Progress for Afghanistan’s mothers and children, but for how long?

by Jasmine Whitbread

It is not often that we are told there has been progress in Afghanistan but, as I saw myself during my last visit there, the country is finally starting to see the fruits of years of investment in maternal and child health. For the first time in two years, Save the Children’s State of the World’s Mother’s report does not rank Afghanistan as the toughest place in the world to be a mother.  And I also believe we can fully expect that when we come to check our report again next year, there will have been further encouraging progress.

Despite the overwhelming media narrative that international assistance in Afghanistan has been a failure, these encouraging signs show otherwise. It shows that there is the possibility of real change for the good. With the international funds invested in health by donor countries, Afghanistan has been able to introduce around 20 000 more healthworkers, 3 000 more midwives and 2 000 new health facilities.  More vital personnel in the country's rural areas has meant care is closer to communities. Childhood diseases and pregnancy related complications can be caught before it’s too late.

As a result of these changes, a national survey last year showed significant declines in the numbers of mothers and children dying in Afghanistan. Previous rates of child and maternal mortality meant every Afghan mother was at risk of losing a child during their lifetime – the new data shows the number of children dying before their fifth birthday to has fallen to 1 in 10.

But much remains to be done. Afghanistan is at a turning point and there is no room for complacency. What most Afghani mothers tell you they want is simple: A safe place to raise their children, honest officials, good teachers and well trained doctors. That’s not asking too much. Yet this is still far from reality in Afghanistan.  And we should not forget the World Bank's recent report showing that health is the most vulnerable sector to decreases in donor funding.

Consider Mohammad, a 38-year-old tractor driver and a single father of four children who met my colleague in Jawzjan province last year.  About a year ago, Mohammad’s wife went into labour. He rented a car and rushed her to the local clinic in the dead of night.  At the clinic, there was no midwife, and he was referred to the hospital in the district capital. There, doctors operated on his wife but his baby girl died immediately and his wife was left in terrible condition, bleeding severely. Doctors told him that to save his wife he’d have to take her to the capital, Kabul, 300 miles away.

“It was a very bad night; I’ll never forget it,” Mohammad told my colleague. “I had no money to take my wife to Kabul and to pay for her treatment so I had to borrow 50 000 afghanis ($1,000).  In Kabul the doctors said the operation had not been done properly, and they couldn’t do anything to stop the bleeding. I took my wife to Pakistan but (a month later) she died there. I borrowed money, but I lost her anyway. I lost my child too.”

“The children always ask me, ‘Where’s my mother? Why she doesn’t come home?’ I keep telling them that their mother has died and she’ll never come back. But my four-year-old doesn’t accept it and cries for his mother.”

Afghans like Mohammad and his family are often forgotten. It’s people like them that need to be remembered as the Afghan government and international community meet at the G8, NATO and Tokyo conferences in the coming months.  The country has shown it can make progress, and is very slowly doing so, but it can’t continue to move in the right direction on its own.