Women And Children Receive Much Needed
Health Care in Afghanistan
By Hajera Pasha
Jalalabad, the capital of Nangahar province is located in the east of Afghanistan, approximately 90 miles from Kabul. Going towards Jalalabad one passes through vast mountain ranges, oasis of emerald blue waters, and lush green fields. As we enter the Balabagh Basic Health Centre (BHC) located in Jalalabad, there seems to be a sudden flurry of blue burqas in the main hall, as women flutter right and left to cover their faces as they spot male members of our group at the entrance. We are welcomed by two self-assured lady doctors with friendly smiles. One is the coordinator of CWS-P/A Mother and Child Health Center (MCH) and the other is in charge of the Balabagh BHC. The waiting room is filled with a group of women and young children from mostly poor households who have come for diagnosis, regular check ups or to get medicines.
The health centre itself is set up in a modest 5 room building with a facility for the male patients at the back. It was donated by the local community as they value the BHC’s services. It has been functioning since the last 7 years and is among the 4 BHCs and 2 Comprehensive Health Centers (CHCs) established in various districts of Jalalabad under the Nangarhar health project. The Balabagh centre alone is catering for an estimated 32,819 patients. Nangarhar Health Project is a replication of the Mansehra Health Project (NWFP – Pakistan). Since 1979, CWS-P/A has been providing health care services in Afghan refugee camps on the request of the Government of Pakistan and with support from Bureau of Population Refugees and Migration (BPRM). The programme has achieved considerable success and recognition amongst the Afghan community.
Women from the Nangarhar community receive free check-ups
from the CWS –P/A‘s lady doctors. NHP provides health services
to 80% of the returning Afghan refugees.
In 1997, CWS-P/A expanded the health programme by establishing its first BHC in Jalalabad. One of the earlier challenges was getting formal permission to start a female medical facility by an NGO in a Taliban strong hold area. CWS-P/A received proper approval and acknowledgement from the ex-Taliban Government because of its relationship of trust, and good reputation amongst the beneficiaries.
Jalalabad is culturally a conservative society, where age old traditions are strictly followed and women are not encouraged to get medical care at public hospitals. At the same time, Afghanistan has one of the world’s highest infant mortality rates and half the children born are stunted and one woman dies of pregnancy-related causes every 30 minutes. The need for female professional medical care is dire. The doctors explain that miscarriages and premature deaths are high in the area due to poor diet, less spacing between children, usage of contaminated water, unhygienic practices and difficult survival conditions.
Families are living in abject poverty and cannot afford expensive treatments. The government medical facilities are inadequately equipped to function properly with out assistance. Patients walk many miles to reach here, because the centres not only provide diagnosis but also medicines at nominal rates or almost free of cost.
Fatima, a widow and a mother of 6 young kids is a subsistence farmer. She lost her 15 year old son to tuberculosis a year ago, because she had no idea about his illness or any means to afford treatment. 8 months back when she heard about the BHC, she came here for free treatment. She has not only recovered herself but also has adopted hygienic practices to protect her children. The lady doctors add that other common diseases in the area include respiratory/ skin infections, obstetric complications and stomach problems due to malnutrition, unhygienic living conditions, displacement, insufficient resources and harsh weather.
The BHC also provides a lab testing facility. A group of community volunteers work alongside CWS-P/A medical staff and play a very significant role. Currently there are 283 Volunteer Community Health Workers (CHWs), and 234 Female Health Workers (FHWs) working to moblise communities and spread awareness. They are given refresher training and their medical kits are also restocked periodically.
CWS-P/A’s CHC in Sultanpur provides both essential curative and preventive health facilities which include the safe motherhood programme. Complicated maternity cases are handled here. The centre also provides training for looking after malnourished children.
The Health Programme Officer mentions there were no reported maternal or neo-natal death cases in 2006. Moreover in Agam district, there has only been 1 maternal death during delivery in the last three years, which is a sharp decline as compared to the previous 7 to 8 deaths per year. This rapid decrease has been due to the presence of trained female health workers, awareness about good hygienic practices and increased post natal care.
Bibi Gul is a simple woman with a compassionate soul; she is one of the first women to join the centre’s community health worker programme as a volunteer. Draped in her engulfing burqa she has a brilliant smile as she emphatically outlines her duties. She keeps a regular follow-up on the expecting mothers in her community and also keeps an equipped TBA kit with her. Complicated cases are then referred to the centre. She is proud to report that she has safely delivered 3 babies this month.
Mothers and children who visit the NHP are taught the value
of healthy and well balanced meals. As a result
many of the children have reached normal weight and height.
Located in remote corners of a highly unstable region, running a health facility with such perseverance reflects on the selflessness with which these male and female doctors work. Possessing a deep love for humanity, these admirable individuals are quite an inspiration.
This centre is providing a great service to the people,’ concludes Bibi Gul. “It brings hope to many families who are childless or who have been through a painful experience of miscarriage. These poor women have no other option; otherwise their lives remain at risk. Here not only they get treatment but also awareness about healthier living.”
