New Website

Please be sure to check out the new website Afghanistan Midwifery Project. I am sure you will be more than delighted with the slight changes.

Leave Her to Her Fate – Nadia’s story from Paktika Province

Nadia’s Story (From Veil of Tears)

Paktika Province in southeastern Afghanistan does not have a single female doctor. This has huge implications for the 180,000 women living there, as conservative traditions prevent women from being seen by male doctors. Nadia, 28, is the only woman with an education in her village, 30km south of Paktika’s main town, Sharena.

I got married 11 years ago when I was in Peshawar, Pakistan. We lived there for more than a year after our marriage, but then my husband said we had to move to Paktika where we both came from, because of economic hardship.

After our return, I discovered how different our village was to where we had lived in Pakistan. I found we had no roads, no school, no clean drinking water and no health clinic.  The women and children were all illiterate. For a fairly well educated woman like me it was very hard to adapt, but I had to. I realized that I would have no access to medical care if I got pregnant, so I asked my husband to wait before we started a family.

After a couple of years, I became pregnant and gave birth in the neighboring province of Ghazni, which is more than 200km away. In those days it used to take two days by car to get to Ghazni.

After the fall of the Taliban, I thought there would be some major changes, but unfortunately we didn’t see any changes in Paktika. The problems the women in this province face are huge. The lack of health facilities and education is stimulating the spread of preventable illnesses among women. There is no female medical doctor in the whole province and there are not enough midwives. In the provincial capital there are a few female nurses and midwives, but there are none in the districts and villages. I myself have seen many women die during or before childbirth.

My son is sick and I know he is malnourished and he will get worse if I don’t take him to hospital. We don’t have proper doctors or medicine to treat him here. Patients have to go to Ghazni hospital. We do not have female health workers, and our men will never take their wives to male doctors. So they leave their wives at home to either get well by themselves – or die.

For generations the attitude has been: “leave her to her fate.” I knowmany pregnancy-related conditions could be easily treated in a clinic, but men in the family just say “what will be, will be.” This means the woman will either die or recover alone.

Whenever I go to Kabul or Ghazni, I make a point of talking to doctors and midwives to ask some questions and get some information, so I can at least give some advice to women in the village.

I know how bad it is for the health of a pregnant woman to perform heavy tasks at home. For example, lack of drinking water means women have to carry water from natural springs very far from their houses. You can’t imagine how difficult it is for a pregnant woman to carry two jerry cans full of water over a long distance. I have seen many pregnant women doing that and I have also seen them having a miscarriage because of it.

Ultimately it’s a combination of three things that are killing the innocent women of my province: lack of female doctors and midwives, ignorance, and conservative beliefs of men who will not take their wives to hospital or to a male doctor.

The answer is for the government to send us female health workers. I am sure men won’t have any reason to say no if we have a female doctor. I know the security situation is not as good in my province as it is in Bamyan or in the northern provinces, but this doesn’t mean that we
should be denied access to good health care.

I have heard there are midwifery schools in other provinces and that the government offers good salaries to midwives from Kabul to go and work in the rural areas.

But most girls are uneducated in this province, and also the men never allow them to go out without a male family member. That means we cannot send them to midwifery schools in other provinces or in Kabul.

I want the government and the international community to focus on volatile provinces like Paktika, too. Security is being disrupted by others, but it’s we civilians who pay the price.

I’ve been to Kabul many times with my husband and I’ve asked government officials to send doctors to our place, but they always say nobody is willing to work in an insecure province.

The news of women dying in pregnancy, childbirth and after delivery is so common here. I fear one day most of my beloved relatives and other women in the village will all have died! We really need an answer to this.

Stories like these really reaffirm what we are trying to accomplish.  Training women to become midwifes can make a huge impact on these rural communities where no clinics exist.  Most of the complications that are causing maternal mortality are very treatable.  A little education can go a long way in improving the outlook for these women.  Please donate today

Veil of Tears – Afghans stories of loss in childbirth

Nairobi, 19th January 2010:

IRIN today launches Veil of Tears, a 60-page colour booklet collecting personal stories from ordinary Afghans on suffering and loss in pregnancy and childbirth. Few families have not been touched by tragic experiences of childbirth in Afghanistan, where maternal mortality is among the highest in the world.

The stories have been transcribed from radio interviews in local languages Dari and Pashto, and were originally broadcast in IRIN radio programmes in Afghanistan. The booklet brings to the fore the voices of ordinary Afghans, women, men and children. One chapter entitled “I hate the snow” brings the rarely reported perspective of a 12-year old child, who saw his mother dying in childbirth in their remote mountain village.

The collection bears testament not only to Afghans’ suffering, but also to their strong desire for better health services, education and infrastructure to be able to improve their lives and the future for their children.

You can download the PDF version of Veil of Tears from the IRIN website at this link http://www.irinnews.org/pdf/veil_of_tears.pdf

If you would like one of the limited hardcopies of the booklet, write to us at feedback@IRINnews.org

Strategic Communication and Spokespersons Unit
United Nations Assistance Mission in Afghanistan (UNAMA)
Kabul, Afghanistan

The Spirit of Charitable Gift Giving

Every holiday season many gift givers must endure hours of endless shopping in order to find the perfect gift for their loved one. We get great pleasure from giving gifts as it satisfies a basic need in all of us to please another. All too often though, we forget about the larger purpose of giving…

During the holiday season, I always try to follow the motto of it is better to give than to receive. There are many ways to give and bring comfort and joy to others as well as focus more on the spirit of giving. While the act of giving a gift to a loved one has an immediate positive impact this personal connection and reinforcement is missing when giving gifts to charity during the Holiday season, or any other time for that matter. Many people put great thought into Charitable gifts. You buy, pick different items for a family charity than a homeless charity, but in the end it just disappears; for all you know it actually went into a black hole. Don’t be fooled though, the importance of giving charity Christmas gifts is far greater than your personal experience.

The act of giving charitable Christmas gifts is actually more important than the gift itself. You don’t need to be affluent to participate in this grand contribution. The care and love you use to purchase a charity Christmas gift represents the larger care, and greater understanding, you have of your role in the world. The uplifting feeling you and everyone involved get, all go towards helping to make the world a better place. You do have the power to make a difference and in the end you need to realize the giving of Holiday charity is not about the gifts, but about the contribution you are making on a larger scale.

For people who want to focus on the spirit of giving this year we have created a Target wish list. All of these items will go towards supporting our mission. You can choose to buy items for the Midwife starter kits that women will receive after they graduate from training or you could choose to buy items that will be used for the babies once they are born. All items will be sent to the programs we are supporting in Afghanistan. Or if you would rather make a monetary donation you can do so by clicking on the Make A Donation button below.

From all of us at Afghanistan Women’s Clinic we would like to thank you for your continued support throughout the year. Happy Holidays!

Target Wish List:

Paypal Donation:

“What we have done for ourselves alone dies with us; what we have done for others and the world remains and is immortal.” – Albert Pike

Afghan Reproductive Health

“We have to educate women and children to begin to understand their rights. That’s one of the ways to stop the mortality and abuse.” —Dr. Qudrat Mojadidi

In Afghanistan, perhaps the only thing more dangerous than being a woman is being a pregnant woman in need of medical care. A 2002 survey counted 1,600 maternal deaths per 100,000 live births. The cause of death was most often hemorrhaging or obstructed delivery, both preventable if skilled health care is available.

The contrast is staggering: in 2005, maternal mortality in four Afghan provinces ranked 130 times higher than the United States, with a reported 50 to 70 mothers dying every day from complications at birth. Nearly half the deaths among Afghan women of child-bearing age have been pregnancy-related and preventable.

A Cultural Legacy

When the Taliban claimed the capital of Kabul in 1996, Afghan women confronted impossible odds to survive in a culture that limited their freedom, banned their education, forced them into marriage and provided only conditional access to health care. The Al-Qeada organization flourished, planning the September 11 terrorist attacks that provoked United States forces to join Afghan opposition and remove the Taliban from power in 2001.

Since then the country has slowly been rebuilding, but the decades of war, extremism and instability have been slow to fade, and Afghan women continue to suffer from the same types of oppression that took root under the Taliban. Today, forced marriages, lack of education, violence and high rates of maternal mortality persist.

In Afghanistan:

25 percent of children die before reaching their fifth birthday.

50 women die each day from pregnancy-related complications.

Most citizens lack access to safe water or sanitation.

2 million children of primary school age do not attend classes.

Chain Reaction: A Cycle of Trauma

The crisis in reproductive health care is the leading cause of maternal mortality and reflects a destructive chain reaction that begins for Afghan women at a dangerously early age. A 2004 study showed that most Afghan women were forced into marriage before they were 16, with some as young as nine. The consequences are steep, impacting the young girl’s physical development and general health as well as her chances for education.

Pregnant women must cope with poor nutrition and scarcity of food in Afghanistan. Weakened by malnutrition, they are vulnerable to anemia while lactating, and this puts their bodies at higher risk for hemorrhaging. Vitamin deficiencies lead to scurvy, while iodine deficiencies cause goiters in mothers and a thyroid condition called cretinism in their babies.

Underlying these challenges is the fact that few Afghan women know how to recognize danger signs during pregnancy. For those who do, lack of money and transportation make getting to a hospital all but impossible. If she does manage to recognize the signs, acquire transportation, survive the broken roads and reach a hospital, the care and facilities a pregnant woman would find would almost certainly be inadequate, if not downright dangerous.

Physician Care

Access to skilled physicians who know about obstetrics and gynecology is no easy matter in Afghanistan. Under the Taliban, men were not allowed to treat women under any circumstances, and some men believed it was better to have their wives die than have a male doctor treat them. Unfortunately there was no alternative, as women were banned from learning medicine or working.

The problem persists, even though by 2000 the Taliban had begun to allow men to treat women. Meanwhile, a generation of Afghan women has fallen so far behind academically that it is difficult to find capable female candidates to learn medicine in the villages. One successful effort has been to offer a vaccination program through UNICEF that is administered by women who can enter houses, see mothers and children themselves, and provide vaccinations and care.

Path to Progress

There is no question that Afghanistan’s health care infrastructure lay in ruins after the Taliban was removed, and it has only incrementally been improving since. In 2002, of the few medical facilities that had toilets, most were hazardous pit latrines. A quarter of those facilities had electricity, half of which depended on generators. Patient transport systems relied on bicycles and horses or were nonexistent.

In 2002, two thirds of Afghanistan’s clinics could not provide basic reproductive health services and only 10 percent were equipped to perform Caesarian sections. Of the 25 percent of children who died before turning five, nearly half died from preventable causes such as diarrhea or respiratory infections.

Prior to 2001 women were absent from Afghanistan’s public life and political scene. By 2004 a new Constitution stated that male and female citizens were equal before the law. As of 2006 Afghan women are represented in both houses of parliament, and more and more are voting, going to school and becoming involved in government policy.

But progress in those areas has not yet changed the daily reality that for many Afghan women, becoming pregnant is forced upon them at a young age through unwanted marriage, and that bearing children is too often a debilitating, if not fatal, consequence.

Source: PBS.org

Every Half Hour

Every half hour an Afghan women dies during childbirth. This is a number we hope to change through the funding of the midwife training program. Currently 14% of births are assisted by skilled attendants, leading to a high maternal mortality rate. By increasing the number of skilled midwifes this will help ensuring that women no longer have to wait to receive medical attention, and are not met by barriers to health and wellness simply because they are women.

How bad can it be?

A clip from Motherland Afghanistan: Follow an Afghan American filmmaker and her father to his native Afghanistan, where he brings desperately needed medical attention and expertise to the women most susceptible to maternal mortality.

Motherland Afghanistan

This is a clip from Motherland Afghanistan. Nobel Peace Prize Nominee Dr. Qudrat Mojadidi works in Afghanistan to improve health care of women. In his own words, ” Most of these doctors don’t have the basic knowledge to take care of their patients. They’re so thirsty for just one word of wisdom, but there’s nobody to give them that, to provide them that.”

This clip gives you an idea of just how under skilled the women in the clinics and hospitals are. Basic training and equipment in the most rural areas of Afghanistan will make a tremendous difference in these women lives. Please donate today and help us sponsor the midwife training program.

Join our cause on Facebook

We have recently joined Causes on Facebook. It is a great way for us to spread the word. Awareness is an important part of what we are doing. The more people that know, the more people willing to help. So please take a moment and join our cause.

Thanks!

Afghanistan Women’s Clinic Cause on Facebook

What women in Afghanistan are up against….

A woman in Afghanistan is often not permitted to be alone in a room with a man who is not her husband, nor does her husband allow her to leave the house on her own. Many of those women who choose to see a doctor anyway, are forced to sit behind a curtain and describe their ailments to the doctor and receive a diagnosis based on the information they give. This imprecise consultation often leads to misdiagnoses and prolonged illnesses among women. Furthermore, because Afghan women have been barred from educational opportunities since the 1990s, the presence of female doctors is slim to none.

For natal care in Afghanistan , the situation is even worse. Only 14% of births are assisted by skilled attendants, leading to a maternal mortality rate of 1,600 to 1,900 deaths per 100,000 live births. Women and men alike lack information about health concerns surrounding childbirth – it is considered a “dirty” practice in Afghanistan , and women are often forced to give birth in barns and other highly unsanitary areas. They are discouraged from breastfeeding during the first week after childbirth to keep the child “clean.”

In 2007 and 2008, Women for Women International conducted a baseline survey of 2000 Afghan women to learn about health awareness and identify key knowledge gaps. 98% of the women indicated that colds cannot be prevented. When asked to identify the signs that immediate care should be sought for a sick child, nearly 25% of women could not identify any signs to seek medical care for their children. Women who are often married as early as age 12 or 13 and have children at very early ages. However, a majority (over 90%) indicated that they had very little or no ability to determine the spacing of their children. Only 8.5% indicated that they use clean water and 8% wash hands with soap after using the rest room.

Women for Women International’s Afghanistan chapter is working to dispel the myths and change these statistics. From 2003 to 2008, Women for Women International – Afghanistan (WfWI-Afghanistan) trained thousands of women to become skilled birth attendants. Over 2,000 women graduated from WfWI-Afghanistan’s health and traditional birth attendant training program. The participants take weekly classes to learn basic information about the prevention and transmission of communicable diseases, personal hygiene, and the proper disposal of waste and rubbish. They’re also taught about AIDS and other sexually transmitted infections, first aid, and the pathology of the digestive system. The women who participate in the Traditional Birth Attendant classes gain knowledge of basic health topics and receive specific training about the genital and urinary systems, the different phases of pregnancy, and how to care for infants.

The benefits of the training continue to multiply after the fact, because one of the core components of the training is encouraging the participants to share their knowledge and take their learning back to their communities. The participants included women from 15 communities in Kabul , Parwan, Kapisa, and Wardak Provinces . Rapid rural appraisals of the communities showed that at least 53 Traditional Birth Attendant graduates are actively providing assistance to villagers in Kabul , Parwan, Kapisa and Wardak. Sweeta Noori , the Country Director for WfWI-Afghanistan, believes that one of the biggest weaknesses in many communities is the lack of knowledge about preventative health and the spread of diseases. “By encouraging the women to share their knowledge, they are reaching more community members and trying to solve this problem,” she says.

WfWI-conducted surveys also report an increase in preventative care to avoid illnesses such as diarrhea, coughs, and general colds. Women have been keeping their living spaces clean, burying their household waste and covering their windows with cloth to keep insects out. After learning about proper disposal of human waste and garbage, one graduate of the training compelled her husband to build a hygienic toilet for her family and their neighbors to prevent them from getting sick.

Surveys have also indicated women are more likely to deliver their babies in local clinics or under the guidance of local midwives. The women who graduate from Traditional Birth Attendant training are given midwifery kits that include first aid supplies and other tools to ensure healthy, safe and sanitary births.

The work of Women for Women International is ensuring that women no longer have to wait to receive medical attention, and are not met by barriers to health and wellness simply because they are women. Gender discrimination is fatal when it means women die as a result of poor or non-existent healthcare. In many rural communities in Afghanistan , a husband taking advice from his wife is unprecedented. But, like the woman whose husband built a hygienic toilet based on her suggestion, the graduates of the training are now sources of knowledge in their communities, giving the women new-found respect among all community members, even men. The health training also empowers women to help one another. They are able learn from each other and build community among themselves, giving them strength and hope to live each difficult day in conflict-ridden Afghanistan .