Reproductive Health Response in Conflict (RHRC) Reproductive Health Response in Conflict (RHRC)

Assessment of Reproductive Health for IDPs

Angola, February 15-28, 2001
 

Malanje, Malanje

Malanje, the capital of Malanje province, is some 450 kilometers east of Luanda. Compared to Bie, there did not appear to have been very much structural damage from artillery but there have been intermittent reports of bombings. During this visit there were masses of military personnel coming into town in trucks and the hotel where we stayed was crowded with high-ranking military officials. The military influx was rumored to be in preparation for a strategic assault against near-by UNITA rebels. The assessment team visited Kulaxito camp about 18 kilometers outside of Malanje center. This camp was established in August 2000 and now has few new arrivals, but camps further outside of the town are receiving new arrivals.
 

Safe Motherhood

The assessment team met with one of two trained (the others had not been trained) traditional birth attendants (TBA) in Kulaxito camp. Both TBA's were trained by International Medical Corps (IMC). Most IDP women, as in the other provinces, prefer to deliver in the camp with the assistance of a midwife/TBA. In this camp delivering at home may also be due to distance and the lack of transportation to the Malanje central hospital.

At the Malanje central hospital the assessment team visited the maternity ward. The ministry of health coordinates this hospital and UNFPA assists in the implementation of an emergency reproductive health project financed by OCHA that includes training of hospital staff in emergency obstetrics techniques. The visit was during the night and only parts of the maternity were lit with electricity while most rooms had only kerosene lamps for lighting. The hospital doctor facilitating our tour said he estimates 95% of women deliver at home. One common reason women come to the maternity is due to a retained placenta. The doctor told us that the maternal mortality ratio for the hospital last year was 4,000 per 100,000 live births. This ratio is staggeringly high and we were unable to confirm it with actual hospital records. He said that most women who die during or after childbirth at the hospital do so because they came far too late after complications arose.

The main differences the maternity staff see between IDPs and the local populations' maternal complications are that IDPs tend not to attend pre-natal check-ups, suffer more frequently from malnutrition, tuberculosis, parasites, malaria and an overall poor state of health before, during and after pregnancy. 

Family Planning

The hospital maternity appeared to be the only place to receive contraceptive counseling and supplies, although we were not able to actually see the supplies.

Sexual and Gender-Based Violence

Cases of rape are said to rise dramatically whenever there is an influx of the military.