Afghanistan's unsung heroes
From 2003-07, I was a midwife trainer at Rabia Balkhi Hospital in Kabul, Afghanistan. Over these five years, I came to know the midwives who basically ran the hospital, especially at night when there were no doctors. There were up to 50 deliveries a day at Rabia Balkhi, and most of them were women with serious complications (at that time about 80% of all babies were born out of hospital and without skilled birth attendants). In 2003, Afghanistan had one of the highest maternal mortality rates in the world: 1,200 maternal deaths per 100,000 births.
In March 2006, I asked some of the midwives to share their stories with me. The midwives at Rabia Balkhi Hospital had endured throughout the Russian occupation, as well as the civil war and Taliban takeover of the country in the 1990s.
The Midwives’ Stories:
“While the Taliban was in control women had a very hard time coming to Rabia Balkhi, especially at night. There were no medications, and no electricity was available. We had to take care of women using candles. One night a woman came who had pre-eclampsia. We had no medicine and had to watch the mother while she had an eclamptic seizure, and both the mother and the baby died right in front of me.”
“I was living in Jalalabad during the Taliban time and I was living in the town. Most women had their babies at home and sometimes I was called by one of the relatives of a mother if her birth was difficult. One night I was taken to a house where a mother was having twins. The first baby came OK, but the second baby was breech and also had a meningocele (sometimes seen as Spina Bifida) that prevented the baby from being born. I had to cut the meningocele open and the baby died.”
“One night one of our midwives came to the hospital very sick. She came alone because her husband and two children had been killed. She lay in the courtyard outside the hospital because she was very poor, and the Taliban would not let her in the hospital unless she paid them money. She needed blood and had no one to give blood to the blood bank so she could not get a transfusion. We midwives each donated blood so that she could get transfusions and she lived and is here with us today.”
“During the Taliban, the midwives were the only ones in the hospital, especially at night, as most doctors left Kabul City and were hiding in their homes in the country or had left the country. We had no pay for five months, but we came to work every night. Now that the doctors are back they don’t respect us for what we did while they were hiding. Now they think we should not attend deliveries and that we should just clean instruments and the floors. When the Americans bombed Kabul and drove the Taliban out, we were all very afraid for our children who we had to leave at home when we came to the hospital. One of my children was killed in the bombing, and I didn’t know about it until two days later because I couldn’t leave the hospital. I still have three children.”
“I lived outside Kabul town in a refugee camp after the Taliban came back to power. The men in that village would not allow their wives to go to the hospital because they were afraid a male doctor might see her. I could not help some of the women if they were very sick, and I tried to find a taxi, but the husbands would refuse. Too many people died in that place.”
These women are the heroes of the wars; 40 years of wars. It is doubtful that more than a few of these midwives were able to get out of Afghanistan over the past decades of American occupation.
I grieve especially for the midwives as they are the backbone of obstetric care in Afghanistan.
– Linda Barnes, Durango