On average, an Afghan woman gives birth to more than six children, and dies before her 45th birthday. Afghanistan has the second highest maternal mortality rate in the world, with one in nine women dying during childbirth – that’s one every 28 minutes.
International Medical Corps is battling these grim statistics in an effort to improve the lives of Afghan women with a variety of programs focusing on women and children.
At the Rabia Balkhi Hospital (RBH) for Women in the capital city of Kabul, International Medical Corps since 2004 has been addressing the shortage of adequately trained midwives and lack of access to emergency obstetric care.
Dr. Mohsena Sediqi, trained by International Medical Corps at the Obstetrics and Gynecology unit at RBH, is now a trainer herself and notes the training program has vastly improved the hospital.
“I have been a trainer in RBH for two years - I’m one of about 15 trainers here,” says Dr. Sediqi. “We were all trainee doctors here and we have all gone on to be trainers so that we can pass on our knowledge to doctors coming up underneath us. When I first came to work here six years ago there was no training for doctors.”
Dr. Sediqi says the treatment and post-operative care patients receive is vastly improved with many important operational procedures implemented at the hospital in the last ten years that were never adhered to before.
“The doctors training us have taught us many new things - skills I can pass on to the doctors I’m training,” she adds. “I have learned a lot of new techniques for performing operations.”
Nine out of ten women in Afghanistan give birth without the help of a trained birth attendant meaning complications often have fatal consequences.
Dr. Sediqi says that emergency obstetrics plays a big part in her role at RBH: “My ward is normally the emergency room. If a woman has to have an operation I am always around in case there is a problem and the trainee doctors need advice. I also have responsibility for the post-operative room. Women who have had a Caesarean section will first go to the recovery room where they can be closely monitored for 24 hours. If their condition remains stable they will then be sent on to the post-operative room.”
General standards at RBH also have been markedly improved by International Medical Corps’ program.
“The hospital is a lot cleaner than it was before,” says Dr. Sediqi. “Workers salaries are being funded by International Medical Corps so that wards and operation rooms are now cleaned regularly.”
The challenges of providing healthcare in Afghanistan – outdated educational standards for medical and nursing programs, a lack of infrastructure and insufficient access to quality drugs and modern medical tools - are compounded by the ongoing violent conflict.
“There was a long period when I was first training as a doctor that there was no school because of the fighting,” says Dr. Sediqi. “I am married with five children and my husband is also a doctor. He works south of Kandahar, which is very dangerous. I get very worried about him and his security there.”
With the help of Dr. Sediqi, International Medical Corps’ work at RBH benefits more than 27,000 women and more than 13,000 children annually. With 27 trainers from International Medical Corps and RBH, the program trained 17 attending physicians, 52 resident physicians, 104 midwives, six pediatricians and 40 health professionals, including pharmacists, anesthetists, lab technicians and radiologists.
RBH is part of International Medical Corps’ countrywide comprehensive program designed to increase the number of trained midwives and reduce maternal and infant mortality rates.
The Community Midwifery Education (CME) project in Parwan Province was named best in the country by the National Midwifery Education Association Board (NMEAB) while the Khost CME program, taken by women such as Rabia, was awarded third place.
More than 2,000 Afghan midwives have completed International Medical Corps’ programs since 2003.
International Medical Corps implemented the Prevention of Post Partum Hemorrhage (PPPH) Demonstration project in the Qarabagh and Guldara districts of Kabul province in 2006 and 2007. The project focused on educating women and their families about postpartum hemorrhage and providing counseling on birth preparedness and complication readiness - demonstrating the successes in doing so when compared to areas that had not received such education.
International Medical Corps also maintains eight refugee returnee assistance clinics in Kunar and Nangahar provinces, and prior to this an emergency obstetric centre, a regional training center, the Nangarhar Medical School library, and two community resource centers and libraries in Laghman and Kunar.
The current program minimizes mortality and morbidity rates for vulnerable Afghans, including women of childbearing age and young children, and works to improve overall living conditions. This has been achieved through increasing access to community-based health care, with a maternal/child focus, for returnees and the local populations. The program also ensures educational services to women and communities through community training on health issues.
In addition, in 3 provinces in the Eastern Region, International Medical Corps provides outreach and awareness on Gender Based Violence (GBV) and its prevention, including training on clinical management of GBV to healthcare providers.
Despite the unsettled security conditions, International Medical Corps has tended to Afghan health care needs for over a quarter of a century. Today, we are the top non-government organization working in Afghanistan in the field of hospital management.