BIRAO, Central African Republic (AP) — Maude Ahmad Fadala’s labor began shortly after sunset in a refugee camp where she had been living, weakened by typhoid fever and without access to a health facility. With no money to travel and the camp lacking any maternity services, she stood up and began walking in search of help. The contractions stopped her every few minutes, and she collapsed on the roadside.
“Di a luz en la calle,” Fadala told the Associated Press. “I gave birth in the street. There was no doctor, no midwife, no one to hold my hand.”
Fadala’s experience is part of a broader crisis across sub-Saharan Africa, a region where armed conflict and displacement have destroyed or overwhelmed health infrastructure in vast areas. Sub-Saharan Africa accounts for 70% of maternal deaths worldwide. Every year, approximately 180,000 pregnancy-related deaths occur across the continent, the Associated Press reported, as part of a series on maternal mortality in the region.
The Central African Republic has been affected by cycles of armed conflict for years, displacing hundreds of thousands of people into camps where basic services are scarce. MSI previously reported that conflict zones force pregnant women into impossible choices between staying in dangerous areas and trying to reach clinics they cannot afford.
Fadala’s story illustrates how the absence of even basic delivery services — a clinic, a trained attendant, transportation — transforms childbirth into a life-threatening event. Typhoid fever, a bacterial infection spread through contaminated food and water, is endemic in many refugee camp settings and can cause severe complications during pregnancy, including miscarriage, preterm labor, and maternal death.
Sub-Saharan Africa has the world’s fastest-growing population, which compounds the strain on health systems that were already fragile before conflict and displacement deepened the crisis. International health agencies have documented that women in conflict-affected areas of the region are far more likely to die from pregnancy-related causes than women in stable areas, due to the collapse of routine prenatal care, emergency obstetric services, and access to skilled birth attendants.