Recently, a very nervous man came to one of AIL’s clinics saying that his wife was dying. He said she was in her last month of her pregnancy. Her labor pains had started hours earlier, but she had not yet delivered the baby. The head of the clinic quickly sent an ambulance to bring her to the clinic.
After she arrived she was taken to the midwives. They did a physical exam, and everything was normal, the baby was still alive. The woman told the midwives that her husband’s first wife had died during delivery. The midwives calmed the woman, telling her that she would deliver the baby safely. Soon, the woman delivered a healthy baby girl. The woman and man were very thankful for the well trained staff at AIL’s clinic.
Afghanistan continues to have one of the world's highest infant and maternal mortality rates. Through its three rural health clinics in Herat and Kabul, the Afghan Institute of Learning (AIL) provides family planning, ante and post natal care and safe delivery environments for women. In 2008, AIL provided reproductive health care services to 19,425 women. Furthermore, 59,229 women received education about health topics which included reproductive matters. Community Health Workers, serving villages near to the two Herat clinics, also provide reproductive health services including family planning advice to 53,443 women annually. In Afghanistan, this kind of information is only given when requested.
Following is a story from one of the clinics, which illustrates how AIL clinic staff is helping women villagers on a day to day basis:
A midwife said: "Bigum was a returnee patient of the clinic. She came to the clinic for post natal care. After a month she asked about family planning methods. I gave her information and suggested Lynstrolol tablets because it doesn't decrease breast feeding. But she told me she has forgotten to take pills in the past. I suggested injections but she didn't like that so I explained about the IUD which she decided on. After a vaginal examination, I inserted an IUD and gave her health education to take care of it. After 15 days she came to the clinic for a follow up and she was happy with it. She told me that she has told other women about the advantages of the IUD."
For the long term, AIL is also training nurse/midwife/health educators through its intensive course in Kabul. This course has been extended in length to 18 months and has between 45 and 65 students at any one time. In the last two years, two classes of nurse/midwife/health educators have graduated and graduates are now working in clinics and hospitals in Kabul Province.
Following is a story clinic staff about Jamila, a graduate of the AIL nurse/midwife/health educator course, who is now working:
"During Ramadan the staff left early, and only Jamila was left in the clinic. A woman came to the clinic, and she had a breach presentation delivery. Jamila performed the delivery perfectly. The personnel of the clinic were very happy with Jamila and impressed that when she was alone she could handle the case and they were happy and thankful for Jamila and for AIL, which trains and graduates such students."
Thanks to all of you who, through your donations to this project, are helping to educate and reduce the maternal mortality rate of Afghan women!!
We would like to share a report from one of AIL’s Outreach Vaccinators in Herat, Afghanistan.
I went to the Koshkak Village as part of the vaccine program and saw that a group of people had come together and were discussing the advantages getting vaccinated. I stayed there and listened to their ideas and questions about the vaccine program. One asked “What is the advantage of being vaccinated?” Another answered “Before the immunization program, our children suffered from polio, diphtheria and measles, but now the vaccine protects them from those dangerous diseases.”
I praised them for their information about vaccines, in addition to what they already knew, I gave them health education and said that the BCG vaccine prevents your children from getting tuberculosis and this vaccine is injected into a baby’s arm just days after birth; we give them the Polio vaccine at that time too. I also told them about the TB clinic that AIL has, and described the symptoms of TB.
I also explained to them that the DPT-Hep B vaccine protects their children from four dangerous diseases. Diphtheria, Whooping Cough, Tetanus and Hepatitis B and that this vaccine is injected during the 6th, 10th and 14th weeks of a baby’s life.
I explained that when we give the DPT-Hep B to their children, we also give the Polio vaccine. I said that we give two rounds of the Measles vaccine in the 9th and 18th months of life.
I also let them know that in addition to the immunization program for children, that we give women the Tetanus vaccination. We give the OPV vaccine to children up to five years old.
I saw in the faces of people that they were very happy about this health education and then I asked them to go home and bring their children with their vaccine cards so that I can see who I must vaccinate. They followed my instructions and the results of the vaccine program that day were excellent for me.
Between January and June 2008, doctors in the Afghan Institute of Learning (AIL) clinics in Afghanistan have treated 9,347 women for reproductive health issues. Health education directly related to reproductive health issues (breast feeding, family planning, nutrition, vaccinations, and sexually transmitted diseases) is chosen by about 25% of the women who receive health education at the clinics. AIL has also held four-day reproductive health workshops for 247 women. So far in 2008 the AIL clinics have delivered 43 healthy babies.
The impact on those served is great. Following are just a few comments of women who have been helped:
Female doctor of the Imam Shish Nur Clinic said: “Habiba came to the clinic 9 months ago; and said that she had amenorrhea. I referred her to the clinic laboratory for a pregnancy test. The result of lab was positive. I congratulated her but she was upset because 25 years ago she got married and had been pregnant 17 times but unfortunately all of them miscarried. I did not think that this pregnancy would be full term as before. Again I referred her to complete all the tests and fortunately all the results were normal. She had a stepdaughter. I give hope to her that this time she would have a safe delivery and her own baby. I advised her to have monthly visits at the clinic. She was given Healthy Mom and Ferfolic. When she passed the seventh month of pregnancy she suffered from hypertension and pedal edema. I referred her to the laboratory for urine analysis test. The result of her examination was proteinurea; I took management of her. Weekly she has come to the clinic for follow up; her blood pressure was under control. A night she was going to have delivery and her family took her to the hospital for delivery. She gave birth 25 years of marriage. Two days later she came to the clinic with her baby; she was very happy and appreciated me and services of the Imam Shish Nur clinic. I was thrilled to see her with her baby. It was one of my best memories. She said I can't believe that after all this time I have a child.”
Midwives of the Jaghartan Clinic said: “One day when we arrived at the clinic a pregnant woman was waiting. She was in pain. Her name was Zia Gul and she had come for ANC to the clinic several times; her pain had started an hour ago, but when we examined her we could see she was near delivery. We got ready for delivery and the woman gave birth very easily. We waited for half an hour for the placenta; but it didn't come out normally. We got ready to take out the placenta by hand. We added Ocytocine injection in the serum because she was bleeding. We took out placenta by hand. Those in attendance said if we don't take her to the clinic; we must take her to the hospital for delivery of the placenta; and on the way she would lose a lot of blood and it would be harmful for her. The baby was male weighing 3.5Kg; and his condition was good. The baby was referred to the vaccine room; for BCG and OPV (0) vaccine. When she was discharged we gave the patient Healthy Mom liquid. The patient’s family was appreciative and very happy with the facilities of Jaghartan clinic and the expert staff.”
Midwives of the Jaghartan Clinic said: “One day when we arrived at the clinic a pregnant woman was waiting. She was in pain. Her name was Zia Gul and she had come for ANC to the clinic several times; her pain had started an hour ago, but when we examined her we could see she was near delivery. We got ready for delivery and the woman gave birth very easily. We waited for half an hour for the placenta; but it didn't come out normally. We got ready to take out the placenta by hand. We added Ocytocine injection in the serum because she was bleeding. We took out placenta by hand. Those in attendance said if we don't take her to the clinic; we must take her to the hospital for delivery of the placenta; and on the way she would lose a lot of blood and it would be harmful for her. The baby was male weighing 3.5Kg; and his condition was good. The baby was referred to the vaccine room; for BCG and OPV (0) vaccine. When she was discharged we gave the patient Healthy Mom liquid. The patient’s family were appreciative and very happy with the facilities of Jaghartan clinic and the expert staff.”
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