KABUL

- If you ask in the Afghan capital about the most important maternal and childcare hospitals, it will be said that the Malali Specialized Hospital for Women and the Indira Gandhi Hospital for Children, and the first impression of those who enter the latter’s building is that it is remarkably overcrowded, with two or three children sleeping on one bed, and the beds stretching in the corridors.

The figures confirm the permanent excess of the hospital’s capacity from 150 to 400 children throughout the year, which is the same in miniature in the pediatric departments in most other Afghan hospitals, which are crowded with children suffering from various diseases, foremost of which is malnutrition or lack of nutrition and the resulting suffering .

No concern for children's health throughout the war years

After a meeting with the director of the hospital, Dr. Amir Muhammad Jalali, a pediatrician, accompanied us on a tour of its departments, saying that this hospital was established during the reign of King Zahir Shah in 1964, and at that time only 500,000 people lived in the city of Kabul, and now 7 million people live in it, and it was not established Another children’s hospital that has not built a building in 40 years, “We are asking the international community to cooperate in this field so that we have specialized buildings, that specialists be trained inside and outside and that we have the tools, as the number of auditors has increased.”

The pediatrician added, "At the level of the ministry, we say that this building is the same that was built 50 years ago, and the capabilities are limited. We demand the international community to help us in all aspects of health care, and we do not want anyone to ignite the war machine for us, but we want the health system because our children have suffered a lot." People are living in the worst condition."

Dr. Jalali explained that the health services situation for the children of Afghanistan is a result of the accumulation of wars that spanned four decades, adding, "Previous governments did not have a project for the children of Afghanistan. Before these regimes, our doctors used to go to France, Germany, the United States and India to specialize and return with specialty certificates."

He continued, "Unfortunately, during these last 40 years, our doctors who had received education abroad left the country, and the opportunity was not ripe for their development at home. The previous regimes did not have such projects, but rather focused on keeping the war machine active."

Red Cross Center for the Treatment of Children with Cerebral Palsy (Al-Jazeera)

Lack of government care for cerebral palsy patients

It is remarkable that most hospitals in Afghanistan - and perhaps all of them are in the estimation of some - do not have special care or departments for children with cerebral palsy, despite a clear increase in its cases. During pregnancy and at the hour of birth, in addition to premature births, and other reasons.

Regarding the reasons for the high incidence of cerebral palsy, Dr. Jalali said, "We do not have enough teams of obstetricians to prevent all factors of cerebral palsy, especially the first moments, such as the lack of oxygen reaching the brain. In the first five minutes, if oxygen does not reach, it will lead to cerebral palsy."

He adds: If the sufferers have jaundice and it has not been diagnosed, this leads to cerebral palsy.

The possibilities are currently limited, and the international community has not previously helped us in this field and is called to help us and work on training and developing maternal and obstetric care.

Waiting months to get your first check up

We went to an International Red Cross center in Kabul, where thousands of parents go every month carrying their children with cerebral palsy.

There, officials tell you frightening numbers. More than 12,000 children with cerebral palsy are registered to receive treatment in the Kabul center alone, and there are between 8-10 thousand cases per month that are treated in the six Red Cross centers, which are in the capital, Herat, Helmand, Mazar-i-Sharif and Jalalabad.

There are medical and rehabilitation staff working in these centers, most of whom are Afghans, male and female, and the International Red Cross is almost the only body that has given this disease clear and special attention.

"Successive governments have been preoccupied and preoccupied with other issues, and cerebral palsy needs medical follow-up for the child for life, and the programs that she saw in Afghanistan are only for rehabilitation," said Maria Regina Zulia Nilo, the Italian supervisor at the ICRC center in Kabul.

She added, "Children with cerebral palsy need treatment related to speech, languages, learning and skills. This is part of the mission of educating people with special needs to improve their activity and improve their lives. All these services are not available and absent in Afghanistan. Cerebral palsy children only receive rehabilitation."

She explained that cross therapists are trying to work with families to reach the child to his best potential, but a child suffering from cerebral palsy needs more of his needs to obtain education, for example, while there is no special education for cerebral palsy children.

And she continued, "Even if they are intelligent, they are not able to communicate well.

Despite the intelligence of the sick child, he cannot use paper and pen, and there are no opportunities for them in the classroom for seats and special educational aids. Schools are not qualified for this category of children.

Sometimes children wait months for the turn to arrive for the first examination. The waiting list included between 300-400 children in the Kabul center alone, who came for the first time.

And the waiting list for follow-up after that lasts for about 8-9 months, and the number is increasing with awareness of this disease.

With the ease of travel now and the freedom of movement during the past months due to the security situation, the Red Cross centers are seeing more children coming from rural areas.

The conditions of the country and the lack of women's access to services greatly affected the number of children who develop cerebral palsy (Al-Jazeera)

Mothers do not receive care

"All the conditions of the country and the problems of women's access to services have greatly affected the number of children who develop cerebral palsy and other disabilities," says the Italian supervisor.

She added, "What we see is that mothers who did not receive maternity care before the birth of their children, and during the hour of birth, face problems. In some areas of Afghanistan, women do not deliver their children in hospitals, but rather at home by traditional midwives, and this has an impact on the number of children exposed to serious neurological and brain injuries.

And she continued: It is necessary to emphasize prevention, as we have large numbers of children who need care now, and some of them are dealing with the Red Cross, but we must work to reduce the rates of infection of other children in the future, through maternal health care and good nutrition during their pregnancy and the hour of birth, as should happen. Children get the health care they need.

This requires raising the level of maternity care during pregnancy and during childbirth, providing options for childbirth, at home, clinic or hospital, and the possibility of performing caesarean sections when the mother or child is at risk and natural childbirth is not possible, according to the Red Cross official.

There is also a need to take good care of childhood, with early examinations of children, giving them special vaccinations, monitoring their food levels, and providing pediatrician examinations, according to the same spokeswoman.

There is a need for health care and early examinations for children and giving them special vaccinations (Al-Jazeera)

Poor maternity care

Dr. Malali Faizi Rahimi was among those appointed by the Taliban government after it came to power to head the Malali Specialized Hospital for Women in Kabul.

Speaking to Al Jazeera, Rahimi said, "The role of women in the Afghan medical or health community is of paramount importance, as the population ranges between 35 and 38 million people, and a large number of them are women. It is important to attend the doctor (obstetrician and gynecologist) to be able to provide important health services Very much for mothers, and currently there are no good health centers in remote states and remote areas of the country, and if the centers exist, they do not have women’s medical staff.”

She added: Because people transfer the patient from a remote state or district, she may die before she reaches the center of the state.

And if we had a female doctor in those remote areas who provides medical services to these women, the death numbers will decrease, and the health problems that the mother faces during pregnancy and childbirth will decline.”

Dr. Malali says, "In Malali Hospital, the medical staff consists of 446 people, 90% of them are women, and we have between 80 and 100 births per day and night, and from 40 to 50 obstetric surgeries per day and night, and the hospital sees 1,000 to 1,500 people during the day and night." ".

She points out that the challenges and problems in the hospital are numerous, such as the lack of medical equipment and means, the lack of medical equipment, and the insufficient staff.