Maternal Mortality
by Alixandra Fazzina
Afghanistan, Shahr-I-Buzorg, August 2008, Siamoy breast feeds her month old baby boy Hokim as she goes to visit her sisters at their home in Khourdakon village. Situated in the remote mountainous province of Badakshan, the area has the highest rate of maternal mortality in the world.
Afghanistan is the worst place in the world for a woman to give birth. A woman dies there every twenty-seven minutes due to pregnancy related complications.
In the mountainous province of Badakshan in Afghanistan’s northeast, there are 6,500 deaths for every 100,000 live births; the highest rate of maternal mortality in the whole world. The majority of women there have no access to healthcare and rely on family or the services of unskilled traditional midwives for both pre and ante-natal care and for assistance with deliveries. Poverty, lack of education, diet, bad hygiene and the high birth rate compound the risks. In such a remote region, access to the single equipped maternity hospital can be expensive and at times impossible as the mined mountain tracks become impassable due to heavy snows and rain. If a woman experiences complications during child birth, there is literally no help.
Afghanistan, Shahr-I-Buzorg, August 2008, Fifty six year old Zebanisa cares for her orphaned granddaughter Fahima in the one room mud covered house where they live alone in Khourdakon village.
Zebanisa's daughter was just twenty-seven when she died during child birth. "She was feeling unwell and in a lot of pain. There was a lot of bleeding but there was nothing I could do- I just had to stand by". Despite finding transport across the mountains for the seven hour journey to Faizabad Hospital, by the time they reached the city there was nothing that could be done to save her.
Fahima's father disowned her, as is the case with children who are orphaned due to maternal mortality- Zebanisa was the only person who stepped in to help. She survives on charity from neighbours. Still in deep shock she feels she has become deeply spiritual. "I pray five times a day to Allah. Where else can I turn".
The hospital is the only medical centre equiped for emergency obstertic care in Badakshan- a remote, mountainous province of Afghanistan that has the world's highest rate of maternal mortality given the lack of access to medical facilities.
Afghanistan, Faizabad, August 2008, A baby is delivered safely by cesarean section in the operating theatre of Faizabad Maternity Hospital.
The consequences of maternal mortality in Badakshan are felt throughout the province. Families have been devastated and thousands of children orphaned. Despite UN member states pledging to reduce rates of maternal mortality worldwide by three-quarters as one of the eight millennium goals, the numbers of women dying in Afghanistan only continue to increase.
Afghanistan, Wandian, August 2008, Sayfora (centre) is watched over by her 5 year old adopted daughter Yatima as she breasfeeds her baby girl at their single room home in the remote mountain village of Wandian.
Afghanistan, Katuq, August 2008, Traditional Birth Attendant Osima points to information on a poster distributed UNFPA alerting women to family planning issues pinned to the wall of the health post where she works in Katuq Village.
Afghanistan, Shahr-I-Buzorg, August 2008, Travelling with her baby Hamza under her burka, twenty five year old Faroza is lead by her father as she is escorted along the rough roads of Badakshan on the way to Shahr-i-Buzorg's health post. Having given birth two months ago, Faroza's husband went to the pharmacy for her but could find little advice and the drugs he bought had no effect. She has been bleeding ever since. After the two hour uncomfortable journey, they are told that Faroza has liver damage- a possible side effect of the drugs and that she could have problems with future deliveries.