In Yemen’s Refugee Camps, Midwives Fight to Ensure Safe Deliveries

This article is published in collaboration with Egab, a platform empowering journalists from the Middle East and Africa to publish stories in international media outlets.

MARIB, YEMEN — The makeshift tents of Marib’s al-Sumayya camp fluttered violently under the icy grip of Yemen’s winter nights, which range from 5 to 8 degrees Celsius. It was late at night in the settlement that is home to over 1,200 families, and most residents had retreated into the fragile warmth of their shelters. The howling winds were broken only by the anguished groans of a young woman.

Wafa Said, weakened by severe anemia brought on by the harsh living conditions in al-Sumayya, was in labor. The 26-year-old mother, deprived of proper prenatal care, had only the shelter of her tent as a sanctuary. Raisa Rabee, one of the camp’s designated midwives, was her sole source of support in the shelter that was built for two to four people but was regularly housing her family of seven.

Rabee, who works as a volunteer midwife in the camp, was summoned to Said’s tent several kilometers from her own that night. With no ambulance available in the camp, and the family unable to afford private transportation, Rabee had no option but to make the 45-minute journey on foot.

Despite significant setbacks, including the lack of proper medical equipment, the dim, lantern-lit light of the tent, and the constant fight against the bitter cold, Rabee safely delivered Said’s baby after three hours, working well past midnight to keep the mother and child safe.

“Raisa and others like her volunteered their time and resources, offering care and support even though they had so little themselves,” Said told More To Her Story. “Without them, I don’t know how I would have made it through.”

In the sprawling displacement camps of Yemen’s Marib province, home to nearly 1.6 million internally displaced people, midwives work against incredible odds to provide safe childbirth in conditions marked by incredible poverty, a collapsing healthcare system, and an acute shortage of essential services such as primary care, emergency services, pediatrics, and OB-GYN care.

“The conditions were unforgiving,” Rabee said. “[Births] often take place in makeshift settings, with rudimentary tools, amplifying the risks of infection or complications. For Wafa, a hospital delivery would have been the safest option, but like many families in the camp, poverty rendered that impossible.”

Midwives like Rabee are accustomed to traveling long distances on foot to reach their patients, sometimes arriving too late to prevent healthcare complications; the lack of proper medical equipment such as ultrasound machines and blood pressure monitors and basic supplies like sterile gloves and stethoscopes; along with the isolation of working without support from a larger and more resourced healthcare network. Despite these obstacles, Rabee remains committed to her work, providing care to anywhere from 18 to 50 women monthly who lack even basic maternal health services.

“These camps are overcrowded, and the challenges are overwhelming,” Rabee told More to Her Story. “Health facilities are scarce, water is limited, and power outages are frequent, but we do what we can to ensure both mothers and babies are safe.”

Midwife Sabah Abdullah sees her work as part of a collective fight to deliver life-saving care under harrowing conditions.

Abdullah said the families in the camps face compounding challenges. “There’s no proper facility offering adequate services. Women urgently need medical equipment, medication, and nutritional support to protect themselves and their children.”

In a camp with over 1,200 families, there is just one small health unit staffed by only three people. Many women avoid seeking care at this clinic because they feel it is poorly equipped and prefer female midwives, rather than the single male physician who works there.

“Many women feel comfortable only with female midwives. Our role extends beyond healthcare; we earn the community’s trust and help women reclaim confidence in themselves,” said Rabee.

The plight of pregnant women in Yemen’s conflict zones, particularly in camps like those in Marib, is “harrowing,” said Rabee. The absence of life-saving medical support during childbirth has driven midwives to step in as lifelines and patients be of the only dependable options for these women.

Rabee’s journey into midwifery began two decades ago in the Sarwah district, where she enrolled in a training program to address the lack of maternal healthcare in her community of Marib. At that time, deeply entrenched cultural norms discouraged women from seeking maternal healthcare from the area’s only foreign male gynecologist. Instead, local midwives were “the community’s most trusted option,” said Rabee.

For Rabee, the mission of assisting pregnant women with childbirth has always been both personal and urgent. Yet the work exacts a heavy toll, as she explains that it often forces midwives to sacrifice time with their own families.

Now 40, Rabee works voluntarily in Sumayya Camp, balancing her demanding role with her responsibilities as a wife and mother. 

“My husband has been my greatest ally,” she said. “And my daughters help with housework, allowing me the time to serve others.”

Marib, a city in central Yemen once considered a relative sanctuary during the country’s early years of conflict, initially benefited from local oil revenues and its sound infrastructure. But the influx of more than 800,000 additional internally displaced people since 2023 has overwhelmed the city’s resources, leading to severe shortages of food, water, and healthcare for refugees. The healthcare system, already strained, has been further crippled by limited basic needs, a dearth of trained personnel, and the exodus of unpaid medical workers.

There are more than 4,000 pregnant women currently in Marib, like Said, suffering from severe complications ranging from pregnancy-induced hypertension to gestational diabetes, as nearly 70 percent lack access to basic healthcare, and 69 percent of the camps are without functioning clinics.

The situation is equally alarming across all of Yemen, with the United Nations Population Fund (UNFPA) estimating that 12.6 million Yemeni women require life-saving reproductive health services, and 114,000 of them are at risk of severe complications during childbirth.

Yet, for women like Said, the reality of giving birth in Yemen’s displacement camps is far grimmer than the numbers suggest. It is a story of resilience, sacrifice, and a healthcare system stretched beyond its limits, a story midwives like Rabee know all too well.

“From the very beginning, my pregnancy was difficult,” Wafa said, sitting outside her modest shelter. “I suffered from extreme fatigue and had no appetite. Life in the camp meant I couldn’t access proper nutrition. I ate whatever aid we received. Sometimes, days would pass without a single nutritious meal.”

When Said started showing signs of anemia, she knew things could only get worse. But going to a hospital was not an option. 

“It was too far, and even if I managed to get there, the services were so limited,” she said, adding that she constantly wondered whether she should try to seek help or stay in the camp and “hope for the best.”

Amal Dahwan, deputy director of the Marib Public Health and Population Office, said that early marriages, poor nutrition, and inadequate prenatal care are commonplace in Yemen, but coupled with the lack of nearby medical facilities, limited transportation options, and insufficient medical staff, it can compound the challenge of providing quality healthcare to communities in need.

“Efforts to address these issues include establishing field hospitals in some camps, deploying mobile clinics for primary care, and introducing referral programs for complicated cases to larger hospitals. These programs often include free transportation,” she said. “We need significantly more support and resources to sustain and expand these initiatives.”

But to women like Said, these solutions are not resonating with pregnant women.

“For now, hope lies in the hands of those on the ground: midwives, aid workers, and local health officials, working tirelessly to deliver lifesaving care amid the most challenging circumstances,” she said.