Midwife describes working under ISIL, taking a dangerous stand for women

AL-QAIM CITY, Iraq – Um Qassem was working as a midwife in Al-Qaim City, in Iraq’s Anbar Province, when the Islamic State in Iraq and the Levant (ISIL, also known as Da’esh) swept into the country in mid-2014. Seemingly overnight, her life became a nightmare, she said – especially when the group tried to recruit her.

“ISIL constantly threatened me, my husband, and my family, as well as other doctors and nurses. We were working under fear,” she described.

“I was emotionally devastated, but I had to put on a brave face for my patients who were bringing in life in such a challenging environment.”

Taking a dangerous stand

The militants turned the maternity ward of Al-Qaim Hospital into an emergency room for its fighters. Maternal health personnel were relegated to a small room to perform deliveries.

And women were suddenly charged for childbirth services, care that had previously been free. Women were expected to pay about $40 to give birth.

“One woman walked in without money,” Um Qassem remembered. “She was in critical condition and needed to go into the delivery room immediately. The head midwife that ISIL had appointed refused to let her in, so I threatened to quit if we did not admit the woman.”

It was a dangerous stand to take.

“I knew that I was risking my life by such action, but the woman and her baby would have died if I had not spoken up,” she said.

Hospital set ablaze

The challenges did not end when ISIL left to Raqqa last October.

The militants stole all the hospital’s equipment, and then set fire to the building. The damage was extensive.

“I felt as if my world had just fallen apart. This hospital was my home. I had been working here for 15 years,” Um Qassem said.

UNFPA has been supporting Al-Qaim hospital since early December 2017, helping to rehabilitate the operating theatres and delivery room. UNFPA also provided financial and logistical support to the hospital’s reproductive health team, and covered the cost of generators and waste management.

Still, the delivery room needed equipment to become fully operational. UNFPA provided a well-equipped mobile delivery unit, able to manage uncomplicated deliveries as well as Caesarean sections. UNFPA also helped to establish a referral system to transfer more complicated cases to specialized care.

With this support, childbirth services are once more free of charge.

Today, Um Qassem’s greatest professional trials are those that normally come with the job: “The biggest challenge is to get these women through the delivery and promise them a beautiful, healthy baby,” she said. 

In the first quarter of this year, the UNFPA-supported medical team at Al Qaim Hospital assisted in 378 normal deliveries.

UNFPA is also working with the Government to expand the availability of maternal health care, including through a countrywide midwifery training programme as well as pre-service trainings and in-service trainings for nurses.

–Salwa Moussa