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Last Updated: Sunday, 20 March, 2005, 01:25 GMT
Helping Afghan women be healthy
By Caroline Ryan
BBC News health reporter

Afghan women queue to have their children vaccinated against polio
Afghan women are gradually gaining more access to healthcare
Giving birth in a remote village in Afghanistan can be a lonely and frightening experience.

Mothers-to-be often have no-one to care for them through their labour, because there are too few female doctors or midwives available.

Male doctors are not allowed to be present, and most women would not want them there anyway.

The difficulties in providing care to women in childbirth highlight the problems which are still being faced in Afghanistan.

The country has the highest maternal death rate in the world, with 1,600 women out of every 100,000 dying in childbirth.

An estimated 257 children per 1,000 die before the age of five.

Even three years after Taleban rule ended, there are very few hospitals in the country, and men and boys take precedence in those emergency departments which do exist.

Women are often not allowed to see a male doctor at all.

'Housebound'

Campaigners are trying to improve the situation.

Hulan Khatibi
There has been improvement and there has been change
Hulan Khatibi

Teams now go to villages to educate women about how to care for and feed themselves during pregnancy, and their babies when they are born.

They also counsel them to move away from unhygienic traditional practices such as birthing stones, kept in many rural houses, which women sit on to have their babies.

These stones are used whenever the woman has a child.

Hulan Khatibi is the director of the Women's Activities and Social Sciences Association, one organisation working to improve healthcare for women in Afghanistan.

She has been part of a delegation led by the charity Action Aid which has visited the UK and US to raise awareness of the help the country still needs.

She told the BBC News website: "During the Taleban's reign, it was impossible. Women weren't allowed to go out of the house. It was very difficult to have access to healthcare.

"We just didn't have female doctors because they weren't able to practice.

"That is why the maternal mortality rate has been so high."

'No hospitals'

Ms Khatibi said the organisation gives women information about how they can live more healthily.

"We give them information about how to bathe hygienically in the public baths that people in Afghanistan use, how to nourish their babies, and what they should be eating while they are breastfeeding.

"We also train a midwife in each area so that they can go on to train other women."

The organisation also talks to men, to widen their understanding of what women need and the freedoms they now have.

But she said a lack of clinics was still a major problem. "In one area, there is only one hospital which it takes two hours to fly to from the outlying parts of that region."

And poverty means that travelling by plane would be an impossibility for many, she said.

Her organisation is now building smaller clinics which are more accessible for people in rural areas.

Ms Khatibi, who lived in exile in Pakistan during the Taleban's rule, added: "We are happy. There has been improvement and there has been change.

"You cannot expect massive change. That is going to take some time."


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