Midwives play a critical role in South Sudan, facilitating antenatal care, skilled birth attendance, and postnatal care for mothers and newborns to prevent death and promote a healthy future for both mothers and children.

This is especially important as the country reports one of the highest maternal mortality rates globally, with 692 maternal deaths for every 100 000 live births. For newborns, the burden is equally severe, with about 40 deaths per 1000 live births. Many factors play a role, including a volatile context of humanitarian crises and climate-related health emergencies.

While midwives are in short supply and almost 60% of births take place without a skilled birth attendant, there is remarkable commitment among midwives to change people’s perceptions and increase health facility deliveries, despite infrastructure challenges, human resource deficits and heavy workloads.

Mary Mania

Sixty-five-year-old Mary Mania has worked for 25 years as a midwife, most recently serving as matron at Torit State Hospital in South Sudan’s Eastern Equatoria State. Despite her administrative responsibilities, Mania still maintains an active role in maternity care. Losing family members to childbirth motivated her to pursue a career in midwifery, first through general nursing and then with specialized training.

Mania recalls working during years of political instability and poor health infrastructure in Darfur, Sudan, and then in Torit hospital. She has trained and collaborated with traditional birth attendants, sharing with them life-saving practices despite the absence of formal education. Her passion for midwifery has remained intact, in the face of frequent shortages of medical supplies, equipment and even electricity. She often uses torches in delivery rooms or contributes from her own pocket when mothers cannot afford supplies.

Under Mania’s watch, maternal mortality at the hospital has dropped from over 13 deaths in late 2023 to just one or two a year currently. She is well known in the community, greeted in the market and remembered by countless women and their families.

“Even when a village is inhabited by very few people, a midwife must be there,” she says. “Midwives are critical wherever life begins.”

Kulang Jasenta 

For Kulang Jasenta, a 42-year-old mother of five children, the work of midwives at Torit Hospital has been a positive and life-affirming experience. She delivered all her children at the hospital and has experienced first-hand the care, respect and kindness of the midwives. “They assist you through labour, speak gently and stand by your side,” she says.

Jasenta now serves as an informal ambassador for maternal health in her community. She advises women to attend antenatal care early and to avoid home deliveries. “When they see someone deliver safely at the hospital, they are encouraged,” she says.

Rose Keji

Twenty-eight-year-old Rose Keji has been a midwife in Torit State Hospital for nine years. She has witnessed women give birth at home and in makeshift health facilities in refugee camps, without access to quality health care. These experiences inspired her to join the profession and make a difference.

Keji’s motivation is deeply rooted in serving her people. “Most services were once delivered by foreigners,” she says. “As a South Sudanese woman, I want to care for my people.” Despite challenges including political insecurity, community resistance, low pay, and a heavy workload, she remains committed. She and her team sometimes use mobile phone lights during power outages and fundraise among themselves when patients cannot afford medication.

Her efforts are paying off. Keji has noticed a reduction in maternal deaths, an increase in hospital deliveries and greater awareness of antenatal care in the community. “When I walk through the market, someone calls my name or offers me a keepsake and I feel proud knowing I made a difference,” she says.