The Central African Republic (CAR), whose health system and people are still suffering the negative effects of years of conflict, records one of the highest rates of maternal mortality in the world. Often lacking access to pre- and post-natal care, and to assisted deliveries by licensed midwives, a woman’s lifetime risk of maternal death in CAR is 1 in 25, compared to 1 in 3,800 in developed countries*.
To help women have healthy pregnancies and safely give birth, ALIMA (The Alliance for International Medical Action) offers free care for pregnant and lactating women at community health centers and hospitals in the towns of Bimbo and Boda.
In 2020, more than 55,000 women benefited from free prenatal consultations in CAR thanks to ALIMA. Our teams also helped more than 10,000 women give birth.
Here are some of their stories:
“Prenatal consultations are essential.”
These are the words of Nadine Ghislaine Bemba, an ALIMA midwife at the Boda Hospital, as she listens to the heartbeat of Solange Maïcro’s unborn child, during a prenatal consultation.
“Prenatal consultations help reduce the maternal and neonatal mortality rate," Nadine says. "They help to detect complications related to pregnancy and care for them. A mother who does not attend a prenatal visit can die, and so can her child. I encourage all pregnant women to come in for their prenatal check-ups.”
For Solange, a mother of eight, who is now seven and a half months pregnant, also explains the importance of maternal health care:
"I gave birth to one of my children in very bad conditions during the crisis here. I gave birth in the forest and I could hear gunfire around me. This is the story of my daughter, Esther. She is constantly sick. The children for whom I did my prenatal consultations since my third month of pregnancy until I gave birth, did not have these problems. Here is my advice:
If you are pregnant, come to the health center, please. You will be well followed and taken care of.”
The journey to the field is not easy. The route between the CAR's capital city, Bangui, and the town of Boda, for example, is 189 kilometers, but the drive can take more than eight hours in a car during rainy season, when much of the road is washed away.
In the Bimbo health district, where ALIMA works, many communities are located far from the city center, only accessible by multiple forms of transport.
“Car, motorbike, boat, feet...our teams do whatever it takes. Despite the difficulty of access, we care for patients."
- Dr. Jean Claude Djoumessi, ALIMA Project Coordinator in Bimbo
Meet Pamela Passiri. She has been working as a midwife since 2014.
“I love working with pregnant women and babies,” Pamela says. “There are so many beautiful moments. Yes, there are difficulties at times – the lack of medicines, supplies, and women coming here too late. First, they try traditional medicines. It complicates our job. But we do our best every day, many times a day, to bring children safely into this world.
It is so beautiful to hear that first cry, to see the mom smile when she sees her child!”
Zita, a health assistant within the maternity ward at the Boda Hospital, holds a newborn baby boy, minutes after delivery. The baby’s mother, Samira, suffers from epilepsy. Her pregnancy and delivery was considered high-risk, but thanks to ALIMA staff, Samira and her new baby are doing well.
To help train local midwives and traditional birth assistants, and improve access to maternal health care, ALIMA opened a maternity training school in Boda in early 2020. Each class, which enrolls 10 students, consists of a one-month training session, including one week of theoretical learning and three weeks of hands-on, practical experience.
Above, as part of a training session for midwives and traditional birth attendants at ALIMA’s maternity school in Boda, two trainees attend a session on episiotomy and suture.
Raïssa (left) explains: "I am doing this training in Boda to improve, to develop my medical skills, to learn techniques that I didn't know. Before, for example, I didn't know how to correctly stitch a woman after she gave birth.”
Below, midwife and head trainer at the maternity school in Boda, ALIMA's Nadege Karo, explains the importance of these sessions:
Nadine Ghislaine Bemba, an ALIMA midwife, shows Agnès Feïti an episiotomy technique, as part of maternity training school of Boda.
"After the training, I want to apply everything I have learned...enabling women to give birth safely.”
-Agnès Feïti, training school participant
Valérie Sousou Irenne, a 49-year-old midwife and mother of 10 children, participates in ALIMA’s maternity school training in Boda.
"I have been working at the hospital in Boda for 29 years," she says. "In 2 days, it will be 30 years! Unfortunately, previously, I didn't know the right delivery techniques. Although I have been working here for a long time, I am now learning some new techniques. I also know more about caring for pregnant women because I have developed my skills."
Four-year-old Reviens (left) and six-year-old Hermine (right), meet their new sister for the first time. Their mom Amina, who just gave birth to her 4th child, came to the ALIMA-supported health clinic in Bomandoro, in the Boda Health district, for prenatal consultations throughout her pregnancy.
“The quality of care is very important for me and my baby,” she said. "In Bomandoro, many women give birth at home in unsafe conditions."
But thanks to prenatal checkups and an assisted delivery, both Amina and her baby girl are in good health.
Ibrahima meets his new baby cousin, a girl, at the Boda Hospital maternity ward.
"I am so happy to finally see her!" he says, smiling.
The neonatal unit within the Boda Hospital, which can care for up to eight babies at the same time, is one of the rare few in CAR. It is vital for saving the lives of those babies who are born prematurely, in distress, or suffering from complications.
Papa Emile Wogbela, a community health worker for the Ministry of Health and father of nine children, poses for a photo within the neonatal unit, where he volunteers his time. He oversees the care here, supporting mothers whose newborns have been admitted to the ward.
"What motivates me in my work is to successfully care for sick babies.
The parents feel helpless...so when they ask questions, I give them advice; when they are scared I support them and reassure them; when they are sad, I tell jokes, to make them smile. Being able to see them leave with their healthy baby is what motivates me, day after day."
"Every baby deserves the chance to live, no matter how small they are.”
-Papa Emile Wogbela, neonatal health worker
After a complicated delivery, Eugénie Mbolipia’s baby boy was not breathing when he was born. The birthing team rushed him to the neonatal unit and immediately began resuscitating him, waiting to hear his first cry. After a few minutes, they did! Eugénie's son was then placed on supplemental oxygen, and is being monitored by a pulse oximeter machine, to measure the level of oxygen in his blood. Health staff hope he can soon go home.
Estella Dimanche gave birth to twins - a boy and a girl! - at the Boda Hospital. Despite carrying the twins to full-term, both were born underweight and had to be hospitalized within the neonatal unit, where they received supplemental oxygen and antibiotics.
Estella holds her babies using the Kangaroo Method, which consists of carrying her twins on her chest, with skin-to-skin contact. The main purpose of this practice is to warm up babies if they are hypothermic.
“I am very grateful to the medical team here because if it wasn't for them, I don't know what would have happened to me and my children,” Estella says.
After nine days, thanks to the care of ALIMA’s team, the twins were in good health and ready to go home. Since then, Estella brings her twins twice a week back to the neonatal unit for checkups and to monitor their weight gain.
Below, Nadège Karo, ALIMA midwife, holds the twins - Gracia Merlyne and Dieu Béni - in arms during a check-up.
Watch Estella's full story here:
“Thank you for saving my life and the lives of my children.”
- Estella
© 2026 ALIMA
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