BAMYAN province’s Naitaq is a sleepy village of mud-brick courtyard houses on a terrace overlooking potato and wheat fields. On April 26 of this year the village’s usually calm starry night was punctured with the screams of Shirin Ghul, a well-built assured mother of five who seemed was about to give birth for the last time. The two village midwives just stood there mute, as sweat poured down Shirin Ghul’s red face _ the dead baby was stuck inside her. Shirin Ghul prayed aloud for help, and her teenage daughter Nargis laid her head in her hands, wishing she were a doctor so she could save her mother’s life.
Dr Santanu Sanyal is with the the Aga Khan Health Service, which implements the programme along with help from the UN Children’s Fund and the World Health Organization. Yes, the programme has increased the number of trained midwives from 50,000 to 150,000 nationally, but he cautions that the battle against maternal mortality will take at least a decade. “We need to educate girls so they marry later and have less children,” says Dr Sanyal. We also need to make sure women and children are better nourished _ and that means improving Afghanistan’s rural economy.
The first class from the Bamyan midwives training programme graduated in March, and already these twenty-two graduates are making a difference. At the clean white Bamyan provincial hospital, Sediqa checks up on a mother resting after a delivery and Najmaa cares for a baby born prematurely. The head of the maternity unit, matronly Dr Aser Bakieva of Tajikistan, says both new midwives have been here a month, and are so good they’re doing the job of doctors.
“That’s because the rigorous eighteen-month programme is meticulously designed and taught,” says Dr Sanyal of Aga Khan. “There are so many ill-informed midwives out there,” he says. “We want to make sure our midwives are properly trained so they don’t cause more harm than good.”
Rosy-cheeked twenty-year old Sediqa says she signed up for the programme after she witnessed three mothers die while giving birth in her home village. She likes the programme because its a practical training course which permits her to serve her people. After gaining more experience at this hospital Sediqa plans to return to her village, an hour and a half drive from here.
Twenty-one year old Najmaa has an infectious smile and likes to kick her right leg in the air while talking. She says she’s now the family breadwinner her US$200 a month here is more than all seven members of her family make combined. I dont have any need for money, says Najmaa. My family supported my education so I give them all my earnings.
Three hour’s drive on Bamyan’s rough hilly roads is Yakawlang district hospital, where Najiba, a subdued and serious 20-year old, has worked since graduating from the programme. Here she sits down with eight mothers a day, telling them to boil the stream water before they drink it and to avoid lifting while pregnant. As she walks around outside she tells the male patients she meets to bring in their wives for consultation.