In the Shadow of Sudan’s War, a Maternity Ward Fights to Survive

The midwife pulled on her latex gloves and flattened her measuring tape against the young pregnant woman’s exposed belly. It was measuring large for 36 weeks.

“Maybe it’s a big baby,” said the midwife, a redoubtable woman in pink scrubs named Nancy Symgambaye. “Maybe there’s too much fluid. Or it could be twins.” All were risky scenarios for any pregnant woman, let alone Taiba Baraka, a 26-year-old Sudanese refugee.

Ms. Baraka looked nervously from the bed as Ms. Symgambaye continued to examine her. It was mid-August, and the ward she had come to for her last prenatal appointment before giving birth was a run-down tent in Aboutengué camp, an isolated refugee station in Chad housing more than 50,000 people, most of them women and children fleeing the civil war in neighboring Sudan.

Pieces of thin floral cloth were strung up to serve as interior walls.

Chad, a sparsely populated Central African country of rugged desert and rippling savanna, has the world’s second highest rate of maternal mortality and is one of its poorest countries. Still, it has taken in 900,000 people fleeing a humanitarian catastrophe of giant proportions in Sudan, where famine, cholera and unfathomable trauma have been among the devastating effects of more than two years of civil war.

Medical workers like Ms. Symgambaye have until recently provided a modicum of care to these refugees, relying partly on funds from the United States. But when the Trump administration announced this year that it would eliminate U.S. foreign assistance worldwide, those workers began to lose their jobs.For decades, American officials argued that aid was beneficial to U.S. interests, saving lives and helping spread American influence abroad. The Trump administration has departed from that argument, pulling government spending and targeting agencies like the United States Agency for International Development, calling it wasteful, fraudulent and run by “radical lunatics.”

But the cuts were so swift and so unclear that relief workers were unable to manage the fallout. Now more lives are at risk and more people are dying, experts say. The consequences of the cuts are unfolding most clearly in places like Aboutengué’s maternity unit in Chad, where until this year the United States was by far the biggest donor.