Birthing a new generation of hope

Afghanistan has the fourth highest infant mortality and maternal death rate in the world (Unicef). Superstition, folklore and the entrenched social systems of a country at war for the past 25 years have meant that most women are denied basic rights.

Research has found that almost half of all deaths of Afghan women aged between 15 and 49 are caused by complications during pregnancy, or by childbirth itself. It also found that 87 per cent of the maternal deaths they investigated could have been prevented with better medical care.

Here, a BMS nurse in Afghanistan tells us how her work has been helping many women and their babies not to become another tragic statistic.

A cup of tea and a miracle

A lady came down the corridor supported by two female relatives - she had been in labour for three days. A young 18 year-old having her first baby had travelled for hours from their village.

Because of the tradition of not eating or drinking in labour once the pains begin, she looked exhausted and dehydrated. She was pale and frightened,

With one of our students I laid her on the mattress on the floor of our delivery room. She hardly had the energy to reply to my questions while I was examining her.

The baby was lying in the right position, the head was low down and the baby's heart was strong - which was encouraging. As she was ready to push the baby out we got her to drink some hot, very sweet tea, to give her some energy.

Her elderly mother-in-law sat behind her to support her. All the signs were good that it wouldn't take long to deliver this baby, but that wasn't to be for her exhausted body.

After a long hard struggle the baby was born - limp and white. There was very little equipment and no oxygen to help us, but after about six minutes he cried and soon was in a good condition.

We were glad the family had come to us as, if they had kept her at home, as many do, it was probable that neither mother nor baby would have survived.

Afghan Village

Sitara

Sitara (meaning "star"), was admitted to the hospital. Her mother had come from a village way up the valley, and it had taken her a long time to get to us.

There are limited tests available to us here, and the only thing that was obvious was that she was seven months old and extremely jaundiced.

Reasons why Afghanistan has such high infant mortality and maternal death rates:

Many mothers' pelvises are too small for birth because they are young - with nearly two-thirds of girls married before age 16.
According to UN statistics about two-thirds of pregnant Afghan women are malnourished.
Millions of women across rural Afghanistan live in a constant cycle of pregnancy and birth through most of their adult lives with little or no medical care. It is not uncommon to meet mothers of ten or 15 children, and they seem old before their time from the physical strain.
Untrained birth attendants called "dayee" help 80 per cent of Afghan women to give birth. Dayees sometimes rely on folkloric techniques eg biting on hair to dislodge the placenta (that may appear to work in simple births but are of little use when things go wrong). More dangerously, they make use of oxytocin -- an injectable hormone that can be bought without a prescription to induce labour - even when the baby just cannot fit through the pelvis.
If a mother dies during or after birth, a lack of medical knowledge and superstition amongst the rural community often spawn rumours that she must have been "bad" to deserve such a fate.
Women are under pressure to have large families. So much so that some women medicate themselves with powerful fertility drugs, purchased in Kabul, to help stimulate ovulation.
Many rural women give birth at home, even when complications arise, as the difficult terrain and lack of infrastructure can mean clinics are days away. Some women have bled to death on donkey rides of several days to find help. In many places there are no cars, no roads, no transport and security is not good.
In a custom entrenched during the 1996-2001 rule of the Taliban, women had to give birth under the all-covering burqa, that most still wear.
Some men still refuse to allow their wives to go to clinics where only a male nurse or doctor is present.

On talking to her mother, we were told that she had had two other children and they had both died of the same condition.

The amazing thing was that Sitara was such a happy child; apart from her colour, she looked and behaved as though she was really healthy. She was feeding from her mother and even smiled when a strange looking foreigner talked to her!

We kept Sitara in for a few days but couldn't make a diagnosis, so we sent them home. We then contacted a hospital in Kabul that would take children without any cost to the family. We pray that they will come back and then be willing to take the long journey to Kabul so that tests can be done.

The mother was so pleased that we were willing to do something to help her. This is why God has put us here - to be Jesus Christ to the poor people around us.

We pray that, in showing his love and compassion to those who are so marginalised, some will eventually "see our good works and glorify the Father in heaven".

If you would like to support work like this in places of great need, click here.

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Afghanistan News

News from 2008