By Rukhshana Media’s reporters
It was midnight when another wave of pain struck. Begum, 35, thought it was finally time for her child to be born, but there were no signs of the baby coming.
“I woke my husband and told him to get a car to go to a hospital. He rented one from our neighbours,” Begum said.
The mother of four travelled while in labour from Ridkhord area in Badakhshan’s Zibak district to the Shahid Ustad Burhanuddin Rabbani Hospital in the provincial capital Faizabad.
Her fifth child, struggling to be born, did not survive the journey.
Begum lived, but many mothers in similar circumstances do not.
Abdullah is currently waiting to hear if his wife will survive their child’s birth.
He and his wife, residents of the province’s Yafta-e-Bala area, came on foot to the central hospital in Faizabad when their baby was due to be born.
“In Yaftal-e-Bala, there are four health centres. However, because of inadequate medical facilities and no doctor available, we had to walk for four or five hours to Faizabad for delivery,” Abdullah said.
“We encountered many challenges along the way, but I couldn’t do much until we reached the hospital.”
Doctors said that because his wife had walked a long distance, it led to severe bleeding and possibly harmed the baby in the womb.
“The mother’s condition is not good and there is little hope for the baby to survive,” Abdullah said doctors told him.
Afghanistan’s deadly statistics for mothers
According to the latest World Health Organization (WHO) report, each day 24 mothers and 167 newborns in Afghanistan lose their lives due to complications in pregnancy and childbirth.
It’s the highest rate in the world.
“The condition of mothers is highly alarming, particularly for those who travel from remote areas and cover long distances,” a specialist at the Shahid Ustad Burhanuddin Rabbani Hospital, who spoke on condition of anonymity, said.
Having worked in Badakhshan for 22 years, the doctor said that the shortage of healthcare services, especially in remote areas, leads to significant health risks for women.
He recalled a patient who arrived at the hospital from Darwaz district about a month ago after travelling for three days.
“Due to the long journey, the patient’s womb had ruptured along the way, leading to the loss of the baby. The doctors only managed to save the mother’s life with great difficulty,” he said.
Discrimination leading to more deaths
There are concerns the situation is only getting worse as the Taliban place more restrictions on women’s mobility and access to support, and the weakened economy sees healthcare facilities struggle to deliver services.
The WHO reported that in 2023, about 428 health centres were closed because of budget constraints.
Dr Suraya Dalil, WHO’s Director of the Special Programe for Primary Health Care and former Minister of Health in Afghanistan from 2010 to 2014, said that Afghanistan has become one of the most perilous countries for mothers due to insufficient healthcare resources.
Dr Dalil told Rukhshana Media that the Taliban’s discriminatory policies make women more vulnerable in accessing healthcare.
“There is a regime in Afghanistan that systematically discriminates against women. For instance, a few months ago, a directive was sent to the central hospital in Ghazni province stating that women without a male companion would not receive treatment,” she said.
“Similarly, in Herat, a directive was issued prohibiting ultrasound services for women at the central hospital.”
She said that ultrasound examinations are crucial for diagnosis and timely treatment decisions, services that have unfortunately been restricted for women.
Recently, the Taliban supreme leader issued an order for all female employees to receive a reduced monthly salary.
“Recently, we’ve witnessed female employees being allocated a monthly salary of only 5,000 afghanis (US$70), disregarding their rank, experience, and job responsibilities solely because they are women. This is systemic discrimination,” she said.
“The impact of the Taliban’s actions on women extends beyond just health issues. It has multidimensional implications.”
Health professionals strike over reduced salaries
This month several doctors, nurses, and midwives in Kabul hospitals staged a strike in protest of this decision by the Taliban leadership.
At least four female doctors and staff from hospitals such as Wazir Mohammad Akbar Khan, Shaikh Zahid, and Sehat-e-Tefl, speaking to Rukhshana Media, said they cannot meet their basic living needs with the salary recently set by the Taliban for all female employees.
Homa*, a physician at Wazir Mohammad Akbar Khan hospital, said their protest lasted only three hours after the hospital’s Taliban-appointed director dispersed them with threats.
Orphaned children left to raise each other
Hanifa, 21, a resident of Sarjai area of Panjab district of Bamyan province now takes care of her two younger sisters and two younger brothers after the death of their mother.
She said that there are no clinics in their village or nearby areas, which is why her mother had to give birth at home.
“My poor mother cried in pain, clutching her back, yet she continued to bake bread. With my father and two brothers away working on farmlands, there was no man at home. My mother, assisted by our neighbor, who was a local woman, gave birth at home,” she said.
“She always delivered her children at home and was used to it, but this time, one of the twins didn’t come out, and her bleeding was so severe that the entire house was stained with blood.
“After giving birth, my mother survived only two hours. Despite our efforts, we couldn’t deliver the second twin because there was no accessible vehicle, and my father wasn’t home to help us.
“When my mother realized her bleeding wouldn’t stop, she urged us to take good care of her daughter, who was a baby girl. She remained conscious for two hours, growing weaker with each passing moment until she eventually lost consciousness.”
Karima Sadiq* a gynecologist specializing in obstetrics in remote areas, said stories like these are increasingly common.
“Sadly, since the Taliban seized power in Afghanistan, I have witnessed a rise in maternal deaths during childbirth, particularly in villages and districts. Every 24 hours, 24 to 26 mothers are losing their lives during childbirth, highlighting a disturbingly high maternal mortality rate.”
The United Nations Children’s Fund (UNICEF) recently reported that one-third of women in Afghanistan give birth without access to essential healthcare facilities, and only around 67 percent of deliveries in Afghanistan are supervised by healthcare professionals.
According to UNICEF’s report, it is recommended that pregnant women visit a doctor at least four times before delivery, but only a third of women in Afghanistan adhere to this recommendation.
UNICEF stated that that if a mother gives birth outside of a healthcare facility and without access to a skilled health professional, her life is significantly endangered.
Note*: Names are changed due to security reasons.
