Obstetrician, Sabrina Das, reflects on providing maternity care in Yemen

Sabrina Das, consultant obstetrician and gynaecologist at Imperial College Healthcare NHS Trust, reflects on working in a war zone, and the significance of what is possible when maternity staff work together to deliver maternity care.

I travelled to Yemen in 2021 with an organisation that provides medical care to people affected by conflict, epidemics, disasters, or exclusion from healthcare. I was called to support women and birthing people who needed the help during the midst of the pandemic. 

I worked for four months as an Obstetrician in a mother and child hospital about 10km from the frontline war zone in Taiz. 

The challenges of being a pregnant person, doctor or midwife in a war zone 

The war in Yemen has been happening since 2015.  A woman and birthing persons plight in a chronic war can go beyond the loss of limb, or injuries from firearms. Many lives are at risk in these circumstances when they are pregnant and cannot access maternity care. 

The roads in and around Taiz are not maintained, so it takes longer for the woman or pregnant person to get to hospital.  Many people cannot afford to pay for care or transport. The most many people can afford is to travel to the mother and child hospital when they are in labour - at which point things have usually already started to go wrong.  

As a mother based in the UK, I could not have imagined what its like to live in a war zone, but I can connect with the universal experience of motherhood. It can be an immense source of joy, but I could also empathise with the level of suffering many women and people experience in those circumstances. Their reality involves knowing that both the life of their babies, in addition to their own, are at risk when they become pregnant without access to adequate maternity care. Witnessing this is a reminder that not everything in life is in our control, and how powerful it can be to share stories that help us to understand each other.

Using empathy to build resilience

When I shared the experiences I had at the mother and child hospital, my friends would ask me about the political views of the people I supported. I would reply, Are you kidding?  We never talked about politics. In a war zone, all of the doctors and midwives in the maternity unit do not talk about politics. We would talk about our shared experiences. Such as our children, and how we juggle childcare with work.  We talked about schools and our commutes. We also talked about our ageing parents and how we cant see them as often as we like because they are far away, marriage and divorce, love and heartbreak. This is to name just a few of the shared experiences we have which can strengthen our bond as a team.

Since returning to work at Imperial College Healthcare NHS Trust, I try to apply the lessons I learned while working as an obstetrician in Yemen.  I am grateful for the access we have to maternity services in the UK, and I dont underestimate the power of compassion in medical care. The strength to laugh, work and learn together grew with every Iftar - the evening meal with which the doctors and midwives would break their fast during Ramadan - and I was reminded that theres a lot of support women, birthing people and maternity staff can find in listening to each otherss stories and building a community.

If you have any questions about Sabrina's work in Yemen, please contact her at sabrina.das@nhs.net.