By Rebekah Mintzer

11 Mar 2010 [MediaGlobal]: Severe and destructive weather patterns in Mongolia have made it very difficult for expectant mothers, many of whom are herders living in isolated areas, to obtain basic obstetric care. Many women cannot make it to hospitals that are equipped and staffed for delivering babies and for treating the potential health complications that come with childbirth. The UNFPA (United Nations Population Fund) in coordination with other UN agencies and Mongolian authorities has responded by sending mobile medical teams and supplies to help these women give birth more safely.

Samantha Lobis, MPH, who is the senior program officer of the Averting Maternal Death and Disability Program at the Mailman School of Public Health at Columbia University, told MediaGlobal that about 15 percent of pregnant women, regardless of what part of the world they live in will suffer from complications during pregnancy, labor, delivery or post-partum, citing the World Health Organization (WHO) handbook, Monitoring Obstetric Care. “Most direct obstetric complications cannot be predicted and if left untreated, they could lead to death or severe morbidity,” Lobis said. “Women in the US develop the same obstetric complications as women in other parts of the world but most often survive the complication because they have access to good-quality emergency obstetric care… and functioning health systems if they need it.”

Access to proper obstetric care has been further obstructed for Mongolian women this year due to a multiple natural disaster that Mongolians call a dzud. A dzud is a combination of a summer drought followed by heavy snow and cold temperatures in winter that results in death of livestock, which Mongolian herders depend on for food and income. According to Argentina Matavel, UNFPA Representative in Mongolia, about 63 percent of rural households’ assets in Mongolia is comprised of livestock. When the dzud occurs, there is too much snow for the animals to graze, resulting in their starvation and death. With the death of the creatures that provide their livelihoods, Mongolian families are thrust into poverty and expectant mothers and their offspring become malnourished and unhealthy because they cannot get food to eat.

“Some herders have lost up to 70 percent of their livestock and this has taken away their income and food source, Matavel told MediaGlobal. “Also, the harsh winter conditions lead limited access to food markets. The times ahead will be very hard for the people living in the countryside.”

The dzud also physically limits access to care, as snow can reach over a meter high, blocking routes to major hospitals in a country where rural people are often already isolated by vast mountains, deserts and steppes. Temperatures of as low as 50 degrees Celsius below zero make the situation even more desperate.

UNFPA and their partners have deployed mobile health units to provide obstetric care to women in 12 provinces. Thus far, 6000 women and their families have received essential hygiene and reproductive health supplies. Due to conditions on the ground, many Mongolian women have been forced to give birth in small local hospitals ill-equipped for adequate maternal care. UNFPA along with the WHO, the United Nations Children’s Fund (UNICEF) and the UN Central Emergency Relief Fund are providing midwifery kits to local hospitals to enable them to perform deliveries or, in the event of a complication, stabilize patients long enough to get them to a larger, better equipped hospital.

However, providing care for the herders of Mongolia, so drastically affected by the dzud, does not end when the postnatal period elapses. According to Matavel, the Ministry of Health in Mongolia has already reported many cases of depression and insomnia amongst women affected by the loss of their livelihoods in the dzud. UNFPA along with the government of Australia and partners within Mongolia are providing counseling, education, and information for these women. The UNFPA is also preparing to try and help Mongolian female herders diversify their skills in order to provide them with more economic security.

“This means that we will be looking at options for vocational training, training in crop cultivation, [and] supporting young people with scholarships to encourage them to learn a profession and make them employable in other sectors,” Matavel said. “This will be an integrated approach and will be linked with the reproductive health activities that UNFPA is currently undertaking including subsidized medical checkups and follow up treatment.”