Source: The Citizen
Japemungo Julienne watches the maternity ward in Nyarugusu refugee camp from her metal bed frame.

She sits on the middle of the bed and behind her lie two nests of vitenge, shielded from the voices of the mothers in the room and the whimpering sounds from women in the other end of the ward. Japemungo arches her back and removes part of the vitenge and two tiny heads and twenty little fingers appear. She brought two small girls into the world less than 24 hours ago on the black gurney in the main hospital in Nyarugusu. Her twins are healthy and fast asleep under the mosquito net, and soon she will take them home to zone eight of the Burundian section in Nyarugusu.

The twins will have to wait to see the place their mother calls home. It is yet too early to return to Burundi, which is still ridden by violence and political tension. Japemungo fled her home in Burundi last year in May with her husband and four children, and now they live in a city of tents in a forest with over 130,000 other refugees. The family is one of many in Nyarugusu which is Tanzania's largest refugee camp located a little northwest of Kigoma. Japemungo is 32-years- old and this is her second time as a refugee in Tanzania.

She gave birth to her first two children in Mtabila refugee camp in Tanzania after she fled an armed conflict in Burundi in 1996. In 2005 when the fighting had ceased, she went back to Burundi and gave birth to two other children, but now she is once again a refugee on the other side of the border.

"When my children lived in Burundi they were happy, here they don't feel as good. I think my children will be happy to go back," Japemungo says.

Her twins are among many children who are born in the refugee camp. Since April last year when Burundians started to enter Nyarugusu refugee camp, 2,409 children of Burundian parents have been born in the refugee camp, according to UN's refugee agency, UNHCR.

The main hospital in the camp is run by Tanzania Red Cross. It was constructed as an emergency facility when the camp opened in 1996. But twenty years later it is still running and serving almost three times its capacity of 50,000 people. Every day 10 to 12 children are born in the small room for deliveries that is separated from the bed wards by a thin pink curtain. Midwife Winifrida Rwehunbiza points towards the two black bunks that are pushed towards the walls, as she explains that when more than two women give birth at the time, the third woman has to give birth while lying on the floor.

In the section behind the curtain, women walk between the beds and hold their big stomachs covered by a kanga, as if their baby might fall out unexpectedly. Winifrida explains that the women have to go outside the maternity ward if they need to go to the toilet. But as they stand there, there is a risk that the child might slip out and into the latrine, Winifrida elaborates with a serious smile. She wishes they had a toilet inside the maternity ward.

A new generation

In one of the other buildings at the hospital, mothers who have already given birth lie on a row of metal frame beds. Some of the women share one bed. Towards the back of the room, 22-year-old Nibisi Anastasie sits with her first-born. She fled her home in Burundi alone last year when the violence broke out. Her parents are still in Burundi, but Nibisi has created her own little family in the refugee camp. She met her husband in the camp and they are married now, so she thought it was a natural development to have a child, she explains. She has not fled Burundi before, but her husband has. He stayed in Mtabila refugee camp under the former armed conflict, and he does not wish to return to Burundi. Nibisi is unsure of what the future will bring for her child.

"I would like to stay here, even if Burundi is calm. My husband doesn't want to go back to Burundi again, because he doesn't want to flee again," she says, as she refers to the two times her husband has already fled his home.

Inside the maternity ward there is a strong smell of heavy perfume that sticks to the clothes. After a while it disappears as the senses accustom to it. It smells like blood.

Back in the first ward, Hamenimana Delfine has her right arm around her new-born baby girl, as she breastfeeds her. She lost a lot of blood when she gave birth the previous day, and they had to give her a blood transfusion, Winifrida explains, as she puts a few pieces of vitenge under Hamenimana's head to stabilise her.

When Hamenimana explains where she lives, she says "Zone ten", but until May last year her home was in Burundi. She came to Tanzania on a boat over Lake Tanganyika with her husband and her six-month-old child. On the boat she breastfed her child while approaching Kigoma, she recalls. Being a 25-year-old mother and a refugee is troublesome.

"It doesn't feel good to deliver a child in the refugee camp, because there is no good care or education here, and the food is a problem," Hamenimana says.

Family planning

The many children who are born in the refugee camp increase the pressure on the camp and the health services. When the Burundian refugees suddenly arrived last year, the organisation International Rescue Committee and Tanzania Red Cross decided to set up a small field hospital in the Burundian part of Nyarugusu. In one of the tents a woman sits with a child on her lap and listens to midwife Marina Jackson who tells her about ways to prevent pregnancies.

Marina has a flat woven basket in front of her with different methods of contraception, and the woman can choose between tablets, condoms, implants and a hormone liquid.

Awareness of reproductive health is even more important in a refugee camp than in the surrounding society, Marina explains. Here the resources are scarce and the women must prioritise their energy.

"It helps the people to do other things, because they don't have the same stress about family planning and children. It is about their health," Marina says.

However, she often finds that the women are reluctant to use contraceptives, because their community views it as unnatural. It can be challenging to make the women consider a family planning tool.

"There are people who think that it is a sin and perhaps the partner doesn't consent, and the side effects also make people a bit afraid," Marina says.

Behind the wall of plastic that constitutes Marina's small office of reproductive health, around a hundred women sit on wooden benches, squeezed together, as they wait for their turn to visit one of the midwifes.

Most of the women are pregnant and wait for a midwife to examine them. Some of them have been waiting for hours, but they sit quietly next to one another. They know that these are the life conditions in their time as refugees.

Go to top