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Twenty-year-old Prudence Mwelwa (not her real name) is convinced she would have died if she had tried to have her first baby at home in her village in Zambia. She said there was a lot of blood during her delivery and she really believes that her relatives would not have been able to stem the bleeding.
She had been feeling anxious anyway as it was her first pregnancy so a week before she gave birth, Prudence and her mother set out on a three-hour walk to one of Zambia’s maternity waiting houses. She liked the idea of having skilled staff on hand to help her with the delivery.
The Rwandan genocide of 1994 is well documented. During what has been described as “one of the most intensive killing campaigns in human history”, over 2 million people fled the country to neighbouring states. As they began to return home, settling in populous refugee villages with limited health support and infrastructure, pre-existing sexual and reproductive health and rights (SRHR) problems grew in volume and severity, and the need for action became ever more urgent.