Grim Conditions in Kabul Maternity Clinics, Review by UN Population Fund Finds

KABUL, Afghanistan - Dr. Olivier Brasseur, Afghanistan Country Director for the United Nations Population Fund (UNFPA), today joined Ahmad Fawzi, spokesman for the Special Representative of the Secretary-General for Afghanistan, Lakhdar Brahimi, in a briefing for the press. Dr. Brasseur made the following statement on women, health and population issues:

Karima thinks she is 36 years old. She was admitted this morning for bleeding at Malalai maternity clinic. She was resting on a bed without sheet, with nine other women in a room. When we asked her how many times she had been pregnant, her answer was "16 times". Only eight children are alive. She said she was 16 when she got pregnant for the first time. She was complaining that the food in the maternity was not good, and that she could not even wash herself.

This very common story illustrates the challenge faced by Afghan women and the health authorities.

Afghanistan has one of the highest maternal mortality rates in the world. This can be related to many factors: early marriage; lack of education; lack of pertinent information on reproductive health; poor antenatal care; low-quality obstetric and gynaecological care; and inadequate child spacing.

Dr. Suhaila Seddiqi, the Minister of Public Health, has asked the UNFPA to help the Department of Public Health coordinate the efforts undertaken by the national organizations and the international community to improve the reproductive health status of women. In accordance with the broad political framework set up in Bonn and under the guidance of the Office of the Special Representative of the Secretary-General, the UNFPA will provide support in this critical health and education area.

In collaboration with the Department of Public Health, the UNFPA conducted a review of the three maternity clinics, Malalai Maternity, Rabia Balkhi Women's Hospital, and the 52-bed Kheikhana Hospital. The buildings are warm and safe. However, the sanitation is very poor, rooms are overcrowded and improperly ventilated, building materials are worn out and difficult to clean, equipment is inadequate and incomplete.

The anaesthesia of women who need a surgical procedure is made with a simple balloon because no anaesthetic machine is working or available. Patients have to buy their own drugs before surgery. No ultrasound equipment is working to allow for proper antenatal follow-up and diagnosis. Despite these very difficult conditions, staff bravely continue to work and to provide care as much and as best as they can.

These maternities are overloaded and cannot keep women for more than 12 hours, and sometimes have to discharge mothers and their babies after only six hours of stay.

The UNFPA will provide the required equipment in the coming weeks and months, and will identify and implement training programmes that can prevent further shortages of staff. The first training program will be established very soon with Hacettepe and Birkent Universities in Ankara. The UNFPA will also identify international organizations that can improve buildings' water and sanitation. According to a quick evaluation, the initial investment that the UNFPA will make is close to $3 million.

In addition, the Department of Public Health has invited the UNFPA to assess the 41 mother and child health clinics in the broad Kabul area, to decrease the overcrowding of outpatient departments in Kabul city and to improve antenatal care coverage. This work will be done in close collaboration with the World Health Organization (WHO) and the United Nations Children's Fund (UNICEF).

The story of Karima is also interesting from a demographic point of view. The uncertainty about her age is a problem for Karima. There is no registration of births or deaths in Afghanistan. Very little is known about the population. The UNFPA will support civil registration. When the overall situation improves and stabilizes, Afghan authorities intend to conduct a census. The last one was done in 1982. Because of the lack of capacity in statistics at all levels, it is not realistic to envisage this enormous and very costly task before 2005-2006.

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The UNFPA is the world's largest international source of population assistance. Since it began operations in 1969, the Fund has provided about $5.6 billion in assistance to virtually all developing countries.

Contact Information:

William A. Ryan
Tel.: +66 2 288 2446
Email: ryanw@unfpa.org

Abubakar Dungus
Tel.: +1 (212) 297-5031
Fax: +1 (212) 557-6416
Email: dungus@unfpa.org