RELEASE 041012-01 / Civil affairs Soldier, Afghan doctor start new birthing program in Afghanistan

RELEASE NUMBER: 041012-01
DATE POSTED: OCTOBER 12, 2004

Civil affairs Soldier, Afghan doctor start new birthing program in Afghanistan

By Spc. Claudia K. Bullard
105th Mobile Public Affairs Detachment

QALAT, Afghanistan (USASOC News Service, Oct. 12, 2004) — The first 40 Afghan women to graduate from a 3-month Traditional Birthing Assistant program sponsored by the 401st Civil Affairs Battalion here proudly celebrated their accomplishment during a recent gathering with their instructors.

The program, which trains women from Qalat and its suburbs as midwives, is the first of its kind in Afghanistan's Zabul Province. The newly-trained students will teach women in their communities how to care for themselves during pregnancy and will assist them with the delivery of their babies. Its goal is to improve successful births in the regions of southern Afghanistan.

The program’s founder, Dr. Gulnar, a gynecologist and general surgeon who received her education at Kabul University, said the mortality rate among Afghan women and their babies during childbirth is very high often because women are not allowed to see a doctor. For example, she said it is not uncommon for the husband to wait until his wife has been in labor as long as four days before he will seek medical assistance for her. By this time it is often too late.

Other issues contributing to high mortality rates, according to Gulnar, are early marriages for young women, back-to-back pregnancies, malnutrition and anemia.

Sgt. 1st Class Victoria Orsi, 401st Civil Affairs Battalion, Qalat Provincial Reconstruction Team, was the liaison and project coordinator. She reinforced Gulnar’s assessment of the plight of Afghan women saying by the time they seek medical aid “they’re at the point of no return.”

Orsi, who was approached by Gulnar and her husband, Dr. Zahir Shah, about starting the program, used Commander’s Emergency Relief Program funds to help the couple with rent for classrooms, to purchase books and desks, and pay for a security team and transportation for the students. The students also received two U.S. dollars for every class they attended.

Orsi is no stranger to the concept of home delivery and said she finds it ironic that she became a part of a birthing program in Afghanistan. While pregnant with her first child, she decided she would have her baby at home much like women in her family had done for generations. However, during labor, a blizzard prevented the arrival of the midwife and doctor. “I ended up having Luke at home with only my husband, sister and sister-in-law,” said Orsi.

According to Gulnar, there were a few obstacles that she and her two instructors – both midwives – had to overcome in order to teach their students. The main difficulty was literacy. Afghan women were not allowed to attend school under Taliban rule. To overcome reading deficiencies, Gulnar divided the group into two classes based on their level of education. One class used written materials and another class, held for those women who had not received a formal education, was taught orally “point by point about pregnancy” using visual materials. Upon completion of their training those women who could not read were tested by personal interview by the instructors. The instructors said they were very surprised and please at how diligent the women worked and how high their scores were.

The women, who ranged in age from 16 to 45 years old, said they were proud of their achievement and looked forward to practicing as a TBA which they said was “a good profession.” They also said they desired to see Afghanistan become a “peaceful, healthy community.” One older student, whom Gulnar said had “suffered much at the hands of the Taliban,” said she did not think five years ago that she "would come here and do this. It was out of my imagination.”

Gulnar is already anticipating what she would like to add or change for the next class. She said she “hopes to set up some delivery cases as a good practical” and she would like to see more structure, such as uniforms and regular class times. She said had to vary the class times because she feared for the women’s safety. Orsi also thinks the future looks promising for the TBA program which she said is the first of its kind in Zabul province. "If it goes well, we want to do more classes at other locations,” she said.

All in all, Gulnar hopes sending the TBA’s into the communities will “increase the social awareness of people.” For instance she explained Afghan women often refuse vaccination programs for their children because they think the shots will bring diseases. Birthing conditions in rural areas are usually non-sterile and primitive she said. The birthing assistants will teach Afghan women basic but important information such as separating waste areas from clean drinking water, personal hygiene and clean procedures for the birth itself.

Gulnar’s husband agrees that education is desperately needed for change in the health of Afghans. “The villages don’t have health facilities and don’t have female nurses,” Shah said. “The women deliver in their houses. They don’t know about the delivery. The Taliban or al-Qaida sometimes tells the people this is the program of the Americans."

"This is not true,” he said. “This is the program of health for all people of Zabul, of Afghanistan, of the world."

Orsi's unit, the 401st CA Bn., is an Army Reserve special operations unit based in Webster, N.Y., and is deployed to Afghanistan in support of Operation Enduring Freedom. Army civil affairs Soldiers help military commanders by working with civil authorities and civilian populations in the commander’s area of operations to lessen the impact of military operations on them during peace, contingency operations and declared war.

- usasoc -

Sgt. 1st Class Victoria Orsi (center), 401st Civil Affairs Battalion, Qalat Provincial Reconstruction Team, stands with Dr. Gulnar (left) and two midwife instructors (right) at the completion of a 3-month Traditional Birthing Assistant course she helped to sponsor using Commander Emergency Reconstruction Funds. Dr. Gulnar, program director, approached Orsi about starting this program, which is aimed at reducing mortality rates among Afghan women and children. Behind them are gathered some of the 40 students who will enter their communities to teach basic hygiene, health and assist women with birthing. (Photo by Spc. Claudia K. Bullard, 105th MPAD)

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