“When I was a small child, I hoped to be a doctor or a midwife in my community. When I heard about this program, I had to apply,” says Suraya, an 18-year-old midwife-in-training at a hospital in Herat, Afghanistan (MacIssac). Married at 14, widowed at 16, Suraya understands more about motherhood than one might expect. She was 15 when she gave birth to a son, Razeq, now three years old. Her mother cares for him at home while Suraya completes her practical midwife training in a program supported by World Vision.
Lack of Rural Health Systems, Shortage of Doctors and Trained Birth Assistants
In a country where girls still have acid thrown in their faces when they dare to go to school, female health care workers and female doctors will be rare. Dr. Forough Malalai is the only female maternal health doctor in Panjshir province, a mountainous region in central Afghanistan with 600,000 residents. They live in vast valleys, many of which are inaccessible by road and often blocked by floods and avalanches during harsh winters. “Some women have to walk for hours, even days, to reach the clinic,” says Dr. Malalai in a UNICEF interview. When they get to the clinic it is often too late.
The Maternal Mortality Rates In Afghanistan is Among the Highest in the World
The most common measure for death in childbirth is the maternal mortality ratio (MMR). It refers to the number of maternal deaths for every 100,000 live births. The MMR in Afghanistan is a staggering 1,600 per 100,000 live births. The primary complications of childbirth are bleeding, infection, hypertension, and obstructed labor. "The situation is so dire that a woman in Afghanistan dies from pregnancy-related complications every 27 seconds," according to a 2008 report by the Central Asia Health Institute. Most of these deaths could be prevented with increased access to maternal health services.
Traditional Customs Discourage Medical Care for Women
After three decades of war and the rule of the Taliban with their primitive interpretation of religious law, the position of women in Afghanistan has sunk to one of the lowest in the world. Religious stigma towards gender separation is so deeply ingrained in some areas that a husband would rather let his wife die in childbirth than allow a male physician to treat her. There is a strong correlation between countries where women are marginalized and countries with high maternal mortality. "In much of the world, women die because they aren't thought to matter", writes Nicholas Kristof in Half the Sky, describing the injustices women endure in the developing world.
USAID, UNICEF and NGOs Support Midwife Training in Afghanistan
In April 2010, 40 midwives graduated from the Herat Institute of Health Sciences, in a programme sponsored by USAID and World Vision. “It takes two years of intense training to provide these women with the knowledge and skills needed to become midwives, and I thank them for committing to the important role of serving mothers and newborns in Afghanistan,” Ambassador Wayne said at the graduation ceremony.
There are signs that the situation is improving. The number of midwives in Afghanistan has increased from 467 in 2002 to 2,200 in 2009. Humanitarians Greg Mortenson — widely recognized for building schools in Afghanistan and Pakistan — and Sakena Yacoobi — founder of the Afghan Institute of Learning — are training girls in maternal health care. More training programs that help increase the number of medical and nursing students are desperately needed to overcome poverty, terrorism and violence. Real progress will be made once the women of Afghanistan will have access to the same educational opportunities as the country’s men.
"In the 21st century, no woman should have to give her life to give life."
United Nations Secretary-General Ban Ki-moon at the World Health Assembly in Geneva (May 2009)
Watch on YouTube: UNICEF Television Midwife Training in Afghanistan
References:
Central Asia Health Review. Maternal Mortality in Central Asia. Special Report. Web. 06/02/2008.
Kristof, Nicholas D. and WuDunn, Sheryl. Half The Sky. New York: Random House, Print.
MacIssac, Mary Kate. Teenagers to Midwives: How Women in Afghanistan are Changing Maternal and Infant Health. World Vision. Web. 11/19/2009.
Midwives Graduate from Herat Institute of Health Sciences. USAID/Afghanistan. Press Release. Web. 4/22/2010.
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