The Killid Group, March 12, 2017

Challenges, year after year

"Only 32 percent of the deliveries take place in hospitals although the facilities in hospitals have increased."

By Habib Viqar

There is nothing new here: Maternal mortality levels have shown little improvement. The majority of deliveries are at home in the absence of medical facilities. There are few female doctors and an acute shortage of mid-wives.

Among the provinces with the worst records is Uruzgan. Hamid Agha, a resident of its Charchino district, says 10 women have died in child birth over a few months. "Clinics don't exist in most districts in our province," he says. "If there are they are just in name; no female doctor is appointed. In an emergency we take the patient, even a woman in labour, to Tirinkoot (provincial capital)."

Agha adds that few women can survive the journey. "Most of them die on the way. More than 10 died during delivery in villages around mine. We have repeatedly complained to the government but no one is prepared to work in an area where security cannot be guaranteed."

Afghanistan is the second worse place to become a mother. (Photo: IRIN)

"We urge the government to provide security and send female doctors to our clinics," he appeals.

Meanwhile, from Uruzgan's Choora district, Rahmatgul Popal shares similar concerns with Killid. "My uncle's wife died due to delivery complications a few days back. She left behind children," he says. "Roads are bad, and security does not exist. Most of our patients cannot reach a hospital; there are many cases of maternal death (especially since) many births are at home."

There is urgent need for female doctors and midwives in Paktika province also, say Baseer Haidakhil, a resident of Katawaz district. "We ask the government to pay attention – it must establish schools for our girls because if we have schools and high schools our own girls would become doctors so we would not need to take them from Kabul and other provinces."

Are provincial officials taking note? Aghakhan Miakhil, head of public health presidency in Paktika, mentions 14 students who have graduated as midwives in the province. "We are very happy that 14 midwives and 27 female pharmacists graduated after two years of studies. They would serve the people at the province level and would be able to decrease the mortality of mother and child a lot."

Nangarhar

The province has 30 freshly-graduated midwives. Speaking at their graduation on Jan 25, 2017, Najib Kamawal, head of Nangarhar public health presidency, said they would be encouraged to join health centres in Laghman, Nuristan and Kunar. "We have at least one female doctor or midwife in all health clinics. That is a big achievement," he says.

Paktia

Thirty six midwives have graduated from Paktia health sciences institute in November 2016. Provincial authorities say the girls had promised to return to their own areas and work after graduating. Dr Sher Mohammad Naqshbandi, head of the public health department, thinks that this will boost health services in even remote parts of the province.

Provincial council members also see the graduation of midwives as a big achievement. Allahmir Bahramzai, a member says, "God is kind that we have fresh graduate midwives. We are sure that these 36 will work with love for their people and the problems of the province would be solved to some extent."

Khost

Efforts have started in earnest to stop the high death rate of mother and child. Following an entrance exam, 50 female students were selected out of 220 for admission to a course in nursing and midwifery. They have promised to fulfill their part of the agreement and work in rural areas,'' says Dr Gul Mohammad Mohammadi, head of public health of Khost.

Dr (Miss) Khadija Safi, responsible for nursing says, "We will absorb the class (of graduates), and depute them in areas that don't have nurses and midwives. We want to solve the problem of problem villages."

Laghman

In November 2016, some 25 girls graduated from midwifery in the province. Abdul Jabar Nayimi, the governor, while speaking at their graduation, said they could be sent to remote areas to work. He asked for financial help for the graduation of a new batch of 25 students.

Paktika

Dr Waligul, head of public health department in the province, asks all people in Paktika to encourage their daughters to study "because we cannot build a community without studies". Mohammad Elyas Wahdat, the provincial governor, says that they would try to build up the profession of midwives to ensure that no unassisted deliveries take place. "I ask honourably the entire nation to send their girls to the schools so that they can serve their sisters."

For all Afghans

The Ministry of Public Health has risen to the challenge and increased nationwide efforts to train midwives. Najia Tareq, a deputy minister of public health, says that the ministry is trying to encourage all families to take pregnant women to hospitals for the delivery. "Only 32 percent of the deliveries take place in hospitals although the facilities in hospitals have increased."

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