Battling to take death out of birth in Africa

By Skye Wheeler

JUBA, Sudan (Reuters) - Lying on a sagging mattress and wincing slightly, Anna Lado laughs at the idea that she should have been afraid of giving birth to her first child, now lying in a crib near her in a hospital in south Sudan. "It's natural," she smiles.

But in fact, she received a life-saving caesarean in the capital Juba's teaching hospital: a relatively rare operation in south Sudan where one in 50 women die in childbirth, the world's highest maternal mortality rate.

In this vast expanse of dusty scrubland where around 10 million people live, the return of peace after Africa's longest civil war has exposed the dire state of the healthcare system.

A 2005 peace deal ended two decades of conflict between the south and the north that claimed around 2 million lives and was fought over ethnicity, religion and oil. The conflict is separate from the continuing violence in Darfur in the west.

Under the deal, the semi-autonomous south will have a chance to vote for independence in 2011. Meanwhile, authorities must try to rebuild a devastated land that has few paved roads, chaotic laws, rudimentary services but large oil fields.

Last June, the United Nations Population Fund (UNFPA) said south Sudan had the highest rate of pregnancy-related deaths in the world, at 2,030 per 100,000 births. That compares to a rate of 509 deaths per 100,000 births in the north.

U.N. officials say at the last count there were nine fully trained midwives in south Sudan, seven of those in the capital. The UNFPA says only around 5 per cent of women in south Sudan deliver in an institution.

At the Juba teaching hospital, wide-eyed babies are weighed in a harness and then passed through a jostling sea of mothers. "It's shocking because most of those women just represent those who get to facilities, how many more did not reach them?" said Magda Armah, who works for UNFPA.