Seated on her bed at a maternity clinic in Dadaab refugee camp, Kenya, Daruno Abdi, a mother of six, watches other mothers breastfeed their newborns. She has been here for the past three days and can’t wait for her turn to deliver her baby.

Daruno fled conflict and famine in her country Somalia. She never expected to deliver in a hospital. Health services in Somalia are scarce because of the devastating conflict that has afflicted the country for decades. For many women in Somalia, which has one of the highest maternal death rates in the world, giving birth is a matter of life and death.

Last week I visited Dadaab, the largest refugee settlement in the world, with a staggering population of over 460,000. When famine was declared in Somalia by the United Nations in late July, about 1,500 people were arriving in Dadaab every day. The camp was created almost 20 years ago and is now the third biggest urban area in Kenya. For many young people who were born there, it is the only place they know.

I was touched by the stories women and youth shared with me. In a clinic in the town of Garissa, near Dadaab, I also met Habiba who had walked nearly 800 km to come to give birth to her tenth child. Five of her children had already died.

Health facilities have been put in place long ago in Dadaab, but the system is currently challenged and stretched by the recent influx of refugees. The strategy has been to strengthen the existing system with supplies, human resources at clinic and outreach levels, and to promote availability and facilitate access to those services by new arrivals. But the uptake of available services is still low amongst new arrivals and more effort needs to be made to strengthen access.

UNFPA aims to improve reproductive health care in Dadaab and in accessible parts of Somalia through the provision of related live saving medical supplies and equipment, which will lead to a reduction in adult and child morbidity and death. UNFPA is supporting the International Rescue Committee (IRC) which runs clinics in Dadaab to help provide essential reproductive health care to pregnant and lactating women.

It estimated that 75 to 82.6% of pregnant women in Dadaab are anaemic, and almost all of them have undergone female genital cutting. Voluntary family planning also remains a key challenge. High fertility rates combined with low contraceptive intake will continue to stretch resources for all.

During antenatal visits to the clinic, expectant mothers receive HIV counselling and testing and screening for sexually transmitted infections. Women also receive treatment for complications during pregnancy and childbirth and are also provided with counselling after miscarriages.

For now, Daruno can be reassured that she will receive neonatal and post natal care and get essential sanitary and hygienic commodities like sanitary towels and soap when it will be time to finally go back to the camp. While Daruno’s newborn will grow up in the camp, UNFPA and other organisations are scaling up their help and will be even more active in the long term to address the needs of women and youth, especially girls. These youth will soon be adults and have children of their own. We will work to ensure that the current and next generation in Dadaab are equipped to make better choices for their future.

Babatunde Osotimehin, executive director, UN Population Fund, UNFPA.

Patient consent has been obtained.