Reports

Malalai Hospital Saves Life of 8 day old Afghan Girl

July 5, 2003

By Dr. Anne Brodsky
July 2003

Little Ghatol* was only two days old when her mother realized that something was wrong, but it took two more days to convince the men in the family that she needed to go to the hospital, and to find her way to Malalai hospital where they diagnosed that not only was her umbilical cord, which had been improperly cut in a home delivery, infected, but the little girl had developed sepsis, a blood infection that was affecting her whole body and putting her short life at grave risk. Now at 8 days old and four days after starting treatment at RAWA’s Malalai hospital, she was finally showing a sucking response, giving a good sign that the regimen of round the clock IV antibiotics and fluids offered free of charge at Malalai had saved her life. Although her life was saved, her story and that of her mother shows the continuing need of Afghan women and children for a service like RAWA’s Malalai Hospital in Islamabad Pakistan.

A Risky Pregnancy

According to the staff of Malalai, doctors and nurses knew from the start that this was a pregnancy that needed tracking and care, and they did the best they could to provide this to Ghatol’s mother, Leyma, the mother of three small children. Leyma was already receiving free care from the hospital for her high blood pressure, epilepsy, and kidney problems, all of which made pregnancy risky for both mother and baby, and additional indications that this baby would be a breach birth all made the hospital staff strongly recommend to Leyma and her family that the birth should occur at Malalai. But in this traditional, uneducated, rural Pushtun family, the health concerns of a woman and baby are not always given the high priority that the staff at Malalai hope and work towards. So when Leyma went into labor she was not taken to a hospital, but rather helped to give birth at home by an untrained helper. The staff is quite clear that it was the refusal of not only the male family members, including Leyma husband, father, and father-in-law, but also of her sister-in-law and mother-in-law that led to this home delivery. Leyma, perhaps in an attempt to avoid trouble with her family, said, apologetically, that although she wanted to give birth at the hospital, it was only because there were no men at home to accompany her to the hospital when she went into labor at 1AM that she gave birth at home. In either event, whether a family’s refusal of necessary care, or a social condition that makes it impossible for a woman to seek necessary health care without a male family member to accompany her when she leaves the house, the conditions that lead Afghan women to have among the highest death rates from pregnancy and child birth in the world are clear.

A Risky Delivery and A Search for Care

Although neither Malalai staff nor Leyma are sure what happened next, and the midwife and family members who are present aren’t talking, it is sure that after a risky breach delivery little Ghatol’s umbilical cord was not only improperly cut, but cut by something that was not even clean, all leading to the sepsis infection that threatened to take her life before it had even begun. Once Leyma recognized that Ghatol was not responding like any of her other children had in their first few days of life, it took 3 days to realize and convince the family that medical care was necessary. The closest hospital was a local Pakistani public hospital where they immediately wanted to admit the infant, but when the family heard what the charges would be for admission, treatment, medicine and food, they knew they couldn’t possibly afford it. So they found a way to bring the dying infant the hour and half trip to Malalai Hospital, the only hospital in the region that treats Afghan women and children at no cost.

The Best of Care

Now after 4 days of intensive treatment little Ghatol seems to be pulling through. And it is not only Ghatol that has benefitted from her time in the hospital. During these days of treatment for the baby, Leyma has also been getting help through the staff’s educational services. They’ve talked with her about the importance of keeping her own and the children’s clothing clean to ward off infection and disease, about the importance of bathing and keeping a clean house to improve the family’s health, about why glass bottles are better than plastic and how to make them clean and safe for her new infant daughter with a new lease on life. When asked about the quality of care at Malalai, Leyma kept her hand gently on her daughter’s tiny uncovered foot while she said that her daughter was doing much better because of the medication offered and the care that doctors and nurses took with both daughter and mother here. When told that her daughter was looking much better and might soon be ready to go home, Leyma offered a shy smile, knowing that it was her instinct as a mother that had finally gotten her daughter the care she needed in the nick of time, and the free medical services and dedicated staff at Malalai hospital that had saved her daughter’s life.

* Names have been changed to protect the confidentiality of Malalai Hospital patients

Anne Brodsky has just returned from a month in Pakistan and Afghanistan and is the author of the recently published book, With All Our Strength: The Revolutionary Assocation of the Women of Afghanistan.