Friday, 22 Mar 2019

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Afghanistan’s maternal mortality ratio decreasing

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Health Desk--- May 23, 2016: Afghanistan’s maternal mortality ratio was one of the highest in the world after the Taliban insurgents gained control in 1996 and put restrictions on women’s health care. 

Women were not allowed even in emergencies to go out to hospitals without a male accompanying them. They were also barred from receiving care from male health workers.

For every 100,000 live births, some 1,600 women died from causes related to pregnancy or childbirth in 2002.

But it dropped sharply to 400 deaths per 100,000 live births in 2014 when the political situation changed and women-led midwifery services was established.

But how easy was it to be a midwife in Afghanistan?

“You’ll not find a single midwife without a personal reason or story,” President of Afghan Midwifery Association Feroza Mushtari said, speaking to newsman on the sidelines of the Women Deliver conference that ended in Copenhagen on Thursday.

The 30-year-old recalled an evening 15 years ago.

“I was a school student. Women were not allowed to go out without ‘maharam’ that means you must be accompanied by a male escort. This was the Taliban rule.

“We were living in Kabul. But my father was not with us at the time. One evening it was dark, cloudy when someone knocked the door and asked for help.

“My mother opened the door to see our neighbour was asking for help. Her daughter-in-law was in labour but they did not have any male in the family to accompany them to the hospital.

“They were asking my mom if there was anyone who could help. She was crying and begging us for help.

Mushtari went on: “I saw that she was bleeding. She was twisting and screaming. I asked my mom ‘Is she dying?’. But my mother cannot help them.”

She said it was when she decided to pretend to be a boy by changing her clothes to take them to hospital.

“My mom said, ‘No, it’s not possible. But in a few minutes I convinced her. I took them to hospital. On the way, I still remember I tried to do what a boy would do in Afghanistan.

Feroza-Mushtari-(left).jpg“In Afghanistan, a male sits in the front seat of a bus. I did the same. I was trying to practise talking like a boy. Thankfully, without any disruption, we went to the hospital and the lady gave birth to a baby boy.”

“I could manage the situation and she was safe. Then I decided to be a midwife because (I thought) if such condition (Taliban regime) continued and women were not allowed to get basic healthcare, then someone has to be there to help them.

“Had I been a midwife at the time, I would have been able to manage the case even at home. This is what motivated to take to this profession.”

“You cannot find any midwife without a personal reason or motive in Afghanistan,” she again said, “they might have lost their own sisters, daughters or mothers before they became a midwife,” Mushtari added.

How is the situation right now?

Today it is much better, she said.

“When the Taliban fell, we had only 467 midwives serving the entire country without updated knowledge and skills. Now we have around 5,000 midwives who are skilled and qualified.”

“Now we are accepted in society and our profession is respected, which means we are contributing to the Afghan economy.

“Midwives are now the breadwinners of their families. So the situation is better despite bad security conditions.”

But Mushtari said their battle has not ended.

There are gender issues and patriarchal values they are fighting against every day.

“When a midwife gets married, she is no longer a decision-maker of her own life. Her in laws and husband may ask her to stop doing the job,” said Mushtari who still single.

The UN agency, UNFPA, considers Afghanistan as a regional leader in the midwifery profession and a model for reducing maternal mortality in post-conflict settings.