Little health care for women in Paktika Province
SHARANA, 1 February 2009 (IRIN) - “I will not take
my wife to a male doctor even if she dies,” said Pir
Gul from Paktika Province, southeastern Afghanistan,
explaining that such a thing went against tradition.
Gul’s mindset is common in Paktika Province where
there is not a single female doctor, though the
Central Statistics Office estimated Paktika’s female
population at over 180,000.
“This is a very serious problem,” Nangyalai (he
only uses one name), the deputy director of Paktika’s
health department, told IRIN, adding that there were
only a few female nurses and midwives in the whole
With the help of aid organisations, the Ministry of
Public Health (MoPH) increased the number of midwives
in the country from 400 in 2001, to about 2,500 in
2008, but that is still not enough.
“An estimated 4,546 midwives are needed to cover 90
percent of the country’s pregnancies,” the UN
Children’s Fund (UNICEF) said in its State of the
World Children’s report 2009.
After Niger, Afghanistan has the second highest
maternal mortality rate (MMR) in the world, and each
pregnant Afghan faces a 1:8 risk of dying from
complications, according to UNICEF.
Limited access to maternal health care, poor
awareness about safe delivery practices and scarcity
of professional health workers are three factors
contributing to the high MMR in Afghanistan, UNICEF
Strong conservative traditions also hinder women’s
education and awareness in Paktika.
“Societal norms require many women to be escorted
outside the home by a male relative, thus restricting
their mobility to access health facilities,” the
UNICEF report said.
MoPH officials in Kabul said they were committed to
expanding basic health services country-wide, but
“insecurity is the biggest problem impeding the work
of female health workers,” Deputy Health Minister
Faizullah Kakar told IRIN.
No one has reliable figures on maternal and infant
mortality rates in Paktika where deaths mostly result
from preventable and curable diseases, aid workers
In the absence of professional health personnel,
women seek treatment and medical care from amateur
midwives and herbal medicines. “Usually an elderly
woman in a village attends during delivery,” said Rozi
Khan, a local resident.
Many women are feared to be suffering, and even
dying, from post-delivery infections due to poor
hygiene and lack of access to antibiotics, experts
Women and young girls with other diseases have
little or no option but to endure pain and
inconvenience until a natural recovery is achieved.
Some use locally produced herbal medicines, while
others seek advice and help from local drug sellers.
In extreme cases and when an illness is prolonged,
those who can afford to, take a sick female to Kabul
or Pakistan for medical treatment.
Integrated Regional Information Networks (IRIN), a
project the Office for the Coordination of
Humanitarian Affairs. IRIN is UN humanitarian news and
information service, but may not necessarily reflect
the views of the United Nations or its agencies.