When the contractions set in, Mary Nakany weighed her options. She could walk to the closest maternity ward, where a midwife and medicines awaited, but the trek would take at least 45 minutes—without stopping for the pain of contractions. If she didn’t make it in time, she’d be giving birth along the way. The privacy and safety of her own home, a round, traditional house with dirt floor she had built just months earlier, seemed a better choice.

In South Sudanese culture, women are to give birth in silence, so Mary didn’t even whimper. The first sound that pierced the night was the cry of her baby, a girl she would later name Monday Kadong, after the day she was born.