Halimo, 27, suffered obstetric fistula caused by prolonged labour during the birth of her third child in March in a displacement camp in the Somali capital Mogadishu that has no access to health facilities.
“This condition I am living with now has completely changed my life. But I thank Allah that I am still alive,” she said.
Halimo’s family survives on one meal a day. With her fistula condition, meaning that she leaks urine, nobody will hire her even for laundry jobs so she is struggling to buy what they need.
“They talk about me openly everywhere. These women around me, my neighbours don’t hide anything, they insult me that I can’t hold my urine. When my kids fight with their kids, they called me names. I just keep quiet, Allah is watching them,” said Halimo, whose real name has been concealed to protect her from further shame.
She was in labour for three days and bled a lot, with only a traditional midwife in attendance. Lack of access to care during pregnancy, labour and birth is particularly worrying for the 800 displaced families who have populated Waqle camp in Kahda district since the beginning of the year.
Halimo’s husband, who arrived in the camp with Halimo from Bay region, abandoned her due to her obstetric fistula and married another wife. He sends occasional money whilst she raises the three children alone.
Waqle is one of several blocks in the larger Shabelle IDP camp, where another 2,600 families are living. The people fled various crises including drought and loss of crops, conflict, and previous floods in Bay, Bakool, Shabelle and Juba regions.
Conditions in Waqle are very poor. The IDPs suffer food shortages and live in flimsy shelters. Water is scarce and costs two cents for a 20-litre container. Women usually look for menial jobs like laundry, earning at most a dollar a day.
Isha Isack Mohamed, 19, a mother of two, is currently in the late stages of pregnancy and is worried about her fate having seen the difficulties faced by other women in the camp. Her main concern is where to find health care as there is no facility in or nearby the camp, and not even a vehicle that could be used for transportation to health facilities further away.
“We have two women who attend to us in this camp, traditional midwives. We need better health services and we have no access to hospitals,” Isha complained.
She is now alone with her children as her husband went back to their farm when the rainy season started hoping to plant again. In the camp he had earned little from odd jobs as a porter.
One of the two midwives in the camp, Hawo Ali Nur said that most women do not get nutritious food and a balanced diet during their pregnancy and are weak, which contributes towards some of their complications and prolonged labour.
However, Hawo and her colleague have no medical training or modern equipment to help a safe delivery.
“I have this blade, plastic paper and cotton, these are enough for me to help a woman deliver,” she said.
Hawo said she has assisted 26 women during their deliveries in Waqlo since January. Most mothers experiencing difficulties, she added, were as young as 15 up to 30
