Sudanese Mother Gives Birth on Road as Aid Funding Collapses

Maude Ahmad Fadala went into labor somewhere between the Chad border and the transit camp. There was no midwife, no ambulance, no medical supplies. Her baby was born on the side of a dusty road, the way thousands of Sudanese mothers have given birth in the past year — unwanted, unnoticed, and without help.

Pregnant and turned away

Maude, 28, had fled Sudan with her husband and three children in early February. They crossed into eastern Chad like thousands of others that month, after fighting displaced them from their home in Darfur. On February 12, she felt contractions begin during the long walk between the border crossing and the Kornok camp. The nearest health post was 14 kilometers behind them. The convoy carrying her family had already moved on.

A humanitarian worker who arrived at the scene told reporters later that both mother and child survived, but only because a fellow refugee had basic delivery knowledge. "If she had gone into labor two hours later, or if the baby had been breached, we would be talking about a very different story," the worker said, speaking on condition of anonymity because she was not authorized to brief the press.

Funding crisis leaves shelters without staff

The International Rescue Committee, which operates maternal health units at three camps in eastern Chad, confirmed it reduced services in January. The IRC said it was forced to cut staffing at its Kornok clinic by 40 percent after a donor country — the IRC did not name which — withdrew a planned contribution of $12 million. Two maternity beds were removed. The on-call midwife was reassigned to another site.

IRC's Chad director, James Kanneh, said the cuts arrived at the worst possible moment. "We had a queue of 340 pregnant women registered for delivery support in February alone," he said in a written response to questions from this publication. "We could only cover 180. The rest were told to come back or go to the next camp."

Eastern Chad's refugee surge

Since April 2023, more than 430,000 Sudanese have crossed into Chad, according to UNHCR data released on February 14. The UN agency reported that 62 percent of the new arrivals are women and children. An estimated 28,000 are pregnant. Chad already hosted 380,000 refugees from previous crises. Its health system, already strained, has no capacity to absorb the surge.

The displacement is not slowing. UNHCR projections show arrivals could reach 600,000 by the end of 2025 if the conflict in Sudan continues at its current pace. That would make Chad the second-largest refugee-hosting country in Africa, after Ethiopia.

The money that never arrived

The broader humanitarian response for Sudanese refugees is $2.4 billion short of its target. UNHCR's 2024 appeal for Sudan-related operations in Chad, Niger, South Sudan, Ethiopia, and the Central African Republic sought $3.1 billion. As of late January, donors had pledged $689 million — less than 23 percent.

The United States, previously the largest bilateral donor to refugee operations in sub-Saharan Africa, contributed $180 million to UNHCR's Sudan response in 2024. European Union contributions totaled $210 million. A UN official who tracks donor commitments said three major pledges made at a Geneva conference in December 2024 have not yet been disbursed. The official declined to be named before the information was formally announced.

What the shortfall means in practice: nutrition programs serving 200,000 children in Chad have been cut by 30 percent. Water and sanitation operations are operating at 55 percent capacity. Vaccinations for measles and polio have been postponed three times since November.

Africa's maternal health emergency

Sub-Saharan Africa already records the highest maternal mortality rate in the world — 542 deaths per 100,000 live births, according to the World Health Organization. For displaced women in active conflict zones, the rate climbs to 890 per 100,000, UNFPA data shows. The UN Population Fund says women in humanitarian crises are twice as likely to die in childbirth as women in stable settings.

African Union guidelines on protecting displaced women set minimum standards for maternal care that member states are expected to uphold. Chad's government, which signed the AU protocol in 2022, says it cannot meet those standards without external financing. "We have the policy framework," said Dr. Mahamat Saleh Annadif, Chad's minister of public health, speaking at an African Union briefing in Addis Ababa last month. "What we do not have is the money."

The conflict in Sudan, now in its second year, has created the world's largest displacement crisis. More than 8.5 million people have been forced from their homes — more than in any other ongoing conflict globally. Most are women and children. Many are traveling on foot for days before reaching the border.

What happens next

UNHCR has called an emergency donor briefing in Nairobi on March 8. The agency has asked seven countries and the European Commission to confirm new contributions before that date. Officials close to the talks say three countries have signaled positive intent but have not committed to specific amounts.

Meanwhile, the IRC said it will not restore full services at Kornok unless it receives at least $8 million by mid-March. Without that funding, the clinic will remain operating at reduced capacity through the rainy season, which begins in June and makes road travel even more difficult.

For Maude Ahmad Fadala, the upcoming donor meeting is an abstraction. She is now at the Kornok camp, three weeks after giving birth on the road. Her baby is healthy. She has been trying to breastfeed while also caring for her three older children. She has not received any postnatal checkup. She does not know when the next midwife will visit the camp, or if she will.

The UN Security Council is scheduled to review the Sudan humanitarian situation on April 10. Aid groups say any resolution that does not include guarantees for cross-border medical access will leave women like Maude with the same options they have now: none.