Approximately 4% of a disaster-affected population will be pregnant or due to give birth (Sphere Handbook, 2018).
When an Australian Medical Assistance Team (AUSMAT) arrives in country, the team faces the challenge of juggling competing demands, absorbing rapidly evolving information and providing immediate care to those affected.
So why do we have to prepare for what may appear to be only such a small fraction of a community?
AUSMAT and Rapid Response Team member Melissa Taylor is a registered nurse and midwife, and is currently investigating and updating AUSMAT’s maternity care kits and contributing to the governance policy.
“A percentage is not reflective of long-term consequences. If we don't prepare to assist these women, if we don't provide appropriate care, consequences may mean life or death and have long-term impacts on a community,” Ms Taylor explained.
According to the Emergency Medical Team (EMT) Minimum Standards, which NCCTRC and AUMSAT adhere to, EMT’s are expected to provide adequate and respectful reproductive, maternal and neonatal health in any deployment setting.
“As an organisation, we are constantly revisiting and evolving in the maternity space, ensuring the services we provide don’t just meet the minimum standards, but actively exceed them,” she said.
NCCTRC developed personalised dignity packs for patients in the field but specifically there are dignity packs for expectant mothers, and those with young children which includes essential items.
The items include breast pads, sanitary and hygiene items, nappies, s, nutritional needs, and clothing items for mother and baby.
Additionally, AUSMAT are also equipped and prepared on deployment with essential medicines and specialist equipment to facilitate a safe and supportive environment for women to birth their babies, and respond to antenatal, intrapartum or postnatal care.
Ms Taylor explained the importance of ensuring the team is prepared to support pregnant women on any deployment in all contexts. She said the necessity to prioritise the 4% was highlighted to her while deployed to Samoa in 2019 to assist during the Pacific nation’s measles outbreak.
“When I arrived in Apia, I truly didn’t think I had the right skill set for the deployment… a midwife and general nurse on a mission predominantly related to paediatric health, however my opinion shifted as soon as I engaged with the women who entered the field hospital,” she said.
“We had a lot of mums who had sick children in the high dependency unit who were also either pregnant and/or breastfeeding a baby at home. Women presented with mastitis and other infections, it was clear their concern for their children was impacting personal health,
“Myself and the two other midwives on the deployment recognised that these mums and other caregivers needed support, education and some medical care themselves. We had to adapt and shift to best respond, so we provided expressing equipment, educational resources and lessons on how to hand express and the importance of taking care of themselves, so they could take care of their child in hospital.”
Ms Taylor said similar situations occurred while deployed to assist the healthcare system in Fiji during the COVID-19 pandemic.
“Some women were scared of presenting at a hospital during this time. Much of my time was spent supporting the midwives on how to educate the new mums on personal protection amid the pandemic and ensure their safety.
“Again, this is another demonstration of where that 4% of community is such a vital component to consider no matter the context.”
As Ms Taylor works to update and innovate AUSMAT’s maternity kits and practises, she said dignity, protection and empowerment are core to how she and all AUSMAT midwives provide assistance while on deployment in a host country.
“We are currently working to implement recommendations from recent humanitarian deployments, recognising the need to be able to rapidly respond in any given situation, especially with the likelihood that disasters are going to increase in coming years, remaining prepared and ahead of the curve is vital,” she said.
“Midwives want to support and join women on their birthing journey. In all deployment situations, I think it’s imperative to empower women in their home setting, be it the local midwives or the women who are about to or have just given birth,
“There is far more complexity to the situation, and AUSMAThas a role to play in advocating for dignity and security of women in a disaster setting, ensuring when they leave our care they have services which will continue to support and protect women and their families.”