Protecting and improving healthcare: Insights from a remote village in Ghor, Afghanistan
With support from UNICEF, primary health centre in Shuturkhan village in Ghor, provides essential health and nutrition services to over 3,000 residents
Ghor, Afghanistan: A 90-minute ride on a hilly terrain, crossing through the Harirhod river, surrounded by snow-capped mountains and breathtaking landscape, brings us to Shuturkhan village, which sits across a vast landscape in Chaghcharan district of Ghor province, in western Afghanistan. An unpaved road with sparsely spread hamlets on both sides is the only road that connects this remote village with the capital city, Firozkoh. This village remained largely isolated due to war and insecurity for major part of the last 20 years. Home to around 3,000 inhabitants, the mud houses are scattered up and down small hillocks. It is still early in the morning, and a line of people, mostly women cradling their babies under their large coats, is waiting outside the area's only primary health centre for their turn for the checkup.
Baby Morsal, who is one and a half years old, has been a regular at Shuturkhan primary health centre for the last nine months. She is cheerful in her mother’s lap as a midwife checks her weight.
“Morsal was malnourished when her mother brought her here for the first time. She was prescribed Ready-to-Use Therapeutic Food (RUTF). She is improving, and her mother has been bringing her to the health centre regularly for screening,” says Khatima Nabizada, a nutrition counselor at the primary health centre.
Morsal is among 600,000 children who received severe acute malnutrition (SAM) treatment from UNICEF in 2022. Earlier this year, UNICEF estimated that a staggering 1.1 million children were expected to suffer from severe acute malnutrition in Afghanistan, also known as severe wasting. In severe wasting, children don’t have enough food, and they become vulnerable to multiple bouts of diseases, which puts them in grave danger.
“Often, mothers who bring their children to the clinic are equally malnourished. In many cases, they are severely anemic. When mothers have inadequate diets, a harmful cycle is created,” explains Parwana Shaiq, a midwife at the primary health centre, while checking the blood pressure of Morsal’s mother.
Shuturkhan primary health centre has a capacity to deliver health services to around 3,000 people. UNICEF supports the health centre to provide essential health services including nutrition, basic health, maternity care, vaccines, and medicine. Across Afghanistan, UNICEF, in partnership with the World Bank, plays a critical role in supporting the operations of 2,311 health centres by covering the salaries of around 26,000 health workers, including that of Parwana and her three colleagues. In 2022, the UNICEF-supported health centres provided primary healthcare services to over 18 million people in Afghanistan.
Outside the primary health centre, as the sun shines brightly amidst freezing temperatures, men and women have queued up. They are waiting for their turns to be attended by the health workers. There are pregnant women visiting the midwife for antenatal care, mothers to screen their young babies for malnutrition and vaccinate them, and a few patients with injuries and flu.
“For years, the continuous fighting in the area restricted people, especially women, from accessing healthcare services. Pregnant women didn’t visit the health centre and preferred to deliver at home. With improved security, women are now seeking health services. Pregnant women come to deliver here at the health centre and follow up after the delivery. We have seen a change in health-seeking behavior of women in our area,” says Parwana.
Although Parwana works a day shift as the traditional norms don’t permit her to work at night, she often stays at the health centre to conduct deliveries late at night.
I have seen my friends and family members suffer during their pregnancies. I wanted to help, which is why I became a midwife. I often work long hours into the night as we now have patients coming from other far-off villages, but I am happy to do so.
Even though, Shuturkhan primary health centre has faced medicine shortages and overstretched staff in recent months due to an increase in the number of people accessing health services, this hasn’t deterred Parwana and her colleagues.
“No matter what obstacles are thrown our way, we will continue working for our community,” says Parwana with determination; Khatima nods in agreement.