At a small hospital in rural Afghanistan, a young, anxious mother has just given birth. The new baby is struggling to breathe. Eventually, things will improve.
Across the hall, another newborn is also getting by. Her 20-year old mother, Pal Wah-Shah’, tells a translator that she is relieved, “At home babies can be injured or die and women die.”
But here, the American government financed the hospital and the professional help comes from the International Medical Corps. The program focuses on education: teaching Afghan women the basics about pregnancy and childbirth. The women learn everything from sanitation, to nutrition, to the tell-tale signs of trouble.
Back home, Pal Wah-Shah’ also learned from her sister-in-law. Without medical care, she lost five babies either at birth or before their first birthday.
Pal Wah-Shah’ was determined to give birth in a hospital, “I left the house at 1 o’clock and got to the hospital at 4.”
While in labor, Pal Wah-Shah’ walked three hours in near freezing temperatures, rather than risk a birth at home. It's a decision supported by the men in her family — which is critically important in the local culture.
In Afghanistan, men rule. They make almost all the decisions, including the decisions about their wives’ health. The may even confer with a religious leader, a mullah, before deciding to send their wife to a hospital.
For those who do seek help, there’s often a severe shortage of health care professionals.
At the Malalai Hospital in Kabul, Dr. Jeffrey Smith is trying to change that. He’s running a woman’s re-productive health program sponsored by Johns Hopkins University. It trains desperately needed doctors and mid-wives.
“If we continue the kind of efforts we are doing now, hopefully in 15 to 20 years, pregnancy in Afghanistan won’t be such a dangerous thing,” Dr. Smith said.
That seems like a long time, but in Afghanistan nothing is easy — including changing the traditional role of women as second class citizens.
These Afghan men have taken a small step, bringing their wives to an American run clinic.
That attitude is encouraging to Smith, “There’s a growing awareness. It’s not necessary for women to die during childbirth… there is a growing sense that they need to take advantage of western medicine.
But, professional help at childbirth is just a step.
As for Pal Wah-Shah’, barely 12-hours after giving birth, she rode a donkey home, where, by tradition, she must stay inside for 40-days.