Refugee mothers benefit from improved referral services

20 February 2018
UNFPA has supported the provision of ambulance services at Ocea HCII for improved referrals. The ambulance serves three other facilities.

Rhino Camp, Arua District: “The distance to the referral level facility is quite far. But we are lucky to have an ambulance stationed here and so can quickly refer mothers on time, thanks to the support from UNFPA,” said Grace Oleru, a Midwife at Ocea HCII in Rhino Camp refugee settlement in West Nile, Uganda.

Grace has worked in Ocea HCII since 2003, providing reproductive health services to refugees and host communities. She recounts how before the ambulance was provided, they had to book the front seat of a truck ferrying charcoal for sale, to ensure a pregnant woman and her care taker make it to the regional referral hospital over 70 kilometers away. This experience was mainly after refugees from the previous influx had repatriated to South Sudan in 2009 and ambulance services provided by NGOs there had ceased.

“With the recent refugee influx that started in 2014, the workload in the facility increased and there was congestion since our units are so small. However, UNFPA came in to support us with reproductive health kits, equipment and supplies like dignity kits, delivery beds, Manual Vacuum Aspiration (MVA). This support continues,” she explains.

Grace is one of the midwives trained on sexual reproductive health, emergency obstetric care, family planning and post-abortion care in Arua district. She is now well equipped to ensure safe deliveries and works hard to prevent a number of maternal deaths by ensuring timely referral and improved emergency obstetric care.

“We used to refer cases of MVA to Arua hospital, we are now able to manage them here; we also used to remove mothers from family planning once they report side effects, now we know what to do differently,” she said.  She is appreciative of the improved referral services.

In the last quarter of 2017, UNFPA and partner CARE International facilitated the District Health Officer (DHO) and the district council team on a monitoring and supervision visit to the refugee serving health facilities in the district. Based on the needs found on ground, the DHO recommended for construction of a new maternity unit in Ocea HCII as part of the ReHOPE project.

Ocea HCII is one of the six health facilities UNFPA supports to provide improved sexual reproductive health services to refugees and host communities, including ambulance services for emergency obstetric referrals. To reduce referral delays resulting from waiting for the one ambulance serving the entire Rhino Camp settlement, UNFPA stationed an ambulance in Ocea HCII that also serves four other health facilities to support emergency obstetric referrals.

In the last half of 2017, Ocea health facility alone referred 33 mothers to Arua Regional Referral Hospital due to complications related to multiple pregnancies, previous scars, code/arm prolapse, pelvis disproportion, prolonged and obstructed labor and cervical dystocia among others.

However, there is still a big gap for ambulance (referral) services for emergency obstetric care. Rhino Camp settlement alone needs two more ambulances to effectively support both refugees and host communities.  Overall, UNFPA will need to provide at least two well-equipped ambulances per refugee settlement in West Nile to be able to strengthen emergency referral for obstetric care.

-Written by Patricia Nangiro