Wati thinks she is 30, but does not look 25. Married at 18 to an old man, she came to the clinic for her fifth pregnancy in four years, including two miscarriages.
“I’m afraid of losing my baby again,” the skinny young Afghan girl sadly explains.
In this small maternity hospital in a poor village in Dand district, near Kandahar, in southern Afghanistan, women are struggling to survive. With the withdrawal of American forces, which is already generating more fighting and starting to deprive the country of international funds, the situation can only get worse.
The women in burqas arrive accompanied by a male relative. The gentlemen, forbidden to enter, wait in the grass. “I’m just allowed to go outside to go to the doctor,” Wati adds, clutching her collected documents in a plastic bag.
Khorma discovers that she is still pregnant, after five children. Her two miscarriages are because she “worked too hard at home,” she believes. “Some families pay no attention to pregnancies: women give birth at home, bleed a lot and come here in shock,” insists Husna, a midwife.
Husna chose to work in the countryside when she saw the plight of women. “If I don’t come, who will?” she asks. The Taliban don’t attack midwives here, so I’m less afraid. “
For many Afghan women, the clinics are too far away, the roads dangerous, the transport too expensive …
Consequence: in 2017, UNICEF recorded 7,700 deaths in childbirth – twice the number of civilians killed in attacks (3,448) according to the UN – and the figures are even worse in the south, at the hands of the Taliban or disputed at the cost of heavy fighting.
This is where women are likely to suffer the most from the drop in aid after the withdrawal of international troops by August 31, a deadline announced by US President Joe Biden.
The already significant decline in aid is having a “deadly impact” on Afghan women, Human Rights Watch warns in a recent report. But with the risk of a civil war or a return of the Taliban to power, donors refuse to commit to maintaining support, which is “more necessary than ever”.
To monitor the health of the villagers, Najia, a midwife, goes from house to house. “Some families prevent women from going to the clinic. Sometimes the men don’t even let me in, ”she says.
At Qasem Pul, Kela receives her in her courtyard, wearing a dirty white veil. Her little boy rested his head on his knees, looking in pain.
The patient recently realized that she was five months pregnant. This is her sixth child. “Afterwards, I want contraception. I am too poor to take care of all my children. My husband agrees, she says. We don’t even have enough money for soap. “
“My baby is dead”
According to a KIT Institute study, in 2018 – 17 years after the arrival of NATO forces in the country – 41% of Afghan women gave birth at home and 60% had no post-natal follow-up. In dangerous and remote areas, these figures are even more alarming.
In Helmand province, a Taliban stronghold, less than a fifth of pregnant women had access to at least one prenatal visit, according to the institute.
In a mobile clinic of the NGO Action Against Hunger, installed in a clay house in Lashkar Gah, the provincial capital, Qandi Gul receives women displaced by the fighting. “Most of them are sick. Families do not take care of them, ”laments the midwife.
The patients wait, sitting on the floor with their sick children: miscarriage on their foreheads, neighbor dead in childbirth… their stories are sordid. “My baby died because I didn’t have access to a clinic or a midwife. Many children were dying, ”said Farzana, 20, who fled the Taliban areas.
Married since the age of 10, Shazia, now aged 18, and her three children had to walk in the Taliban zone for three hours to reach the clinic. “It was very dangerous. Three women died on the way. “
At ACF Hospital for Undernourished Infants, desperate mothers risked their lives to arrive. On their beds, they remain silent with their emaciated babies.
Rozia, arriving from the Taliban areas, looks at her son Bilal, seven months old: born prematurely, he suffers from a cleft lip, pneumonia and acute malnutrition. “I was very scared of the fighting,” says Rozia, who crossed the front line when her son’s health worsened. No one knows if he will survive.
She has already lost a child, born prematurely: the hospital sent her home after the birth, for lack of resources to keep her. The baby survived three days.
Taliban have ‘strategic advantage’, says Pentagon