Afghanistan the worst place to give birth

As Madina Rashidi marched along 1,000 other midwives from around the world in South Africa, she wanted to deliver a message: Save the women and children in Afghanistan.

The 19-year-old midwife from the province of Jawzjan in rural Afghanistan told me during the midwifery congress in June that she chose to become a midwife to avert deaths from lack of skilled deliveries. The number of proper health services and midwives or skilled birth attendants are minimal or next to nil in places where Rashidi belongs.

A recent article in TIME magazine, citing Save the Children, reports that Afghanistan is ranked as the worst place to give birth, followed by Niger and Chad.

TIME writes: “In these countries, 60% of all births are not attended to by skilled health professionals. On average, about 1 in 23 mothers are expected to die from pregnancy-related causes. Children also die young and suffer from malnutrition, and education for girls is poor.”

“An Afghan woman is 225 times more likely to die in childbirth than a woman in the UK,” a statement in Save the Children’s website reads. The non-governmental organization has been helping Afghans and Afghanistan since 1976.

The statistics from Oxfam, another non-governmental organization, is startling: In Afghanistan, a woman dies every 27 minutes due to pregnancy-related complications; 1,600 maternal deaths per 100,000 live births; and in the remote area of Badakhshan province, the rate is 6,500 per 100,000 – the highest recorded rate of maternal mortality in the world.

In rural Afghanistan, according to the report in TIME, there is a scarcity of midwives. Gulpari, the midwife mentioned in the article is one of the four midwives for at least 40,000 people.

But people like Pashtoon Azfar, a midwife for 15 years in Afghanistan and also the founder of the Afghan Midwives Association, believes in change.

As she spoke in the midwifery congress in Durban representing her country, she mentioned about the progress.

From 17 midwifery programs in 2005, there are currently 32 midwifery education programs in Afghanistan’s 34 provinces.

The number of working midwives has also soared, from 467 in 2002 to 3,000 with an additional 800 in training.

“By the end of 2011, we’ll have another survey [on maternal and child health] and you’ll see the result of midwifery education,” said Azfar, who is also known as the Nightingale of Afghanistan.

According to the TIME story, the Afghan Safe Birth Project funded by the US Department of Health and Human Services has helped reduce deaths by 80%. But the budget cuts by the US in April could mean more problems on the frontline.

A country ravaged by war and torn by poverty, though millions of aid seems to be pouring from around the globe, women and children are still dying, that too at a rapid pace. And it’s not bombs that are killing them.

According to the State of the Word’s Children Report 2009 by UNICEF, that illustrated a 2005 data, South Asia constitutes 35% of the world’s maternal mortality rate.

But people like Rashidi show some hope, if not on a country level then on a community level.

And it was for her genuine effort and contribution to improving maternal and child health in her country that the young Afghan was awarded the Save the Children Midwife Award in South Africa.

And if we’re really talking about development, the world surely needs more people like Rashidi. The world certainly needs to be talking about saving the mothers and children.

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