Celebrating the Unsung Heros: International Day of Midwives How a midwife saved two lives while risking her own as floods hit Tanzania

MANYARA REGION, United Republic of Tanzania – “One night, I received a call that a woman in the final weeks of her pregnancy was stuck in her house, surrounded by floods and bleeding heavily,” said midwife Theodora Peter Nakey. “This is a medical emergency.”

The recent flash floods in the United Republic of Tanzania are among the worst the country has witnessed in decades. Since November 2023, heavy rain in the northern Hanang District has triggered mudslides and floods, washing rocks, logs, and other debris into villages. Thousands of people have been affected, with lives lost, homes shattered, and hundreds displaced.

“They almost surrounded the villages here,” Ms. Nakey told UNFPA, the United Nations sexual and reproductive health agency. “Many people were cut off from everything, including food and health care.”

Mariam Dominic Nyalusambu, the woman on the radio to Ms. Nakey, was in the village of Gendabi. The disaster had disrupted surrounding health services and infrastructure, including roads, electricity, and communication systems – leaving her stranded.

Although it was dark when Ms. Nakey arrived at the maternity unit where she works, the waiting area outside was unusually crowded. “There were at least ten men waiting, so I asked them to accompany me to rescue this woman.”

A Courageous Journey

After reaching Ms. Nyalusambu, the team carried her on a blanket to a local emergency health center, walking for three hours through floodwater in the middle of the night. Ms. Nakey examined her patient and found her slightly anemic from the blood loss but otherwise stable. “I suspected that the placenta had started to separate from the uterine wall, which can be one of the most critical conditions in pregnancy,” she explained.

Ms. Nyalusambu was already in the early stages of labour but still bleeding heavily, so her delivery was induced to give the baby a better chance of survival. Soon after, her daughter was born – but not breathing.

Ms. Nakey performed a resuscitation process on the newborn. “At last, there was a cry, and a wave of relief broke over me: The baby girl was breathing on her own. She would be fine.”

Climate change and the disasters it increasingly causes exert a heavy toll on women and girls, from inaccessible health centres to a lack of sexual and reproductive health supplies and support, and exposure to violence during displacement. As these crises become more frequent and intense, having sufficient numbers of skilled health workers like Ms. Nakey is crucial to meet rising needs, especially in hard-to-reach areas.

Last year, UNFPA trained over 330 health-care providers and community workers across Tanzania in maternal and perinatal surveillance and response, including emergency obstetric and newborn care. Over 1,600 maternal deaths were also averted thanks to provisions of family planning and reproductive health supplies.

With homes and belongings swept away by the floods in Hanang, women and girls are still facing shortages of reproductive health and personal hygiene supplies. To meet their immediate needs, UNFPA is providing supplies such as menstrual pads, soap, underwear, laundry soap, toothpaste, and toothbrushes, all packed inside 20-liter buckets.

A Double Emergency

For Ms. Nyalusambu, the emergency wasn’t over yet: Bleeding heavily after the birth, the new mother needed a blood transfusion.

“She started losing consciousness,” said Ms. Nakey. “It was the middle of the night, and we didn't have enough staff to deal with two emergencies simultaneously; luckily the neonatal nursing team stepped in to help.”

The health center has a small blood storage unit made up of donations from volunteers – one of only a few maternity facilities in the area with this option. Yet donations are often hard to come by, particularly for less common blood groups.

“We can always get one unit of emergency blood, but the patient’s well-being often relies on donations from family members – in this case, her relatives stepped up without hesitation.”

And they weren’t the only volunteers – the men who carried her to the health unit offered their help again too. “Many of them were very young adults, their thin bodies showing the consequences of harsh living conditions,” explained Ms. Nakey. “It was touching to see them, having been through an immense physical feat to arrive there, now lining up to donate a pint of blood to help us save others.”

By sunrise, Ms. Nyalusambu had received three units of blood and was recovering well, and Ms. Nakey and the night shift team could finally go home.

This is part of a series of stories illustrating progress made since the 1994 International Conference on Population and Development, which committed to ensuring gender equality and the right to sexual and reproductive health for all.