Kabul Maternity Hospitals Lack Equipment and Supplies; Help from UNFPA Is on the Way
- 19 February 2002
KABUL, AFGHANISTAN -- The small surgery in the Khair Khana 52-Beds Hospital smells of blood. (Actually it is more a clinic than a hospital.) Laundry is drying on the operating table. Equipment for anaesthesia and sterilization of instruments is obsolete, inadequate or nonexistent.
In a tiny adjoining room, a 35-year-old patient recovers from a hysterectomy. Doctors removed her infected uterus because the hospital wasn't equipped to treat the infection.
Midwives in the dingy delivery room, where 10-15 births take place daily, work by the light of a floor lamp meant for office use. The kitchen is unventilated and full of smoke. Because of a bed shortage, mothers and infants are sent home not long after delivery. At 5 o'clock one afternoon, none are around and the clinic is strangely quiet, despite a rush of births the night before.
Conditions are better at the Rabia Balkhi Women's Hospital, which has some 30-40 deliveries per day. But there is just one incubator--at least three are needed. Sanitation is poor, despite cleaning, because building materials are crumbling. There is just one washing machine, and sheets and bloody gowns are washed in buckets or on the floor using a hose.
"We need a blood bank…and as we have emergency patients here, we need equipment for operations and anaesthesia, and an incubator," says Dr. Sara Anwari, chief of obstetrics and gynaecology. "We only have one operating table."
"Because of the lack of transportation, patients from outside Kabul come only at the end of their pregnancy and have many problems, such as a post-partum infection or enlarged uterus," the doctor adds. "We try to solve each patient's problem on an outpatient basis; the child is treated, the mother is treated. After that, if there is no choice, we operate. We perform up to four caesarean sections a day."
The outpatient obstetrics-gynaecology clinic is a simple shed in the hospital courtyard; a dilapidated examination table sits behind a curtain. Patients crowd the waiting area outside. Every day, a handful of health workers see up to 300 patients, who wait up to three hours for an exam.
This is the best maternal care available in Afghanistan. At the other extreme, seven out of eight women have no access to any reproductive health care whatsoever.
New equipment-- including autoclaves, an operating table, incubators, ultrasound scanners and anaesthesia machines--and a full range of medical supplies for the Khain Khana clinic and Rabia Balkhi hospital, and for the Malalai Hospital will arrive in Kabul in early March, part of an airlift the United Nations Population Fund (UNFPA) is sending from Copenhagen.
In addition, with support from the Government of Italy, UNFPA is making plans for a complete renovation of the Khair Khana clinic's maternity ward. The plans and work will be carried out by an Italian nongovernmental agency, Intersos.
Also starting in March, a UNFPA expert will assess maternity hospitals and reproductive health care in several other Afghan cities, and the Population Fund and the World Health Organization will jointly evaluate training in emergency obstetric care.
William A. Ryan
Tel.: +66 2 288 2446