Bringing Safer Motherhood to
Kabul,
UNFPA Steps up Health Assistance
KABUL – The United Nations
Population Fund (UNFPA) continues to expand health care and
education programmes in Afghanistan aimed at reducing maternal
and child mortality as well as empowering women. In Kabul, UNFPA
has opened an advanced mobile hospital which can assist births
24 hours a day and is equipped to treat patients affected by
virtually any kind of trauma, including complex pregnancy and
birth complications. The Fund is also supporting the government of Afghanistan in a
major logistical challenge of the next three years; undertaking
a nationwide population and housing census. The last attempt to
conduct such a comprehensive survey was in 1979. The census project consists of a massive effort to train local
staff all over Afghanistan and conduct first a rapid assessment,
then a national census to better inform and guide the
reconstruction and development programmes in the country. Preliminary results are expected in late 2003 with nationwide
results scheduled for mid-2005. The time-table is ambitious,
officials say, because Afghanistan’s infrastructure is badly
fractured and most of the terrain is challenging, but the need
for data is urgent as development speeds up in Kabul and other
cities. Enumerating the rural population is especially crucial
to choose the right locations for development activities,
housing, new hospitals and other social services in this vast,
rugged country. Hospital Reconstruction: Saving More Lives
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The mobile hospital is
located next to a football field in northern Kabul, only
700 metres from the Khair Khana hospital that it
temporarily replaces.
Photo:
Jesper Jensen. |
In Kabul, UNFPA is working with
the Government of Afghanistan as well as international and local
non-governmental organizations (NGOs) to rebuild and upgrade
clinics and hospitals as well as ensure a steady supply of
medical equipment and consumables. The Fund also supports
training programmes for local medical staff to ensure that the
health care services are sustainable and self-reliant. As part of this relationship, UNFPA has helped the city expand
medical capacity, most recently in northern Kabul where the
Italian NGO, Intersos, renovates the Khair Khana Maternity and
Child Hospital. In August, the Fund opened an advanced, 72-bed
hospital – the Danish Emergency Mobile Hospital (DEMH) – which
will service the area until renovations finish in March 2003. The mobile hospital, which can identify and treat almost any
kind of medical emergency, will provide much needed
referral-level capacity for a network of hospitals, clinics and
health care providers in the city.
 |
The hospital’s surgical
theatre is equipped with advanced x-ray and anaesthesia
systems to handle all obstetric complications as well as
severe trauma.
Photo: Jesper
Jensen. |
Designed for conflict and disaster situations, the hospital is
equipped with two operating theatres which, in this setting,
will address obstetric emergencies and complicated births and
pregnancies. The hospital also has an emergency ward, an
advanced medical laboratory and two maternity wards.
The hospital plays a particularly important role in UNFPA’s
efforts to save women’s lives and reduce maternal and infant
mortality because of its training capacity. The Danish medical
staffers are specialists in a number of medical fields and all
have teaching experience in advanced medical skills and
technology. Both Afghan and Danish staffers are rotated
regularly to maximize the use of skills and time.
The mobile hospital was procured by UNFPA with support from the
Governments of Luxembourg, Italy, the Netherlands and Norway.
The Danish Government is also independently funding the project.
 |
Made up from tents and
cargo containers, the Danish Emergency Mobile Hospital
provides flexible and advanced medical capacity to Kabul.
Photo: Jesper Jensen. |
"Afghan women urgently need access to reproductive health care
services," said Thoraya Obaid, Executive Director of UNFPA, when
the DEMH opened in August. "This hospital is one small step
towards saving the lives of countless women and children."
UNFPA has previously upgraded the Shahuda clinic in bombed-out
western Kabul and is currently supporting Afghan-run training
programmes for midwives and traditional birth attendants (TBAs).
Most women in Kabul give birth at home, as do nearly all Afghan
women. If they experience complications during birth, they often
die because they medical attention is unavailable or cannot be
reached in time. Earlier this year, UNFPA provided several
ambulances to hospitals and clinics, which now make daily runs
in the city.
Background: Rebuilding Afghanistan
UNFPA is participating in Afghanistan's reconstruction as part
of the integrated United Nations assistance mission. Priorities
identified together with the Ministry of Public Health and the
Ministry of Women's Affairs include strengthening maternal
health services and girls' education, with an initial focus on
rebuilding health and education infrastructure.
As reconstruction efforts gain ground in Kabul, Afghanistan
still faces a major logistical challenge in trying to plan and
implement both emergency and reconstruction assistance. There is
an almost complete lack of reliable data about the country's
existing infrastructure for addressing Afghanistan's tremendous
health problems, particularly related to maternal mortality and
morbidity.
In order to solve this information problem, the Afghan Ministry
of Public Health, USAID and UNFPA are collaborating with two
international non-governmental organizations (NGOs) to organize
an intensive, rapid and comprehensive national survey of health
facilities and resources, covering every district in the
country. Survey data are expected late this summer.
This critical study has been planned and will be implemented by
two international NGOs; the US-based Management Sciences for
Health, and the Japanese NGO HANDS (Health and Development
Services). The US NGO's activities will be funded by USAID, and
the HANDS component will be supported by UNFPA.
The UNFPA contribution will focus on all aspects of the health
infrastructure that relate to reproductive health, including
physical facilities. For example, mother and child health (MCH)
clinics with specific areas for care of female clients as well
as female staff.
The results will be used by the Ministry of Public Health, NGOs,
and donor agencies to allow precise targeting of underserved
areas for rapid expansion of the service infrastructure, largely
through support to key international NGOs with the capacity to
rapidly increase their activities to these areas. It will also
provide the essential database for planning training programmes
and other functions needed to support this expansion.
UNFPA: Expanding Relief Efforts
Overall, the United Nations Population Fund (UNFPA) continues to
expand its efforts in Afghanistan to help women and girls
recover from years of discrimination and reconstruct development
gains that have been lost to 23 years of armed conflict.
The Fund is working to save women's lives and provide crucial
basic health care services such as:
- Safe delivery
- Pre and post-natal care
- Safe motherhood
- Prevention and management of
sexual violence
- Prevention and treatment of
sexually transmitted diseases
- Protection of mothers' and
infants' health
- Family planning services,
including counselling
- Literacy courses and
income-generation skills for women
UNFPA is planning to expand
these activities to all major Afghan cities and is currently
hiring additional local staff to facilitate the expansion into
all major Afghan cities.
Focus on Lack of Medical Personnel
A major obstacle in extending reproductive health care to
Afghans is the severe shortage of trained female doctors and
midwives The vast majority of Afghans have no access to family
planning, prenatal care or assisted deliveries, resulting in one
of the world's highest maternal and infant mortality rates. 23
years of conflict and devastation have prevented training of
doctors, nurses and midwives, particularly female health workers
during the rule of Taliban who banned women from working.
UNFPA is working to alleviate the shortage as part of its
ongoing assistance to several non-governmental organizations
that provide health services.
One of the NGOs supported by UNFPA is the Swedish Committee for
Afghanistan which manages a network of over 200 basic health
centres and 57 clinics in six of the country's 31 provinces; 24
clinics provide maternal and child health (MCH) services, 14 of
them in Kabul.
Women come to the clinics for family planning, prenatal checkups
and treatment of reproductive tract infections. Some deliveries
are done there, but most women deliver at home. Where possible,
patients with complications are referred to emergency obstetric
care centres. Health education classes cover family planning
methods, child health and the benefits of child spacing.
Donor Response
International donors have responded generously to UNFPA's appeal
for funds to support these activities. Five governments have
donated almost $9 million: Luxembourg, $4.5 million; Italy, $2.3
million; the Netherlands, $715,000; the United States, $600,000;
and Norway, $560,000.
Reducing maternal mortality is a priority area for UNFPA, which
supports safe motherhood interventions in 89 countries, as part
of its commitment to reproductive health. This work is
facilitated by a strong network of partners, a wealth of
experience and a broad presence at the country level.
Partner NGOs
UNFPA's partners in providing health care, reproductive health
supplies and educational services for Afghanistan and Afghan
refugees include:
ACTED
Afghan Health Development Services
Afghan Inkishafee Tarbiawee Markaz
Afghan Institute for Learning
Aide Médicale Internationale
Healthnet International
Ibn Sina
International Federation of Red Cross and Red Crescent Societies
International Refugee Committee
Marie Stopes Society
Médecins du Monde
Médecins Sans Frontières
MERLIN
Medical Relief Unit
Relief International
Save the Children UK
Save the Children U.S.
Solidarité
Swedish Committee for Afghanistan
Women's Commission for Refugee Women and Children
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