Afghanistan News Wire

Afghan health system fails women as maternal deaths increase

October 19, 2004

Published on Oct. 19, 2004. at The Star online.

Faizabad, Afghanistan – Lying in the hospital bed with her baby on her breast, Momagul is one of the lucky ones.

Her husband allowed her to go to hospital, her home was only 20km away, and she received medical attention in time to save her life.

“She was bleeding heavily after delivery, and we gave her a blood transfusion,” said Dr Hajira Zia, head of gynaecology and obstetrics at the Maternal Care Hospital in Faizabad.

In the remote and mountainous province of Badakhshan, of which Faizabad is the capital, more women die in childbirth than any other place in the world.

Despite having the right to vote in Afghanistan’s first direct presidential poll held recently, many women are still fighting for a more basic right – life.

Some 6 500 mothers in every 100 000 die giving birth in the north-eastern province compared with 2 200 in Kandahar, 400 in Kabul and only 12 in the United States.

Afghanistan is one of the worst places in the world to become pregnant.

A United Nations Children’s Fund (Unicef) survey in 2002 put maternal mortality in four Afghan provinces at 1 600 per 100 000 live births, twice as bad as Niger, 12 times worse than Iran and 130 times higher than the United States.

In this part of the world, healthcare often takes second place to honour, and men are reluctant to allow their female relatives to be attended to by strangers.

“There are some districts in Badakhshan where husbands don’t give permission for their wives to come to the city to see a doctor, and there are no doctors in their villages, so they die,” said Dr Anis Akhgar, director for women’s affairs in the province.

Geography is another big obstacle in Badakhshan and other remote parts of Afghanistan, where donkeys are a sought-after form of transport.

In districts such as Rah, even with permission from their menfolk, women are unable to trek over the perilous mountain passes to reach a hospital when they’re pregnant.

Poor nutrition and intermarriage lead to birth defects and osteoporosis, and with contracted pelvises due to a lack of calcium, many women in this mountainous province die in labour, Zia said.

The Maternal Care Hospital was built with funds from Unicef and foreign aid agencies with 10 beds, and Zia and her staff often treat 30 patients at a time with no incubators or high-tech equipment.

But since the French charity Medécins Sans Frontières shut its operations in July after five of its staff were murdered in western Afghanistan, Zia has even less to offer those who do make it to hospital.

Sitting in her office, both Zia and Akhgar said the October 9 election was a good thing, but little had changed for women since the fall of the Taliban.

“I don’t feel safe to walk outside without a burqa on,” said Zia, sitting under a picture of her wearing a suit, her head bare, receiving an award.

Five people were killed yesterday when a landmine hit a vehicle being used by election staff in south-east Afghanistan.

The vote count entered its fourth day with the chief rival of interim leader Hamid Karzai claiming that fraud had helped Karzai amass a 45-percentage-point lead in preliminary results from the poll.

Read the original article here.