Afghanistan is one of the countries with the highest rates of maternal and newborn mortality. Therefore, the need for specialized care is crucial. Insecurity is one of the biggest challenges facing every midwife and pregnant woman in this country.
This is how the situation summarized by Zahra Kochezad, the supervisor of midwives at "Doctors Without Borders" in Afghanistan, and she personally witnessed this painful reality, according to an article she wrote and published on the organization's website.
The maternity ward run by the organization at Dasht-Burji Hospital in the capital was attacked on May 12 last year by an unknown attack, which killed 24 people, including the midwife Mary and 15 mothers, ten of whom were receiving postpartum care, and five mothers died with Embryos who did not see the light.
And Zahra, who is driven by her passion to help women deliver their babies because of her strong desire to serve her people, has chosen to engage in work in this field. What convinced her of this choice was reinforced by the profession of a number of women in her family in this profession. Some of her aunts and the daughters of her aunt work midwives in different hospitals in Kabul, and they in turn chose this profession because of their desire to serve others, especially women, and because they knew that most deaths during childbirth as a result of complications can Avoid it.
Very difficult
"Our work is very difficult compared to anywhere else, we help women to have a new life in this country under more severe conditions. Every year, about 130 million babies are born around the world, which means that millions of women need help during pregnancy and during labor," Zahra says. In my opinion, procreation is one of the greatest moments and most sensitive situations in a woman's life.
Although the situation has improved somewhat over the past years, Afghanistan is still experiencing one of the highest maternal and newborn mortality rates in the world. Therefore, the need for specialized care is extremely important.
In Switzerland, for example, five mothers die for every 100,000 newborns. In Afghanistan, this number jumps to 638 women who die, and this number does not include of course the 15 mothers and the five children who did not have the opportunity to come to the world, and who were systematically killed in the maternity ward where she used to work as a flower.
Terror in the maternity pavilion
"How can I forget that day, the weather was beautiful and the air is refreshing, and I felt peace pervaded my being as soon as I was," says the supervisor of the midwives of the maternity ward run by "Doctors Without Borders" at Dasht-Burji Hospital in Kabul, where the attack took place on May 12. "Once I arrived, I saw my colleagues working, all anxious and excited to start a new work day to provide services and care for pregnant women."
"It is true that we are accustomed to the daily tragedies in our societies, but none of them would have made us ready in any way to face the terror that awaits and awaits us," Zahra said.
The maternity ward is one of the few places where women drive. The terrorists entered an area where even men were not allowed. They stormed the maternity ward, armed with weapons, and started shooting, killing the expectant mothers and newborns.
Their leader must be very proud and proud of them, they must celebrate the victory against a army of one-day-old children and women armed only in hospital clothes, says Zahra.
The hospital is supposed to be a protected area, as stipulated by international humanitarian law. However, the attack on the maternity ward where Zahra worked is not an exception, as attacks on health care facilities happen again and again here. But what distinguishes this attack from other attacks?
Zahra answers, "We are leaders behind the scenes in our country, alongside pregnant women who give birth to the future of the country and we must be protected. Protecting a maternity ward like the one in which it worked means protecting all our future and protecting midwives like Maryam the beloved who was killed without reason at a time when she was providing Helping mothers waiting for their newborn babies.
Potential destinies
On the day of the four-hour assault on the maternity ward in Dasht-Borgi, not only did the terrorists attack pregnant and newborn babies, but their brutality also took decades of continuous work to reduce maternal and newborn deaths.
Because of this attack, it is impossible today for women from the western region of Kabul, which has a population of more than one million, and coming from remote provinces, to obtain any comprehensive care for obstetric and newborns.
After this incident, the only option available to them today is a nearby hospital with a capacity of 50 beds, of which only seven are dedicated to maternity services. However, Zahra does not know whether pregnant women who go to this hospital, or others, will receive the care they need. Will they get the help they need? Will they have the financial means to pay hospital expenses? Would they survive labor if they did not have the opportunity to be hospitalized?
"I am even afraid to think about the potential fate of these women who would have taken refuge to us had it not been for this sinister attack," Zahra says.
The maternity ward used to provide high quality services to more than one thousand and 200 mothers giving birth in a month. And if the women in the Dasht constellation need help in the delivery process, they will go to the hospital with a small capacity, but if they have any complications, this hospital will refrain from receiving them as it does not include an operating theater for emergency cases. With the Covid-19 pandemic, options for those with complications or special needs are severely limited and more distant.
Free services
Most of the patients who come to Dasht-Burji Hospital are from the Al-Hazara community and do not have the economic resources to pay for their treatment elsewhere, and some reach the hospital under severe conditions.
And she remembers a sick flower who arrived for the first time, losing strength and barely able to walk, and her face looked very pale, from an area on the outskirts of the capital. I checked her and realized she had severe anemia. Antenatal care services were not available in the area where she was staying, because of her lack of capabilities to buy food, she did not eat well, and when I asked her about the last time she ate the food she answered "yesterday".
"At the end of these words my heart was broken, but I felt happy later to see her recovering and having a healthy baby," says Zahra.
Her story is only one of the thousands of stories that describe the reality of the lives of patients in the Dasht-Burji area, where patients come to the hospital and some of them without a single penny in their pocket to return home.
Patients and the community were very happy to rely on the maternity ward, which provides services for free, especially since government hospitals charge some money for their services. Zahra is saddened by the lack of a good health system, lack of resources, and insecurity, and health care centers in Kabul are running with a lack of some energies due to the injury of a number of their workers to Covid-19 disease.
"I got hurt. My life has changed, but I am still committed to continuing my work. I know that my people need us and expect me to get up after what happened with the support of Doctors Without Borders. I will not forget the patients who need good help and care, and they have become our friends and pray for us." We want to disappoint them, especially now, with the suffering of many and many from the Covid 19-pandemic.