scrubs and I started to work.

The armed men who had arrived at the maternity to receive emergency healthcare were already gone by the time I arrived, referred onward to other structures. But there was blood everywhere, and three bodies on the ground in a small consultation room – each time there is an influx of injured people, that is where we put the corpses so that they aren’t in everyone’s view.

Because of the hosptal's location in the PK5 neighbourhood, the staff is also trained to provide first-line care to victims of violence  Photo: Sandra Smiley/MSF

The hygienists and guards were scrubbing the floor. I helped my colleagues prepare the bodies to be given back to the families.

The men here do know that this is a maternity ward and that our primary activity here is to take care of women and their babies. But they also know that we are the only structure to offer healthcare in the neighbourhood 24 hours per day. They also know that we will not send them away.

We deal with our stress in these kinds of situations. Personally, I have no problem finding the motivation to work. Whether I’m in the delivery room or the triage service, I’m here to save lives.

In these situations, we put the injured people in the postpartum room in order to stabilise them. When they start arriving, we ask the new mothers to move into the delivery room so that they aren’t mixed in with the trauma cases and so that they are more comfortable. We do not want them to stress – can you imagine? You’ve just given birth and men with combat wounds start arriving where you’re supposed to be resting.

The women are definitely aware of what’s going on around them in these moments. Generally, they keep their cool as they know the context. Some of these women haven’t left this neighbourhood since 5 December 2013. They are used to seeing this kind of violent episode. So they try to make light, they thank us, they are understanding.

Find out more about MSF's work in the Central African Republic.