Aid organizations are warning that Sudanese refugee women in the Vakaga province of northeastern Central African Republic (CAR) face a rising risk of death during childbirth as US aid cuts weaken already fragile obstetric health services.
Tens of thousands of people have fled conflict in Darfur, Sudan, into the remote Vakaga region of CAR, straining a health system that was already overwhelmed. CAR has one of the highest maternal mortality rates in the world, and the refugee influx has pushed scarce medical facilities to their limit, according to humanitarian agencies.
In and around Birao, a small town near the Sudanese border, several clinics supported by the United Nations Population Fund (UNFPA) offer prenatal checkups, emergency obstetric care and basic delivery services for both refugees and local residents. These services depend heavily on international funding, including contributions from the United States, which pay salaries for midwives, medicines and equipment.
Aid groups say US cuts to foreign assistance have forced them to rethink programs and staffing at a time when demand is growing. Some facilities have reduced night shifts and community outreach, raising fears that more women will give birth at home without professional medical help or emergency drugs.
Refugee women—many of whom walked for days through the wilderness while pregnant—face multiple risks. Malnutrition, malaria and untreated infections are common. Many say they had never met a midwife before arriving in CAR and have little information about danger signs during pregnancy. Health workers report that complications such as obstructed labor, hemorrhage and pre-eclampsia occur frequently—conditions that can be fatal without timely intervention.
Local women in Vakaga are also affected. With poor roads, insecurity and few ambulances, reaching the nearest clinic can take hours. When facilities lack supplies or staff, families often turn to traditional birth attendants or delay seeking care until it is too late.
UN and NGO officials warn that further funding cuts could lead to the closure of some maternity wards, reduce the number of trained midwives and shrink emergency referral systems. This would undermine recent progress in encouraging women to give birth in health facilities rather than at home.
Humanitarian agencies are appealing to donors to maintain and increase support for maternal health services in CAR, arguing that the cost of sustaining midwives and basic obstetric care is small compared to the human toll of preventable deaths. Without stable funding, they say, both refugee and local women in one of the world’s poorest countries will bear the consequences.
