Today Médecins Sans Frontières (MSF) opened a new centre for obstetrical emergencies in Kabezi, in the vast province of Bujumbura Rural that encircles the country’s capital. This specialised centre is an essential part of MSF’s work in Burundi, providing medical care for women with complications during pregnancy or delivery that cannot be treated in other health centres.

Since November 2006, MSF has been using three ambulances, a radio communication system and qualified medical personnel to refer these emergencies from a dozen health centres in Bujumbura Rural to medical facilities in the capital. The transport and healthcare are provided by MSF free of charge.

Some months, MSF has transferred over 100 women with obstetrical emergencies, many resulting in caesarean sections. From now on, these patients can be referred to the new centre in Kabezi. The 35 bed facility is equipped with an operating theatre, transfusion supplies and a maternity unit — essential tools for dealing with obstetrical emergencies.

“Complications arise in 15 to 20% of deliveries,” explains Dr Marc Postel, MSF project coordinator. “The mother has to be within reach of an operating theatre and a blood transfusion in order to benefit from emergency healthcare and, as a last resort, a caesarean. The medical care offered by MSF is crucial because obstetrical emergencies place the mother and baby’s lives in danger and can cause serious after-effects such as sterility or a vesico-vaginal fistula.”

In a complicated delivery, time is crucial in saving the life of a woman who may already have lost several hours in reaching the health centre. In the MSF ambulances, a midwife or nurse with obstetrics experience can provide the specialised care that is often not available in the health centres. The new MSF centre in Kabezi will be managed by a team of about 100 staff, including 8 international specialists — among them a nurse, a midwife, a gyneco-obstetrician, an anaesthetist, and a laboratory technician.

MSF’s obstetrical emergency program has already provided life-saving care to more than 1,500 women. It would be impossible for most people to find this type of care in Bujumbura Rural, given the obstacles: the poor state of roads, insecurity in the area, and the lack of medical professionals, materials and medicines.

But the main obstacle is undoubtedly financial. “I've seen women who've had to walk for hours before reaching a health post,” relates Dr Postel. “Many families are perfectly aware that these women are in a critical state, but they don’t have the money to pay for a taxi and medical care.”

A presidential decree adopted in 2006 guarantees free healthcare for pregnant women and children under five in Burundi. Yet this free access remains an illusion for the people of Bujumbura Rural. MSF will draw on the Kabezi project to bring attention to the high rate of mortality among mothers and infants in Burundi, and to emphasise their need for free and accessible medical care.

MSF has been working in Burundi since 1993. In Bujumbura Mairie, MSF’s Seruka centre provides medical and psychological treatment to about 120 victims of sexual violence every month. MSF teams also carry out awareness-raising activities in Burundi’s capital. MSF second program in Burundi is located in Bujumbura Rural and focuses on obstetrical emergencies.