By Matthew Bullard
The maternal mortality ratio in Afghanistan was in 2002 approximately the highest in the world at 1,600 deaths per 100,000 live births. In some parts of HealthProm’s programme area (Balkh province in northern Afghanistan) the figure a few years ago was even more, but over the last 30 months not a single woman has died from complications of pregnancy or childbirth. Much of the credit for this belongs to local safe motherhood groups set up by village women on encouragement from the project HealthProm and local partner HealthProm Afghanistan (HPA), and to local government midwives supported by HPA to run ante-natal checks and birth planning for each family. As a result, increasingly large numbers of women are coming into local health centres so that midwives can help with the delivery. In emergencies, however, there is often no alternative but to take women to hospital in the city, which can be up to 6 hours away even in good weather.
The last recorded maternal death took place in the village of Khaneqa, Charkent district, in January 2014, when a mother and her baby both died after the project vehicle was unable to get near enough to take them to hospital in time. Part of the problem was that the access track to the main road through the valley ran along the northern side of a ridge and was therefore often blocked by snow even in spring, and by impassable “blue mud” after each snow thaw or rain.
With UKAID funding for the programme (2014-16) HP Afghanistan and community leaders in Charkent were able to plan a new 3 km access road on the southern flank of the ridge. The budget available was small (only £3500) but community leaders from five different villages came together to persuade local people to provide the land, materials and much of the manual labour for free. HPA Operations Manager Mohammed Osman Parsa also arranged with a local company to provide equipment and drivers (one excavator and four trucks to move aggregate) for a fixed fee closer to actual cost than to commercial rates. In the end the work was completed in 20 days, with 108 villagers joining in to help (see video) – another extraordinary example of what Afghan communities can achieve if given the support and extra resources they need.
Watch a clip from the construction of the road here.