June 18, 2024


KHOST, Afghanistan: Zubaida traveled from the agricultural outskirts of Khost in japanese Afghanistan to offer start at a maternity hospital specializing in difficult instances, fearing a destiny all too frequent amongst pregnant Afghan girls — her loss of life or her youngster’s.

She lay dazed, surrounded by the unfamiliar bustle of the Docs With out Borders (MSF)-run hospital, exhausted from supply the day earlier than, however relieved.

Her still-weak new child slept close by in an iron crib with peeling paint, the kid’s eyes lined with khol to push back evil.

“If I had given start at residence, there might have been problems for the newborn and for me,” stated the lady, who doesn’t know her age.

Not all the girls who make it to the hospital are so fortunate.

“Typically we obtain sufferers who come too late to save lots of their lives” after delivering at residence, stated Therese Tuyisabingere, the pinnacle of midwifery at MSF in Khost, capital of Khost province.

The ability delivers 20,000 infants a yr, practically half these born within the province, and it solely takes on high-risk and sophisticated pregnancies, many involving moms who haven’t had any check-ups.

“It is a huge problem for us to save lots of lives,” stated Tuyisabingere.

She and the some 100 midwives on the clinic are on the entrance traces of a battle to cut back the maternal mortality price in Afghanistan, the place having many youngsters is a supply of pleasure, however the place each start carries heavy dangers — with odds towards girls mounting.

Afghanistan is among the many worst nations on this planet for deaths in childbirth, “with one lady dying each two hours,” UN spokesman Stephane Dujarric stated earlier this month.

The Afghan well being ministry didn’t reply to repeated requests for touch upon this story.

In line with the newest World Well being Group figures, from 2017, 638 girls die in Afghanistan for each 100,000 viable births, in contrast with 19 in the US.

That determine, furthermore, conceals the massive disparities between rural and concrete areas.

Terje Watterdal, nation director for the non-profit Norwegian Afghanistan Committee (NAC), stated they noticed 5,000 maternal deaths per 100,000 births in distant components of Afghanistan.

“Males carry the ladies over their shoulders, and the ladies die over the mountain making an attempt to achieve a hospital,” he stated.


Earlier than the return to energy of the Taliban in August 2021 and the tip of their insurgency, girls would generally need to courageous the frontlines to achieve assist, however now there are new challenges — together with a “mind drain” of experience.

“A number of gynaecologists have left the nation,” Watterdal stated.

Furthermore, Taliban authorities wish to do away with the cellular medical groups visiting girls as a result of “they can’t management the well being messages they have been giving,” he stated.

Underneath the Taliban authorities, girls have been squeezed from public life and had entry to schooling restricted, threatening the way forward for the feminine medical subject in a rustic the place many households keep away from sending girls to male medical doctors.

“Entry to antenatal and postnatal care for a lady was (all the time) extraordinarily difficult. It’s much more difficult right now,” stated Filipe Ribeiro, MSF director in Afghanistan.

This is because of measures taken by authorities in addition to the failings of the well being care system — together with structural help from international donors.

“What little there was has been put below even higher strain,” Ribeiro stated.

The monetary pressure on households amid the nation’s financial disaster will increase the dangers, stated Noor Khanum Ahmadzai, well being coordinator for non-governmental group Terre des Hommes in Kabul.

In a public hospital the place the midwives are overworked and poorly paid, girls need to convey their very own medication.

A supply prices round 2,000 Afghanis ($29) — a major sum for a lot of households.

Regardless of the dangers, “girls who used to go to the general public sector now desire to ship at residence, as a result of they don’t have cash,” stated Ahmadzai.

An estimated 40 p.c of Afghan girls give start at residence, however that shoots as much as 80 p.c in distant areas — usually with the assistance of their mother-in-law or a neighborhood matriarch, however generally alone.


Islam Bibi, pregnant with triplets, went to the MSF facility in Khost in ache, and empty-handed.

“I used to be sick, my husband didn’t have any cash. I used to be instructed, ‘Go to this hospital, they do every little thing free of charge’,” stated the 38-year-old, one in all tons of of 1000’s of Afghans who fled Pakistan in latest months, fearing deportation.

A number of births like Islam Bibi’s are frequent, stated Tania Allekotte, an MSF gynaecologist from Argentina.

“It’s valued right here to have many youngsters and many ladies take a remedy to stimulate their fecundity. We frequently have twins right here,” she instructed AFP.

The typical lady has six youngsters in Afghanistan, however a number of pregnancies, repeated caesarean sections or miscarriages enhance the chance of loss of life.

There are some rays of hope.

Girls in neighboring Paktia province might have fewer dangers now, because of a first-of-its-kind maternity heart opened lately by NAC within the small provincial capital Gardez — a clinic run by girls for girls.

“The sort of clinic doesn’t exist within the majority of provinces,” Khair Mohammad Mansoor, the Taliban-appointed provincial well being director, instructed the all-male viewers.

“We have now created a system for them through which sharia regulation and all medical ideas can be noticed.”

The NAC facility goals to assist “lots of our sisters who dwell in remoted areas,” supervisor Nasrin Oryakhil stated, with related clinics deliberate for 4 different provinces within the coming months.

Its partitions freshly painted and adorned with posters selling nutritional vitamins and iron for pregnant girls, the small clinic is ready up for 10 deliveries a day, stated head midwife Momina Kohistani.

Retaining moms alive as they bring about new life into the world is near residence for her.

“My mom died in childbirth,” she murmured, tears rolling down her cheeks.