In Kirkuk, The Midwife Knows Best

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After Kirkuk woman, Rua Abdullah, gave birth to her first son in a state hospital, she swore she would never repeat the experience.

“The doctors treat the patients badly and they make giving birth tougher than it is already,” Abdullah explains. “After dealing with all kinds of humiliation and insults I finally heard the cries of my son. I praised God because I was still alive. But then I swore never to go back to that hospital.”

And in fact, Abdullah, who is 27, gave birth to her next child – a daughter – in the home of one of the area’s midwives.

Stories like Abdullah’s are becoming more common here. Expectant mothers have lost confidence in government hospitals because of poor services and treatments and they prefer to use the services of private midwives. Sometimes, women will even pay to bring their midwives to hospital with them; this usually costs around US$80. 

There’s a lack of awareness about what can go wrong at a midwife’s, the doctor says.

“The number of women who prefer to give with the help of a midwife is increasing in Kirkuk,” Hassan Sabar, a doctor and spokesperson for the health department in Kirkuk, confirmed to NIQASH. “This is especially true in the villages and districts, compared to the city centre.”

Both educated and uneducated women are turning to midwives, who also have the legal power to give out birth certificates in Iraq. This is even though many of the women living in city centres are well aware of the potential dangers when they give birth in somebody’s home. For example, if the baby or mother need medical intervention, they would then have to be transferred to a hospital.

Noor Mohammed, 35, is trained as a lawyer and has three children. None of them were born in the local hospitals because, Mohammed says, she doesn’t trust the local hospitals and she had heard many bad things about the way patients are treated there from friends and relatives.

Instead Mohammed’s mother and sisters prepared a room in her own home, complete with sterile equipment. “The midwife then came to my house and I gave birth to my children there,” Mohammed explains. “It was a very good feeling to do this at home.”

Her first child was actually born at the midwife’s house. She says the midwife she uses is very experienced and Mohammed trusts her implicitly. “At her house, the room was clean and all the tools she might need were there,” Mohammed says, “including – most importantly – a machine used to revive a baby’s heart if it stopped beating and another one to remove fluid from a baby’s lungs.”

Visiting one of the area’s most experienced midwives, Baxan Ahmad Mohammed, and one finds a similar variety of specialized equipment. It is more like a birthing centre than a bedroom, with a sterilizer, surgical equipment, a special bed as well as a variety of medicines and other machines for resuscitation and monitoring.

 

The Kirkuk maternity hospital.

 

Of course, the standards among midwives here differ, Ahmad Mohammed told NIQASH. She herself has been a nurse since 1988, at the state hospital, and in 1993 she began practicing as a midwife after getting certified by the authorities. In Kirkuk, she is nicknamed “grandmother” because of her role but not all midwives are like her.

 “Some have a lot of experience and have also taken courses in medicine to educate themselves further,” she says. “But others lack the required experience. Some of these are responsible for women’s deaths.”

Ahmad Mohammed then tells a horror story about a mother who came to her in her ninth month and asked to be given medication to bring on contractions: She wanted to give birth before a certain date.

Ahmad Mohammed refused. “I only give that injection in rare cases, when the patient needs it and her health allows it,” she says.   

The woman left but she obviously managed to find somebody who would give her the injection. Later in the evening, Ahmad Mohammed was working at the local hospital where she is also a nurse, when the woman was brought in, bleeding heavily. “The staff couldn’t do anything to save her and she passed away,” Ahmad Mohammed notes.

It is not always legal for expectant mothers to seek out the help of a midwife. The Iraqi Ministry of Health’s guidelines say that the first and fifth child should be delivered in hospital and that any females with a medical history that includes issues like diabetes, obesity or heart problems, or who have previously had caesareans, should also be having their babies in a hospital. 

If a woman like this goes to a midwife, the midwife apparently bears the legal consequences if something goes wrong.

Sabar of the health department says midwives operating in Kirkuk are tested annually and are required to undergo further training. “If a midwife violates these conditions, they may be prevented from doing further business,” Sabar says.

Shalah Abdul-Rahman, a Kirkuk obstetrician, says she understands why locals are choosing midwives over hospitals. For one thing, there are not enough beds for patients, she notes. “There are not enough staff either and often spaces are small and crowded,” she continues. “So women don’t like to come here because there are too many people and the staff are always too busy.”

However, Abdul-Rahman adds, a lot of locals don’t seem to be fully aware of the dangers of going to a midwife for birthing rather than to a hospital. “There’s a lack of awareness about what can go wrong,” she says.

 


source: Niqash

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In Kirkuk, Vote-Hungry Politicians Play With Ethnic Fire

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Mobilizing voters using ethnic rhetoric is an easy way to gain popularity in the northern Iraqi city of Kirkuk. And the parties representing the district’s three main ethnic groups – the Kurds, the Arabs and the Turkmens – don’t just want votes, they have a point to prove: They also want to indicate how big a part they make up of the local population. This is because Kirkuk is still one of Iraq’s disputed territories. That is, Iraq says it belongs to the country but the Kurds say it belongs to them and should be part of their semi-autonomous region. One of the ways of resolving this dispute would be to take a census. If there are more Kurds living here, then the Kurds have more of a claim on the area – and vice versa.

The three different political groups in Kirkuk are headed by politicians who have not been afraid to talk tough and argue with one another, either in the media or in person. Over the past four years in Baghdad they clashed frequently, about issues such as the local security forces and the appropriate administration of Kirkuk.

Increasingly it is becoming clear that these elections will be more important, and possibly more dangerous, than the last ones in Kirkuk.

Those antipathies are now manifest on the street. There is an organized campaign in the city where the supporters of each of the three different groups go around ripping up the campaign posters of the other groups. The leaders of the different ethnic blocks continuously play on the ethnic sensibilities.

During a visit to the town of Hawija, Arab leader Mohammed Tamim kicked off his campaign by saying that his alliance needed to win many votes in order to “surprise” the competition. Tamim is well known for his inflammatory statements directed at other ethnic groups in the area, especially attacks on Kurdish politicians in Kirkuk.

During a rally attended by thousands of his supporters, Arshad al-Salihi, a senior Turkmen politician in Kirkuk and leader of the biggest Turkmen party, said his re-election as an MP was not enough. He wanted all Turkmen to support him to demonstrate the power of local Turkmens to the other two ethnic groups.

The only Kirkuk politician not to play the ethnic card quite so dramatically was Ribwar Taha, who heads the most popular Kurdish party in the area, the Patriotic Union Of Kurdistan, or PUK. He called upon voters of all ethnicities to choose him because, he said, he would fight in the Iraqi parliament for all the people of Kirkuk, not just one ethnicity.

Tamim told NIQASH that a lot of the ethnicity-related rhetoric was just about election campaigns. “In the end every candidate wants the most votes they can get,” he explained. “But this battle between the leaders of the different blocks is a campaign fight. After the elections are over they could well begin to work together again.”

Al-Salihi was less conciliatory. “We cannot agree to anything that goes against the interests of our people,” he told NIQASH. “That is why when a certain Kurdish group became hostile towards the Turkmens, our response was strong. That doesn’t mean we did that for the votes. It was our duty and we lived up to that duty.”

 

The streets of Kirkuk will be blocked off on election day.

 

Additionally al-Salihi believes that things have changed and that the different groups will be forced to work differently together in the future.

There is a possibility that things will change in Kirkuk after May 12, the day of the elections. At the last elections, Iraqi Kurdish politicians won the majority of the 12 seats available to Kirkuk in Baghdad – they got eight out of 12 seats, with the remaining four split between the area’s Arabs and the Turkmens. However since late October 2017, when the ill-fated Kurdish referendum on independence saw the balance of power change dramatically in the Kirkuk area, the outcome is no longer assured for the Kurds here.

Increasingly it is becoming clear that these elections will be more important, and possibly more dangerous, than the last set of elections in Kirkuk in 2014.

The fact that politicians are exploiting existing ethnic tensions worries a lot of locals in Kirkuk. They fear that political supporters could go from ripping up posters to fighting in the streets.

“Kirkuk will be stable and safe on election day,” Saad Maan, the Iraqi army officer in charge of counter-terrorism forces in Kirkuk, stated late last month. Together with the local police and election authorities, Maan announced the plan for security for polling day on April 26.

Previously the Iraqi Kurdish military were in charge here and recently there has been criticism that the Arab forces, from elsewhere in the country, don’t have the same intelligence and local knowledge to carry out the mission.

Vehicles will not be allowed into the city and transport will be provided for locals to go to voting centres. “Iraqi army aircraft will also be on duty above the city,” Maan said.


source: Niqash

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