The Female Engagement Team was in a unique position to provide training to these women but they did not have the resources to supply them with any medical items. The AMP sent them over 10 midwife kits that included everything a midwife would need to deliver a baby successfully. The AMP also ensured that they had enough medical supplies going forward.
During their time there, the FET trained over 15 women with valuable medical knowledge. Another success story for the AMP!
In the past few months, the AMP has been contacted by more and more Army PRT teams that visit remote villages and meet midwives that need additional resources, training, and medical supplies. The most recent request that AMP was able to assist in was for a team that was in the Kunar Province of Afghanistan. There were 4 midwives that worked in that province and had no assistance in getting medical supplies. The AMP sent over $2500 in medical supplies to include gloves, heart rate monitors, basic surgical instruments (forceps, hemostats, etc), as well as items for newborn babies. This will enable the midwives to provide better care to the women that they treat and the consumable supplies we sent (gloves, masks, etc) them will last around 6 months.
We have two more pending requests that we are trying to help with. One of the requests is for a midwife school that is requesting teaching supplies and medical equipment. The other is for another PRT team that has 8-12 midwives that need basic supplies. With your continued support we can continue to help midwives in Afghanistan get the basic equipment that they need to ensure that childbirth is safer in Afghanistan! If you would like to help with the two pending requests, a list of specific items that they are requesting is available and all supplies can be sent directly to U.S. Soldiers that will be delivering them to the midwives and the midwife school. THANK YOU FOR YOUR SUPPORT!
A couple of months ago, two soldiers in two different provinces reached out to the AMP asking for help. During their missions they had come across midwives that were badly in need of resources. AMP of course wanted to help so we started reaching out to companies for donations that we could send to the soldier’s. We were able to get some fetal heart rate monitors donated from our friends at Dynamic Doppler and we were able to get some other items from AMP supporters. In total, we were able to send both soldiers a combination of over 20 boxes! These boxes contained everything from surgical supplies, gloves, over the counter medicines, and items for newborn babies such as clothes, bottles, and toys. Attached are some pictures of one of the midwives receiving their supplies. We have a few other requests from soldiers, so if you would like to help send them items, please email the AMP for items that they could use.
As always, thanks for your support in continuing our mission!
It was the day after Christmas 2008, and Sgt. Michelle Johnson was deployed in Afghanistan, the country ranked most dangerous for women by the Thomas Reuters Foundation. That night, a 13-year-old girl pleaded for medical help at the base’s gate. The nearest hospital was unreachable via bomb-plagued roads controlled by the Taliban; a helicopter request was denied. The girl had been in labor for days, her stillborn child lodged in her pelvic bones. With no other option, a doctor on base prepared for a traumatic delivery.
“I volunteered to help, figuring I would just be holding her hand,” Johnson said.
She quickly learned males do not treat Afghan women without the patient’s risk of being stoned to death. Having the smallest hands in the room, Johnson was designated to extract the lifeless child and stop the mother’s bleeding. Johnson, guided only by verbal instructions from the male doctor and no medical training of her own, was able to save the mother’s life.
Following the horrific experience, Johnson and two other female soldiers began to help at a local women’s clinic in Waza Khwa, Paktika. Here, the Americans witnessed a shocking shortage of pre- and post-natal care and learned that some clinics even operate without running water or electricity. Afghanistan health institutions do their best, but they aren’t often supplied with the necessary tools to prevent severe complications or death.
“It is typical in impoverished countries to see a lack of sanitation standards, but it’s appalling to see such a lack of knowledge regarding germs and infection,” Johnson said.
Upon hearing from her sister in Afghanistan, Danielle Johnson began to send vitamins and other aids overseas from Illinois. She started a blog to generate donations, resulting in monumental progress within the clinic. The donation of a fetal heart rate monitor allowed women to hear their babies’ heartbeats for the first time: a touching experience for the soldiers.
Johnson returned to Illinois in July 2009, and with her sister, started the Afghanistan Midwifery Project (AMP), a nonprofit organization that garners donations for equipment and medicine to be used in Afghanistan. AMP began by supporting the Inchu Clinic in Parwan.
“The hospital had mold growing on the walls; they had to carry in water to wash instruments and their hands; and they had no way to keep medicines refrigerated,” said the AMP president.
These impediments have resulted in Afghanistan’s ranking as highest in the world for maternal mortality rates. The statistics from the State of the World’s Children 2009 report by United Nations Children’s Fund (UNICEF) revealed an estimated 1 in 8 maternal deaths and 257 deaths in children before age five to each 1,000 live births. Many injuries, infections, diseases and disabilities still occur in survivors. These pregnancy-related ailments often present permanent consequences, which contributes to an Afghan woman’s low life expectancy rate of less than 48.
According to the study, only 14 percent of Afghan women have a skilled attendant present during delivery, but even birthing in a medical institution has proven a noxious experience. Mothers are rushed and often barely cleaned up before their husbands collect them.
“A woman had maybe 10 minutes after giving birth before she had to hop on a motorcycle or get in a truck for a bumpy ride, as none of the roads were paved,” remembered Johnson.
In an attempt to improve medical care for women and help with the shortage of female doctors, AMP works with the Afghan Midwives Association in Kabul. The Chicago-based AMP hopes to raise $20,000 this year to support midwives’ continuing education. Here in the United States, the nonprofit shares personal accounts of Afghan women’s struggles through speaking engagements and fundraisers.
“These women deserve as much of a right to deliver a safe and healthy baby as any other woman in the world,” Johnson said.
More information can be found online where you can also make an impact with a modest donation. Find out more about these women’s plight and what AMP is doing to make a difference in Afghanistan’s future at afghanmidwiferyproject.org.
It’s been over a year since we have started supporting the Inchu clinic in the Parwan province of Afghanistan. We have been able to supply them with a generator, water pump, and medical supplies. Our last shipment of medical supplies went to the clinic in November of last year. This shipment was utilized by the 15,000 women who frequent the clinic. We were able to purchase 6 months’ worth of medical supplies such as antibiotics, bandages, supplies for the midwife to utilize, and other lifesaving medicines. One of the biggest things we hear from the families who are benefiting from the help is that they are receiving high quality medicines and are very grateful to have some where to go that can help them at no cost. Many of the other clinics provide services at no cost, but they do not have the medicines to supply to the patients. We have been able to not only help the clinic with medical supplies, but the medicines that are vitally important to treating these women and children. The clinic treats all ailments from OB/GYN issues to pneumonia, cold and flu, and more serious problems like minor surgery. Below are pictures of some of the families who have benefited from the AMP. Thank you to all of our donors for making this happen and your continued contributions to ensure we can carry on our support to the Inchu Clinic.
Imagine that you are nine months pregnant and have to drive seven hours to reach the nearest hospital. You have never seen an obstetrician or midwife for prenatal care and emergency health services are miles out of reach. This is the situation in parts of Afghanistan, where the maternal mortality rate is the highest in the world.
As of 2008, it was estimated that 1 in 11 Afghan women die in childbirth. (In Greece, the country with the lowest maternal mortality rate, the statistic is 1 in 31,800.) With a fertility rate of 6.62 children per mother, the life expectancy for women in Afghanistan—recently ranked “the most dangerous country for women” by the Thomson Reuters Foundation—is less than 48 years.
Now, a national midwifery program is one of several initiatives to drastically improve women’s maternal safety, report Isobel Coleman and Gayle Tzemach Lemmon in Ms. Magazine. Funded by organizations like the U.S. Agency for International Development, the United Nations, and the European Union, the program has trained more than 2,500 midwives. Coleman and Lemmon write:
For women in the country’s most remote provinces, who face the greatest challenge accessing health care in this overwhelmingly rural country, the midwives serve as a lifeline. Of the approximately 500 birth complications that occur daily in Afghanistan, 320 happen in those rural areas. Midwives are also active in cities, making home visits to women too poor or limited in mobility to seek help at clinics or hospitals.
The midwives can affect more than just the maternal mortality rate, they continue:
Along with saving mothers’ lives, the midwives serve as homegrown role models whose economic strength and earning power are changing their families’—and their communities’—views on women’s roles. Midwives can earn around $350 each month, a substantial salary in one of the world’s poorest countries and where per capita GDP is less than $500 per year. The money matters and is playing a role in shifting male attitudes toward women’s work outside the home…. When women begin contributing economically to the family, they also have a greater say in what happens to them and to their children.
“Most people have a lot of respect for midwives because they need health care,” says Fatima, [a] student in the program. “Midwives save mothers’ lives and women’s lives.”
Source: Ms. Magazine (excerpt only available online)
A chronic shortage of midwives and basic health services makes having a baby one of the most dangerous things an Afghan woman can do.
A woman dies during childbirth every 29 minutes in Afghanistan, which is wracked by poverty, insecurity and deeply ingrained discrimination against women.
At a tiny ultrasound room at the Malalai maternity hospital in Kabul, 35-year-old Benafsha gives birth to a baby girl.
She already has five children; her family would have preferred another son, but she was dreaming of a daughter.
“When she grows up she should go to school and increase her knowledge,” she said.
It is one of the biggest maternity hospitals in Afghanistan, but most Afghan women never reach there.
Eighty-six per cent give birth without any trained help, and it can be a deadly scenario.
Benafsha’s first two babies died during the Taliban’s rule because her family would not let her go to the hospital.
She still remembers the tiny faces of her lost newborns.
“I feel sad and cry – what else can I do?” she said.
Even in hospital, childbirth is traumatic; the midwives abuse Benafsha, accusing her of being too slow.
More than 130 babies are born at the hospital everyday, with some women given only half an hour to deliver.
Midwives slap Benafsha on her pregnant belly to speed up the contractions. If Australian midwives did the same, they would be stood down and could even face criminal charges.
The baby looks deathly white and motionless when it emerges. The midwife cuts the cord and rushes down the corridor, carrying the newborn girl face down along her arm.
When the nurse reached the neo-natal ward, the doctors take over. They use a suction tube and a foot pump to try and open the baby’s airway.
The baby has swallowed faeces or meconium during the traumatic delivery and now has severe asphyxia.
It is many more minutes before the baby finally coughs out her first cry.
Her skin colour starts to change from white to blotchy pink. Her arms and legs begin to move. She weighs in at four kilograms, a big baby for Afghanistan. The doctors are relieved for now.
“She is very beautiful,” Benafsha said.
Fathers are not allowed inside the hospital so the guard at the front gate announces that Benafsha’s baby has arrived.
In the baby’s first minute of life, she was given only two out of 10 on what is known as the APGAR score of newborn health.
In Australia, a baby in this condition could be sent to intensive care.
But only three-and-a-half hours after she is born, her father orders the baby and Benafsha to be discharged because he does not want to wait anymore.
‘No-one cares about them’
Neonatal doctor Noor Zia Sharifi is worried the baby could die of infection or have some brain damage from the asphyxia.
“If the newborn is a girl, they don’t pay much attention to her,” he said.
“They won’t let the mother and baby stay in hospital for a few days so we can take care of them.
“But if the newborn is a boy the relatives touch the feet and hands of the doctors, begging for us to keep the baby boy in hospital. They want us to give him the best treatment.”
Despite the gains made since the fall of the Taliban, Afghanistan remains one of the most dangerous places on the planet to be born female.
The average Afghan woman is dead by the age of only 44.
Dr Sharifi is struck by the loss of opportunities and talent that Afghanistan so desperately needs.
“The baby girls born here, many have potential, they are intelligent and alert,” he said.
“But no-one cares about them. Even if they try to go ahead in the future, their talents are strangled by the situation in this country.”
It always amazes me the power people have to change something and how big people’s hearts are. Being involved with the AMP over the past two years has been one of the most rewarding experiences of my life. Not only because we are helping women and children in Afghanistan but also because so many people have given their time and their money to making a change in the world. I have always liked the quote from Mahatma Gandhi, “Be the change you wish to see in the world,” It has always inspired me to take action when I see something that needs to be fixed instead of waiting for others to change things. I was reminded of how people can change what they don’t like the other day when a young woman in New Jersey sent the AMP 3 boxes full of supplies. She took the AMP on as her Girl Scout project. She was nominated for The Girl Scout Gold Award which is achieved by girls who complete rigorous leadership projects that involve a minimum of 65 hours of planning, implementation and completion. A big thank you to her for supporting the AMP!
”In the arena of human life the honors and rewards fall to those who show their good qualities in action.” ~ Aristotle
That’s a wonderful sentiment, and one that we’d like to think applies to us here at Afghan Midwifery Project. And just recently, we were given an honor that we’d like to share with all of you!
The authors of SQUAT birth journal, a web and print publication, have selected AMP as part of their Stuff We Love: Organizations Edition! We couldn’t be prouder!
The SQUAT Stuff We Love: Organizations Edition, includes mention of several other birthing organizations including; National Advocates for Pregnant Women, 123 Hi Baby, Best for Babes, Sistersong, The International Center for Traditional Childbearing, and Mama Baby Haiti). While each of these organizations have a different mission, they all have have a healthy mother and baby focus, and we are very proud to have been selected alongside them.
About SQUAT Birth Journal
SQUAT is quarterly publication that is put together by a just a few people who dedicate their time to create a magazine to support healthy and empowering birthing practices. Find out more at the SQUAT Birth Journal blog.
Afghan women suffer under the constraints of tribalism, poverty, and war. Now they are starting to fight for a just life.
By Elizabeth Rubin
Photograph by Lynsey Addario
Twenty-five years ago an Afghan girl with green eyes haunted the cover of National Geographic. She became the iconic image of Afghanistan’s plight, a young refugee fleeing the war between the Soviet-backed communists and the American-backed mujahideen. Today the iconic image of Afghanistan is again a young woman—Bibi Aisha, whose husband slashed off her nose and ears as punishment for running away from him and his family. Aisha fled to escape beatings and other abuse.
Why do husbands, fathers, brothers-in-law, even mothers-in-law brutalize the women in their families? Are these violent acts the consequence of a traditional society suddenly, after years of isolation and so much war, being hurled into the 21st century? And which Afghans in this society are committing the violence? There are significant differences between the Hazaras, Tajiks, Uzbeks, and Pashtuns, the most populous and conservative group and the one that has dominated political life since the 1880s.
In the Pashtun crescent, from Farah Province in the west to Kunar in the northeast, life was—and in many ways still is—organized around the code known as Pashtunwali, the “way of the Pashtun.” The foundation of Pashtunwali is a man’s honor, judged by three possessions—zar (gold), zamin (land), and zan (women). The principles on which the honorable life is built are melmastia (hospitality), nanawati (shelter or asylum), and badal (justice or revenge).
The greater a Pashtun man’s hospitality, the more honor he accrues. If a stranger or an enemy turns up on his doorstep and asks for shelter, his honor depends on taking that person in. If any injury is done to a man’s land, women, or gold, it is a matter of honor for him to exact revenge. A man without honor is a man without a shadow, without assets, without dignity.
But it is not generally acceptable for Pashtun women to extend hospitality or exact revenge. They are rarely agents. They’re assets to be traded and fought over—until they can stand it no longer.
At a shelter in Kabul for women who have escaped domestic abuse, I heard about a girl from one of the richest Pashtun families in a province bordering Pakistan. She fell in love with a boy from the wrong tribe. Her father killed the boy and four of his brothers, and when he discovered that his own mother had helped his daughter escape her father’s wrath, he killed his mother too. Now he is offering a $100,000 reward for his daughter’s dead body.
These are extreme actions by an extreme man. But many Pashtun men perceive that their manhood and very way of life are under assault—by a foreign military, foreign religious leaders, foreign television, international human rights groups—and they hold fast to traditions that for so long have defined what it means to be a Pashtun man.
One day in a Kabul bookstore I found a collection of landays—”short ones”—the two-line poems the Pashtuns recite to each other at the village well or at wedding celebrations. The book, originally published as Suicide and Song, was compiled by Sayd Bahodine Majrouh, a celebrated Afghan poet and writer assassinated while in exile in Pakistan in 1988. He first collected women’s landays in his native Kunar River Valley. Majrouh, a humanist, found glory in these cries from the heart, which defy convention and in many ways mock male honor. From cradle to grave, the Pashtun woman’s lot is one of shame and sadness. She is taught that she is undeserving of love. This is why, Majrouh wrote, landays are “a cry of separation” from the idea of love and a revelation of the misery of misalliance.
A woman’s husband is often either a child or an old man forced on her through tribal bonds:
Have you with your white beard no shame? You caress my hair and inside myself I laugh.
Tauntingly, a woman lances a man’s virility:
In battle today my lover turned his back to the enemy. / I am ashamed of having kissed him last night.
Or voices her frustrated desire:
Come, my beloved, come quickly and be close to me! / The “little horror” lies in slumber and you may kiss me now.
The “little horror” is the man a woman is forced to marry, a kind of dupe. Only without his knowledge will she find true love. As Majrouh understood them, Pashtun women, for all their submissiveness, have always lived in a state of deep craving for rebellion and for the pleasures of earthly life. He called his book Suicide and Song because these two acts are how they protest their anguish. In Majrouh’s time the two methods of suicide were poison and drowning. Now they are poison and self-immolation.
The Afghan Parliament recently drafted a law intended to eliminate violence against women, who are beginning to reject old cultural practices and assert themselves in public and in private. I went to the Kabul home of Sahera Sharif, a Pashtun and the first female member of parliament from Khost. “No one knew a woman could put up campaign photos and posters on the walls in Khost—men didn’t allow women to even have jobs in Khost,” she said.
As a girl, Sharif stood up to her father, a conservative mullah, locking herself in a closet until he allowed her to go to school. She lived through the civil war between competing mujahideen groups, who ravaged Kabul before the Taliban conquest in 1996. She witnessed unimaginable cruelty and many deaths. “Much of the violence and cruelty you see now,” Sharif said, “is because people are crazy from all these wars.”
After the Taliban fell in December 2001, Sharif started a radio station to educate women about hygiene and basic health. More radically, she volunteered to teach at the university in Khost (a first there). She took off her burka (another first) and stood before the male students teaching them psychology. They blushed. And so she began to reeducate them.
As we talked, I could see what an inspiration Sahera Sharif has been to her 15-year-old daughter, Shkola, who interrupted her mother to show me a photograph of a woman in a magazine. The woman was lying with her throat cut, murdered by her husband’s family. The woman’s mother, mad with grief, had begged the magazine to publish the photograph. “I became crazy from this picture,” Shkola said. “I saw it over and over like a film.”
Shkola is studying Islamic history and law. She intends to become a lawyer in order to help women defend themselves against violence and injustice. In the meantime, she is scouring books from Iran to find stories for children “like you have,” she said. “We have almost none here. So I’m translating them into Pashtu, and I’m also writing a novel.”
In various corners of the country—in Khost and Kandahar, in Herat and Kabul—I’ve met young women like Shkola. They’re writing not the old landays but poems and novels, and they’re making documentaries and feature films. These are the new stories women are telling about their lives in Afghanistan.