Afghan motherhood in a fight for survival

Posted: 6 June 2003

Afghanistan has among the world's highest rates of both infant mortality and maternal death because of difficulties during pregnancy or during childbirth, says a new study.

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 10 or 15 children, and they seem old before their time from the physical strain.

The maternal mortality rate in Afghanistan is the highest in the world, according to Dr Peter Salama, director of the United Nations Children Fund (UNICEF) in Afghanistan.

The final results of a study conducted last year by UNICEF and the Atlanta-based Centers for Disease Control and Prevention show a national ratio of more than 2,000 maternal deaths per 100,000 live births.

Almost half of the deaths of Afghan women from 15 to 49 are caused by complications during pregnancy, or by childbirth itself, the study found. The researchers state that 87 per cent of the maternal deaths they investigated could have been prevented with better medical care.

Death rates vary significantly between Afghanistan's urban and rural populations, with the rural areas, where there are few skilled medical professionals and no comprehensive medical care, far worse off. Only 6 of Afghanistan's 32 provinces have hospitals that can perform blood transfusions and Caesarean sections.

In a society in which women rarely leave their family compound and never show their face to a male other than their husbands or blood relatives, Afghan village women rarely see a doctor at all. The few doctors who work in rural areas are invariably male.

Female doctors and other health workers tend to work in the cities, given the cultural restrictions on women's movements in villages. Most village women, for their part, are illiterate and cannot qualify for any medical work beyond that of assistant midwife, said Zakia Kohistani, an Afghan midwife who trains women through A.M.I.

Foreign health experts working in Afghanistan foresee no quick solution to the alarming mortality rates of mothers and young children.

Inadequate medical care, poor nutrition; stunted growth, which causes difficulties giving birth; a lack of education; teenage marriages and women's low social status contribute to this cause.

Source: PlanetWire; New York Times, 25/May/03