* Any views expressed in this opinion piece are those of the author and not of Thomson Reuters Foundation.
Maha Muna is a humanitarian specialist with UNFPA's Eastern Europe and Central Asia Regional Office and she wrote this after a recent trip to Kyrgyzstan
BISHKEK - When the fighting began in Osh and later spread to Jalabad (two cities in the Feregana Valley of Kyrgyzstan), Nurgul was three months pregnant. The last thing she wanted was to leave her home, but as the fighting intensified, it seemed the only reasonable thing to do. Nurgul remembers that she was six months pregnant in 1990 when a similar crisis erupted in this region. She remained in her neighborhood then, but after she was hit by an army tank, she had to be hospitalized and lost her baby.
She still carries the scars of the accident, her left arm is completely mangled, and she does not want to take any chances of losing the baby she is carrying now.
Nurgul is one of the many pregnant women who had to endure specific challenges during the emergency situation. But she, like many others also found unsung heroes to care for them, whether in refugee camps across the border in Uzbekistan or in internally displaced camps and settlements in Kyrgyzstan - the doctors, nurses and midwives who participated in the emergency response.
Nurgul took refuge at an IDP centre just outside Osh city and is being cared for by Nora, a family doctor who comes to the centre daily and spends two hours with the internally displaced. She does not have much to offer, but Dr. Nora checks her patient's blood pressure and provides Nurgul with the micronutrients and vitamins that she left behind when she fled her home. Dr. Nora is monitoring her pregnancy and can refer her to a local Maternity Hospital when it is time to deliver.
In some cases, IDPs are reluctant to go to hospitals, and are instead choosing home deliveries.
The Director of one Osh Oblast branch hospital said that there are normally no more than one or two home deliveries a year in his catchment area. But since the crisis, there have been five home deliveries in six weeks. Roads were insecure and checkpoints frequent. Even today tensions remain high between the communities and some patients report having been harassed and intimidated at medical facilities.
Dr. Mukadas is a midwife who lives in an Uzbek Mahala, or neighborhood. At the height of the week-long crisis, she was called to two homes to assist with deliveries. She brought her midwifery bag with her, with some basic drugs, a cone to hear the baby's heartbeat, new razor blade to cut the umbilical cord and suturing supplies in case they are needed. In both cases, a boy was born.
"I arrived after the lady had fully dilated, and the head was crowning," Dr. Mukadas remembers the first home birth. "The mother was afraid to cry out during the delivery but she broke down and cried after the baby was born." It is hard to give birth in a world gone mad.
In other cases, midwives, nurses and obstetric-gynecologists were called in to provide first aid care to the injured and wounded who made it to the hospital. "At first they did not want to be seen by me because I am an Ob/Gyn," Dr. Khiykharkhan remembers, "but then I explained that I am a doctor and am well trained."
Doctors, nurses and midwives also cared for survivors of sexual violence. While people lay dying in beds downstairs, women were giving birth upstairs.
The pregnant women at Khiykharkhan's Jalalabad Maternity Hospital were moved to the third floor so that the first and second floors could be used for triage, first aid and surgery for patients with bullet wounds and other injuries.
"Most of the pregnant women were taken home during the first three days of the crisis," she recalls, "and out of the 105 women in the maternity ward, only 42 remained."
Between 12-14 June, 34 women gave birth, one to twins. Three required a Caesarean section. Two gave birth prematurely and one woman lost her baby.
"At one point, we were running out of drugs and supplies," Dr. Khiykharkhan recalls.
UNFPA, the United Nations Populations Fund, has since replenished seventeen secondary hospitals and Family Medicine Centers, as well as 16 primary care facilities in Osh and Jalalabad, with reproductive health medicines, supplies and equipment, including clean delivery kits for home deliveries, basic rape treatment kits, supplies for management of complications of miscarriage, blood transfusions and clinical delivery.
Now that the refugees have returned to Kyrgyzstan and the internally displaced are also returning to their communities, each day of calm offers hope for mediation and eventual reconciliation in the scarred Feregana Valley.
Rows and rows of burned homes and businesses in targeted communities are testament of the crisis, but beautiful babies bring hope for a more peaceful future.
The Director of the Jalalabad Maternity Hospital has been visiting all the mosques in town to reassure people that the hospital is open and that services are provided to everybody, without prejudice or discrimination.
Young men are gathering at the base of the holy Mount Solomon to begin to talk to one another across community lines. Osh city recently celebrated 3,000 years of human habilitation in this rich, fertile valley which was an important destination along the ancient silk route.
With the birth of every new child, there is hope that the next generation will not have to suffer the tragedies and losses of another crisis, and that harmony can be restored.
