Severity of Bleeding: Awaiting the Face of a Child or Angel of Death?

Image: BBC

A Narrative of Women's Painful Childbirth Under the Shadow of the Taliban

“The clinic has been closed for three months. Noor Bibi, my daughter-in-law, became ill at midnight. She lost so much blood that she collapsed from weakness, and her baby suffocated. Before reaching the city by morning, my beloved daughter-in-law passed away in my arms.”

Shirin Gul, the mother-in-law of 24-year-old Noor Bibi, narrates the crisis stemming from the lack of doctors and healthcare facilities in Gharmoshak village, Zindajan district of Herat province.

Speaking with a deep sigh and a voice choked by sorrow, she says that this was Noor Bibi’s third child who not only suffocated before being born but also cost Noor Bibi her life due to severe bleeding and unbearable pain.

“God did not take just one from me; He took both the innocent child and the mother. If only there had been a midwife.”

Although Shirin Gul doesn't know why their local health center was closed, she says that even the mobile units of the health center have been taken away by the government for the past three months, leaving them without access to doctors or medication.

According to Shirin Gul, to reach the nearest health center, they would have had to travel several kilometers. However, at the time of Noor Bibi’s childbirth, arranging transportation and paying for a vehicle was prohibitively expensive for this impoverished family.

She explains that at two o’clock in the morning when Noor Bibi went into labor, the entire family sought help from Ghuncha Gul, the oldest woman (midwife) in their neighborhood, hoping she could oversee Noor Bibi's delivery. But contrary to expectations, Noor Bibi’s eyes closed due to severe pain and bleeding, and her newborn also lost its life due to suffocation.

Shirin Gul, recounting the intensity of her daughter-in-law’s pain and bleeding in a distressed tone, says she made every effort to save both her grandchild and daughter-in-law, but could not manage to get Noor Bibi to a health center in time.

“At first, I didn’t think it would turn out like this. My daughter-in-law’s condition worsened terribly, the bleeding increased, and there was no doctor. We didn’t even have a single medicine at home for pain relief or bleeding. I ran from house to house shouting, trying to find a car. Everyone said it was midnight and impossible to go to Herat city, at least 3,000 Afghanis were needed for the fare. I didn’t even have a hundred Afghanis at home. My grandchild died before my eyes, and my daughter-in-law died in my arms.”

Shirin Gul says Noor Bibi’s delivery was extremely difficult. But due to the lack of transportation to take her to Herat’s central hospital, they were forced to endure her cries and agonizing moans from labor pain and bleeding until morning.

“At dawn, when the mullah gave the call to prayer, the city-bound transport vehicles finally started moving. But by then, my daughter-in-law had stopped breathing, there was no sound from her. We put her in a wheelbarrow and took her to the end of the alley near the vehicle. With each moment, her body weakened. When I looked again, she was no longer breathing. She died in my arms.”

According to Bibi Gul, Noor Bibi left behind two children named Esra and Rita. However, poverty and hardship have not spared two-year-old Rita either.

Rita’s pale skin, thin face, and frail body reflect the signs of malnutrition.

With concern, Bibi Gul says that due to the closure of the health center, children in the village no longer have access to nutritional supplements, and the number of malnourished children among neighboring families has reached over 25.

“Look how skinny she’s become. The doctors said she’s suffering from malnutrition. She used to be fine. I would take her to the clinic and they would give us a food package. Now even that’s gone. I’m afraid this grandchild of mine might die from this illness. Many children are like this. Maybe more than 25 children just in our surrounding neighborhood are in the same condition.”

Death of Infants During Childbirth

Shaista, a 27-year-old resident of Zindajan district in Herat, told Zan TV that after the shutdown of health centers in the district, she lost her baby during childbirth two months ago and has since suffered from various health issues caused by bleeding and labor pain.

“There’s no midwife. It's been over three months since left. People say the aid has been cut off and doctors left because they weren’t being paid. When I was nearing delivery, I fell ill at night. My husband went to bring my mother. When she arrived, I was barely conscious. My condition had worsened.”

She adds that due to the lack of access to a doctor and medicine, her baby died during childbirth.

Shaista, her voice trembling with tears, says that if her baby had survived, she would have been the first daughter in the family.

She says she now has three sons, and although the life of girls in today’s Afghan society is dark and uncertain, having a daughter was a cherished dream for her and her family, one that was never fulfilled.

“Children, whether boys or girls, are blessings from God, but the father of my sons and I really wanted a daughter. Because there was no doctor, the baby died. Two months ago, I experienced heavy bleeding and haven’t recovered since. I fall ill every day. And we don’t have doctors or medicine.”

Replacing Doctors and Medicine with Amulets and Prayers by Mullahs

Meanwhile, a number of pregnant women in Gharmoshak village, Zindajan district of Herat province, say that after the closure of their village health center, they have turned to mullahs for healing prayers and charms.

Shabnam, one of the elderly women of the village and the daughter of a mullah herself, says that over the past three months, the number of women coming to her father for prayer sessions has increased.

She considers one of the main reasons for this surge in women seeking prayers and amulets from her father to be the absence of a health center and the growing illnesses among the women in the village.

“I myself went to my father to ask for a prayer. These days, many women and girls are coming to my father. The prayer comes from my father, but healing is from God. Earlier, when our clinic was open, people used to go there and get medicine. Now, just to find some comfort, they come to my father.”

Shabnam says that medicine and prayer each have their own place, but it is necessary to provide healthcare services to the women and children deprived of medical facilities in this area.

“It’s true that prayers have an effect, but there must also be doctors and medicine available to the people. If someone falls ill at midnight, there’s not even a single person who can give an injection.”

According to the residents of Herat province, the shortage of healthcare personnel is evident across all districts and nearby villages because after the suspension of American health organizations’ activities, many health centers have ceased operations, not only in Herat but across other provinces as well.

According to a report by the World Health Organization, after the suspension of activities and support from American health organizations in Afghanistan, more than 202 health centers across the country have been closed, and by the end of this month, this number may reach 220.