In Afghanistan 26,000 women a year die while pregnant or giving birth. In rural areas women are not allowed to be treated by a male doctor. Pashtoon Azfar’s Afghan Midwives Association is making a difference.

From an article in the New York Times by Denise Grady:


“Afghanistan has the world’s second-highest death rate in women during pregnancy and childbirth (only Sierra Leone’s is worse). For every 100,000 births, 1,600 mothers die; in wealthy countries the rates range from 1 to 12. In one remote northeastern province, Badakhshan, 6,507 mothers die for every 100,000 births, according to a 2005 report in the medical journal Lancet. In all, 26,000 Afghan women a year die while pregnant or giving birth.”

“The main causes of these deaths are hemorrhage and obstructed labor, which can be fatal if a woman cannot obtain a Caesarean section. Even if the mother survives, obstructed labor without a Caesarean usually kills the baby. Most of the maternal deaths — 78 percent, according to the Lancet report — could be prevented.”

Pashtoon Azfar’s mother gave birth to 10 children, always alone, behind a closed door. When Pashtoon was 9, she began to help, by waiting outside the door to receive the newborn baby and wash and swaddle it, while her mother then delivered her own placenta.

At 16 she began studying midwifery, Pashtoon finished a three year program.  “It was a very well-respected profession in my country,” she said.

The came war and her family fled to Pakistan.  Decades of war destroyed midwifery and much of health care, she said. Professionals fled the country, and many never went back.

By the time she returned to Afghanistan, she said, midwifery was in a shambles. Spots in professional schools of all kinds were being filled by people with political connections instead of those with good grades.

“A culture of war was going on,” Ms. Azfar said. “If a mother came for delivery they didn’t treat her as she deserved or needed to be treated. There was no emotional support.”

A mother of five herself, Ms. Azfar works 12 hours a day, seven days a week. She has irked relatives by missing weddings and other family events because of work.  “My children are not happy,” she said in an interview after her speech.

By day she directs Afghanistan’s Institute of Health Sciences, by night she works for a nonprofit group from Johns Hopkins University that focuses on women and children’s health, and somehow she also manages to serve as president of the Afghan Midwives Association.

Pashtoon Azfer

Pashtoon Azfer

Every country in the world has people like Pashtoon Azfar. People are any countries greatest resources.  Given half a chance people working together can solve any problem.