22-year-old Sharifa is one of the thousands of Afghan mothers struggling to overcome the hurdles that are posed by a healthcare system weakened by decades of war, poor facilities, and social and cultural barriers that are difficult to break.
WHEN THE TALIBAN ATTACKED my village, I and many others fled to seek refuge in the Panjshir Valley. We walked through the night, and all of the following day, the constant dull thud of bombs echoed around us. Some of those we were escaping with died; we saw their bodies tumbling down the valley-side into the river. There was nothing we could do to save them, we had no choice but continue walking to find safety. Without food, water, warm clothes, or blankets to protect us from the bitter cold of the night, we kept walking.
We endured these horrible moments, and survived. While working in a government field hospital I heard that nearby EMERGENCY was building a surgical centre, and that they were hiring staff. I went to EMERGENCY’s Surgical Centre in Anabah for an interview the following day. I was immediately told the rules of the hospital: open 24/7, no discrimination between men and women, treatment for all war victims without any distinction. Following a successful interview, I was given one day to decide whether to accept the job. I consulted my family who were very supportive and suggested I accepted the offer.
I finally had a job.
When the fighting between the Taliban and the Northern Alliance finally stopped the number of war casualties arriving at the Surgical Centre decreased. This freed us to focus on other pressing issues, such as the extremely high maternal and infant mortality rates in Afghanistan. It was clear there was a need for highly specialised and accessible medical and surgical care for women and new-borns. And this is why EMERGENCY opened its Maternity Centre in Anabah.
OPENING THE MATERNITY CENTRE
On the 1st of June 2003, the Minister of Health, the local mullahs, and the village chiefs of the entire valley came to the inauguration of EMERGENCY’s Maternity Centre; the first and only specialised and free-of-charge centre in the region. In the first few months after the opening, only a few women were coming to the Maternity Centre to give birth. Most of our patients would consult EMERGENCY’s gynaecologists on the overall pregnancy but they would continue to give birth at home. At that time we would often visit EMERGENCY’s First Aid Posts (FAPs) – built in the most remote areas of the valley – and talk with local women. We told them about the newly opened Maternity Centre, completely devoted to women like themselves, and we trained and employed local women in our FAPs to offer guidance, advice, and referrals for pregnant women.
We also spoke with their husbands about the importance of medical assistance during pregnancy. At that time the roads connecting the villages to the Maternity Centre were in utter disrepair, many destroyed during the fighting. Only a few people owned cars. In view of this we distributed ‘delivery kits’ to every village; made up of gloves, sterile scissors to cut the umbilical cord, sterile gauzes, sterile compresses, soap and plastic sheets. We trained women in every village on how to use the kit and on how to prevent infections in mothers and new- borns.
With the months passing the number of patients at the Maternity Centre continued to increase. We began to deliver more and more babies. We saw a greater number of hospitalisations due to complications during pregnancies. We also began to see the hospitalisation of new-borns, with complications related to the delivery or manifesting themselves during the first few days of life. The population of the valley quickly understood the importance of EMERGENCY’s Maternity Centre. They trusted us and spread the word within their villages. Since its opening, the Maternity Centre has enabled mothers and new-borns to receive specialised, free-of- charge, medical and surgical treatment, effectively lowering maternal and infant mortality and spreading awareness of the importance of women-centred healthcare. Our patients’ husbands also feel involved: they understand just how important it is to take appropriate care of their pregnant wives, even only by taking them to our Maternity Centre or to one of our FAPs for a check up to make sure that the pregnancy is going ok. This is an extraordinary success in a country where, until just a few years ago women were not allowed to go to the hospital, not even in life-threatening situations.
But the merits of the Maternity Centre go beyond the surgical and medical treatment: for women in Panjshir the Maternity Centre has become a symbol and place of emancipation. Here they now have the chance to work, to receive a high standard of training, and to have a role and a status within their communities that goes beyond being a wife or a mother. The Centre has also made a significant impact on the next generation too; following the example set by the midwives at EMERGENCY’s Maternity Centre in Anabah, many young girls in the valley have started enrolling in nursing school in the hope of one day joining the profession.