Young Afghan women train as midwives as country’s maternal mortality rate is amongst the highest in world

Streaming HUBMarch 18, 2023

In a small village surrounded by velvety white snow-capped mountains in Afghanistan’s Bamiyan province, Aziza Rahimi mourns for her baby boy, who she lost last year after a harrowing birth without any medical care.

Rahimi, 35, said, “When I lost my child, it was very difficult for me. As a mother, I carried the child in my womb for nine months, but then I lost him, it is very painful.”

The rugged and remote beauty of the village in Bamiyan’s Foladi Valley brings life-threatening obstacles for expectant mothers. A narrow road to the village with few vehicles sometimes gets cut off by snow, cutting off lifelines to hospitals, clinics and trained health workers.

However, a potentially life-saving improvement is on the way. Rahimi’s village is one of several villages around Bamiyan that have sent 40 young women to the provincial capital to train as midwives for two years, after which they will return home.

Doctors and aid workers say isolation can become a death sentence in any difficult birth, contributing to Afghanistan’s extremely high maternal and infant mortality rates, among the worst in the world.

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The United Nations estimates that an Afghan woman dies every two hours during pregnancy and childbirth, making Afghanistan’s maternal mortality rate among the highest in Asia.

The United Nations Refugee Agency (UNHCR) has led the trainee midwife program in conjunction with the Watan Social and Technical Services Association, a local charity. They hope to expand the program, which also takes place in neighboring Daikundi Province.

Since taking office in 2021, Taliban officials have banned women from universities and most charity jobs, but have made an exemption in the healthcare sector and the UNHCR says local health officials are supportive of the project.

Aziza Rahimi, 35, poses for a photo inside her home in Foladi Valley on March 2, 2023 in Bamiyan, Afghanistan. Rahimi gave birth, but her child died shortly after.

Aziza Rahimi, 35, poses for a photo inside her home in Foladi Valley on March 2, 2023 in Bamiyan, Afghanistan. Rahimi gave birth, but her child died shortly after. (Reuters/Ali Khara)


“With no means of transport when roads are blocked, people also use donkeys to carry patients to clinic centres,” said Mohammed Ashraf Niyazi, head of UNHCR’s Bamiyan office, but sometimes Never even gets the chance to do so.” ,

Rahimi, who has five other children, said the question of riding a donkey did not arise when she woke up in pain four months ago while nine months pregnant. After stumbling and bleeding for two hours when she could not find a car or an ambulance to take her husband to the hospital, she gave birth to the child there.

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The child died shortly afterwards. It was too late, an ambulance arrived.

Women giving birth in the main city hospital of Bamiyan experience a very different situation, where trainee midwives work alongside the staff, and with the help of an instructor, assess and guide pregnant women, giving birth and learn to provide postpartum care.

“We want to learn and serve the people of our village,” said a 23-year-old intern, who walks two hours every day to the hospital. UNHCR asked the trainees not to be named for protection.

In a small hospital clinic where dozens of women are waiting outside, a trainee midwife guides a woman through a book of images on how to prepare for birth under the watchful eyes of two trained health workers Does

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Any women at risk of complications are admitted to the maternity ward in a nearby building, where another trainee midwife takes the blood pressure of a pregnant patient suffering from an infection. She routinely checks on a woman who had given birth six hours earlier, her baby girl lying next to her.

Many trainee midwives, some of whom have young children of their own, have faced logistical and financial challenges, often traveling great distances, or living away from home, to attend the programme.

“At first, I didn’t want to study nursing or become a midwife, but after experiencing problems and pain during my pregnancy, I wanted to study midwifery,” said a 20-year-old trainee, mother of one child 18 month old son who was struggling to make ends meet in his village. She added that many women and families in remote areas do not have the information and support they need to prepare for a safe delivery.

“We have to change such attitudes… I want to go to remote areas to treat women who face problems.”


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