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Delivering babies in a Nigerian camp: ‘I’ve had to use plastic bags as gloves’ | Global development

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Having watched a woman and her baby die needlessly after being refused admission to a hospital over a lack of money, Liyatu Ayuba wanted to never let it happen again.

The 62-year-old is one of Nigeria’s nearly 3 million internally displaced people (IDPs) – driven out of their homes by the violence of the Boko Haram Islamist militants. Ayuba fled Gwoza in the north-eastern state of Borno in 2011 with her family. After her husband was killed by Boko Haram and her teenage son badly wounded, she went to the makeshift Durumi 1 IDP camp, in Nigeria’s capital, Abuja, where about 500 families live.

“Two days after arriving in the camp, a pregnant woman became ill. She was suffering from eclampsia,” says Ayuba. The woman had trekked for two weeks from Cameroon, her first stop of refuge from Boko Haram, before being brought to Durumi 1.

“We took her to a government-owned hospital, which asked us for 150,000 naira [£265]. Even when we told them that we were IDPs and had no such money, they insisted. The woman and the baby died,” says Ayuba.

Early in the conflict, the Nigerian government allowed the camp’s residents to access public hospitals. But with the nearest hospital almost 10 miles away, many of the impoverished residents could not afford to get there and, as camps grew more crowded, the government put pressure on IDPs to return home, by cutting off their access to public health services. Ayuba had spent years watching her grandmother deliver babies as their village’s traditional birth attendant and she took on the task of becoming the camp’s only midwife, though untrained medically.

Since then, Ayuba has helped deliver 118 babies, becoming known in the camp as the “woman leader” and, for the mothers she helped, a saviour.

Hafsat Ahmed and one of her children
Hafsat Ahmed with one of her children, who was born in Ayuba’s clinic. Photograph: Dahlia Kholaif

“We do not have enough money to go to the hospital. Having the ‘woman leader’ means we can deliver our babies for free. Who else can we run to when we are in labour? But with her clinic so close to us, we can just walk down, have our babies and return home,” says Hafsat Ahmed, one of Ayuba’s patients.

Another, Deborah Daniel, says Ayuba came to her home to deliver her baby, now seven months old, because she could not get to the clinic.

According to 2019 World Health Organization figures, Nigeria accounts for about 20% of the world’s maternal deaths, with more than 600,000 recorded between 2005 and 2015, and 900,000 maternity near-miss cases. A 2020 study attributed the exceptionally high maternal and neonatal mortality rate to delays in finding healthcare.

For roughly 1.17 million IDP women, of whom 510,555 were adolescent girls of reproductive age in 2016, these delays are multiplied. A 2020 report by the Center for Reproductive Rights, a global legal advocacy group, said most women in Durumi camp gave birth in their tents and that often those who sought care at a health clinic in the city were detained there for not paying fees. In one incident, the report said, the body of a woman who died in the clinic was not released until fellow IDPs raised the money to pay the bill.

Thus Ayuba’s services are priceless. But their complete dependency on donations, including the 12-metre (40ft) shipping container given by an aid organisation to serve as the camp’s clinic, means her work is not sustainable.

Covid has drastically cut visits by humanitarian organisations so supplies given to Ayuba to help her maintain services have dried up.

“I once had to use polythene bags to cover my hands because there were no gloves,” says Ayuba.

Umar Gola, whom the camp residents elected as their public relations officer, confirmed Covid’s impact.

“At one point, we wondered if we were the ones who brought the sickness to Earth because people stayed away from us. Donations that once covered 100% of our needs dropped to 20% or 15%,” he says.

Adequate staffing is another major challenge facing Ayuba, as she struggles to recruit assistants.

“It is important to train others in case I am not around to help,” she says, adding, however, that not everyone is up to the task. “There is blood, seeing one in pain and so many other things involved. You can’t force people in such matters.”

At the moment, Ayuba has one assistant, 41-year-old Hadiza Ali. “I am happy doing what I am doing, even though it comes with many challenges. Sometimes the labour comes at midnight,” says Ali. “But I have this passion for it. I work well with woman leader, bringing joy to many.”

Ayuba and Ali attending to a pregnant woman
Ayuba and her assistant Hazida Ali examine a pregnant woman at the clinic. Photograph: Dahlia Kholaif

In 2016, Ayuba’s work won wider recognition when she was offered four months training by a private hospital in Abuja to enhance her skills in obstetrics.

“Ayuba’s work is commendable but what pregnant women need is access to health facilities,” says Ummi Bukar, programme director at Participatory Communication for Gender Development (Paged) Initiative, an NGO.

“These IDPs need to be recognised by the authorities. This will enable them to have access to all basic services.”

Bukar, whose organisation uses media to advocate for the needs of IDPs in Abuja, says they are pushing government agencies to recognise IDPs’ needs, “Right now, they are just left to fend for themselves, with nobody responsible for them.”

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EU to propose universal phone-charger law

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The EU plans to propose laws harmonising mobile-phone, tablet, and headphone chargers and ports on Thursday in a bid to make life easier for consumers, Reuters reports. But Apple, whose iPhones use a special ‘Lightning cable’ has said the move will lead to piles of waste and deter innovation. Rival Android-based devices use so-called ‘USB-C’ connectors, but ‘USB micro-B’ and Lightning connectors account for about a third each of market-share.

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Brexit: British Embassy launches survey on key issues affecting UK nationals in Spain | Brexit | International

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The British Embassy in Madrid has launched a survey aimed at finding out how UK nationals in Spain have been affected by key issues, in particular, the United Kingdom’s exit from the European Union, a process commonly known as Brexit.

The poll is for Britons who are full-time residents in Spain (not those with second homes) and are covered by the Brexit Withdrawal Agreement, i.e. they were officially registered in the country before December 31, 2020, when the so-called Transition Period came to an end.

Questions in the survey address issues such as access to healthcare and the uptake of the TIE residency cards, which were introduced as a replacement for green residency cards (either the credit-card size or the A4 sheet version, officially known as the Certificado de Registro de Ciudadano de la Unión).

As we approach a year since the end of the Transition Period, we really want to hear from you about the key issues…

Posted by Brits in Spain on Friday, September 17, 2021

The aim of the poll is to gather vital information on the experience of UK nationals living in Spain that will help the British Embassy provide feedback to Spanish authorities. The survey takes around 10 minutes to complete, and all answers are confidential.

Have you heard our Spanish news podcast ¿Qué? Each week we try to explain the curious, the under-reported and sometimes simply bizarre news stories that are often in the headlines in Spain.



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‘The challenge for us now is drought, not war’: livelihoods of millions of Afghans at risk | Global development

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The war in Afghanistan might be over but farmers in Kandahar’s Arghandab valley face a new enemy: drought.

It has hardly rained for two years, a drought so severe that some farmers are questioning how much longer they can live off the land.

Mohammed Rahim, 30, grew up working on a farm along with his father and grandfather in the Arghandab district of Afghanistan’s southern province. Famous for its fruit and vegetables, the area is known as the bread basket of Kandahar.

Like most in the valley, Rahim’s family relies solely on farming. “The fighting has just stopped. Peace has returned,” Rahim says. “But now we face another war: drought.

“Now we have to dig deep to pump water out of the land. It has been two years, there has been little rain and we have a drought here. I don’t know if our coming generations can rely on farming the way our ancestors used to do.”

Pir Mohammed, 60, has been a farmer for more than four decades. “Not long ago, there were water channels flowing into the farm and we were providing the remaining water to other farmers,” says Mohammed. “Before, the water was running after us, flowing everywhere – but now we are running after water.”

The water used to come free from the river but now the daily diesel cost for the water pump is at least 2,500 Afghani (£21).

“We don’t make any profit. We are in loss, rather. Instead, we are using our savings. But we don’t have any other option as we do it for survival,” says Mohammed. “However, the scarcity of water has affected the quality of crops as well.”

About 70% of Afghans live in rural areas and are particularly vulnerable to the impacts of drought.

Last week, Rein Paulsen, director of the Food and Agriculture Organization’s Office of Emergencies and Resilience, said severe drought was affecting 7.3 million people in 25 of the country’s 34 provinces.

He warned: “If agriculture collapses further, it will drive up malnutrition, increase displacement and worsen the humanitarian situation.”

Arghandab has been a favourite destination for farming because of the abundance of water and fertile lands. Neikh Mohammed, 40, left the Dand district of Kandahar to work in Arghandab in 2005. When he arrived he was amazed to see the greenery and pomegranate farms.

A dam affected by drought in Kandahar.
A dried up dam in Kandahar. A majority of Afghans are particularly vulnerable to the impacts of drought, as they live in rural areas. Photograph: Xinhua/Rex/Shutterstock

“It used to rain a lot here and we could not cross the river and come into our farms. We had a life with abundant water. But the past is another country now,” he says.

According to a report by the UN mission in Afghanistan, many local farmers were caught in the crossfire between the Taliban and the Afghan security forces. The Taliban carried out attacks from thick foliage on the farms, which provided a hiding place, ideal for an ambush.

“For the past 20 years, we did not have peace and could not work after dark in our farms. But now we can stay as long as we want without any fear,” says Neikh Mohammed. “Now the challenge is not just restoring peace but the drought and escalating cost of essential commodities.”

Farmers say they want support from international aid agencies and assistance from the new government headed by the Taliban to help them survive.

Pir Mohammed says: “The real challenge for us now is drought, not war. We need food, water, dams and infrastructure in our country. The world should invest in us and save us.”

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