A Midwife in Kabul

August 24, 2006

Summer 2006 in
Kabul

All summer there seems to be a constant trickle of depressing news about Afghanistan: Taliban resurgence, poppy lords controlling the eco/political scene, maternal mortality not being reduced despite millions being poured into the health system.  The numbers of Internally Displaced Persons steadily increase according to UNHCR; most IDPs end up in the emergent urban sprawl around Kabul.  Basic needs are not being met…potable water, electricity, health care…let alone the amenities of education, transportation, and accessible commodities.

The new NATO commander recently suggested the country close to anarchy.  The revival of the “Department for the Promotion of Virtue and Prevention of Vice,” infamous during the Taliban, elicits fear and outrage among Afghan women.

So, what to think about my time in Afghanistan, along with others like myself who have lived and worked in
Afghanistan?  What difference will it make in the long haul?  Some say, with historical credibility, that Afghanistan is a “failed state”…never should have been carved up the way it was…destined to revert back to tribal territories. 

As America’s focus turns toward other “hot spots” Afghanistan is being weaned off American reconstruction funding, but Afghanistan remains 100% dependent on those funds. The withdrawal of funds is acutely felt in efforts to increase services to pregnant women and newborns.   

Before I left in early August I had the opportunity to visit one of the Kabul districts where midwives with the NGO “Terre des Hommes” (TDH) provide a wide range of services for women and children who have little access to basic health care. TDH is of Swiss origin and has worked in Kabul District since 1997.  There is currently a cadre of 28 midwives who visit homes in pairs providing a full scope of midwifery services ranging from antenatal care, intrapartum assistance and family spacing.  Most women in these communities have little hope of delivering their baby at a hospital and are dependent on relatives or neighbors to assist them in birth.  TDH midwives provide education, support and simple birthing kits for the often inevitable unassisted birth.  They are dedicated to women whose lives are at risk every time they become pregnant.