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Defying odds, a female doctor tackles maternal health in Afghanistan

'Healthy Women, Better World' – Tracking maternal, newborn and child survival

© UNICEF/NYHQ2007-1459/Khemka
At the Malalai Maternity Hospital in Kabul, Afghanistan, Dr. Sumaira Yaftali uses a traditional stethoscope to check the heartbeat of a foetus.

By Cornelia Walther

UNICEF and other international leaders in maternal health and child survival are meeting in Washington, DC, to accelerate a global campaign aimed at reducing deaths of pregnant women and young children. Here is one in a series of related stories.

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KABUL, Afghanistan, 8 June 2010 – For Dr. Sumaira Yaftali, medicine is more than just a career. It’s the culmination of her life-long ambition.

“I want to become a good doctor because the Afghan society is so damaged,” said Dr. Yaftali. “War has brought many needs, especially for women. Our culture makes access to health care very difficult.”

The 28-year-old doctor, who began medical school at the age of 16, now works at Malalai Maternity Hospital in Kabul, the biggest women’s hospital in Afghanistan, treating women who would otherwise not have access to care. But the government-run institution is overcrowded and underfunded, and its staff is overworked.

Women struggle for care

With a rapidly growing population and a severe lack of resources, Malalai Hospital faces steep challenges.

© UNICEF/NYHQ2007-1447/Khemka
Saideh (not her real name), 20, holds her newborn twin girls at Malalai Maternity Hospital in Kabul, Afghanistan.

“Usually we keep the patient for a maximum of six hours,” Malalai Administrative Director Dr. Nasrin Oryakhil said, adding that many require much more extensive care. “We have 200 beds and 108 midwives and nurses. But even if we had sufficient staff, there wouldn’t be enough space for additional operating tables.”

Malalai is too frequently the last hope for women who live in regions even more poorly served by trained medical staff. Many women arrive there in very advanced states of difficult deliveries.

“Frequently the family refuses to allow a hospital delivery until the very last minute,” said Dr. Yaftali. “Especially in rural areas, husbands do not want their wives to be treated by a male doctor.”

High-risk maternity

Afghanistan is one of the worst places in the world to be pregnant. It is estimated that a woman in this country dies every 30 minutes from complications relating to pregnancy. War, social stigma around gender, and a lack of trained medical staff add to the risks.

© UNICEF/NYHQ2007-1446/Khemka
A newborn child lies swaddled in bands of cloth at Malalai Maternity Hospital in Kabul, the Afghan capital. His 30-year-old mother, who has nine other children, first gave birth at age 15.

In this environment, Dr. Yaftali is keenly aware of the obstacles women face in getting proper care. Wearing a headscarf and a white coat as she makes her rounds, the doctor faces daily battles in helping women deliver safely – particularly when surgery is needed.

“Frequently, the family is against a caesarean,” Dr. Yaftali explained. “Often they get very angry. Most of them are scared because they consider this operation too risky. Others, who are uneducated, want eight or more children and fear that after a caesarean their wife will be less fertile.”

Attitudes changing

Dr. Yaftali is the first woman in her family to become a doctor. Practicing medicine was her childhood dream. She has relatives in one of Afghanistan’s remote north-western provinces, where deprivation for women is often the most severe, and thus finds her work deeply personal.

Born into a professional family in Kabul, Dr. Yaftali has parents who support her career. But many Afghan women who aspire to practice medicine are forbidden by their families or are forced to drop out when they marry or have children.

However, Dr. Yaftali is optimistic that those old attitudes are changing. “Many families have started to send their daughters and sons to the capital to study,” she said. “Today an increasing number of husbands are proud when their wives work and bring money home.”

The young doctor anticipates that her parents will soon choose a husband for her, and she is happy to oblige them – on one condition.

“Whomever I marry must agree to my profession and to the objective of helping our people,” she said. “Good quality health care should be possible everywhere, even in poor, remote areas.”




27 May 2010: UNICEF Radio talks with Dr. Sumaira Yaftali about maternal and child mortality in Afghanistan.
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