Three years after the Taliban takeover of Afghanistan, meet the midwife who stayed, delivered – and saved lives

BAMYAN PROVINCE, Afghanistan – “If I had left, a mother or a baby could have died. I stayed because people, especially pregnant women, needed my support.”

Mariza Ahmadi had been working as a midwife at the Ahangaran family health house in Bamyan Province for just one year when the Taliban seized control of the country in August 2021. As foreign troops suddenly withdrew, life for millions of Afghans descended into chaos – especially for women and girls.

“I was worried, but I couldn’t leave because people needed our services – pregnant women were worried about where to deliver as health facilities were closing,” Ms. Ahmadi told UNFPA, the United Nations sexual and reproductive health agency. “So I didn’t close the family health house.”

Public health workers were severely affected by the takeover, as hospitals and clinics were either forced to close or rendered non-functional and their staff could no longer make it to work safely.

One of the women who sought help at the Ahangaran clinic was 29-year-old Sughra, who was nine months pregnant. 

“A few days earlier, I had gone to the provincial hospital in Bamyan City, but staff told me they weren’t sure whether they would remain open in the following days,” Ms. Sughra explained. 

Uncertain about the availability of skilled care she would find in the city and stressed by the unfolding security situation, she decided to go to her father’s home, in the village of Ahangaran, as soon as she felt some early, pre-labour contractions.

Humanitarians at work

With her husband and sister-in-law, Ms. Sughra endured a three-hour trip in the back of a truck on rough roads to reach the village.

“I was afraid I would give birth on the truck,” she recalled. 

A few days later, Ms. Sughra started having labour pains and asked to be taken to the family health house – which is supported by UNFPA and is the only available facility in the area.

“We arrived very early in the morning, but my labour lasted throughout the day. The midwife said if the baby didn’t come by 4 pm I would have to be taken to the provincial hospital.” 

But when they contacted the hospital in Bamyan City, they were told all the medical staff had left. The only option would be to travel there with Ms. Ahmadi, who would deliver the baby. She just needed the equipment at the hospital to manage possible complications, such as a Caesarian delivery, for which the health clinic was not equipped.

Luckily for Ms. Sughra, her labour progressed quickly after that. She delivered a healthy baby boy without any complications at 2 pm on 19 August 2021 – on World Humanitarian Day.

“The labour was agonizing, but I was happy that we managed everything from the family health house,” recalled Ms. Sughra. “If the clinic hadn’t existed during those days, God knows what could have happened to me.”

A commitment to her country

Behind the safe delivery was the bravery of the midwife. “That was a tough situation, but this clinic did not close for a single day during those times,” Ms. Ahmadi said. 

“I was also scared, but if I left all our efforts to prevent maternal and newborn deaths would have gone to waste.” 

Afghanistan has long had one of the highest rates of maternal deaths in the world, with one woman dying every hour due to pregnancy and childbirth complications – deaths that could be largely preventable with adequate skilled midwifery care. 

Now, as the de facto authorities have drastically reduced women’s ability to work and travel without being accompanied by a male guardian, the situation is only looking more perilous for the women and girls – and future generations – of Afghanistan. 

Ms. Ahmadi assisted with three other deliveries that week for women who had been displaced from other districts in Bamyan Province. 

“I stayed because people needed my support and I had to serve them in such crucial situations,” Ms. Ahmadi explained.

“For the four years I have been working here, there have been no maternal deaths in this clinic.”

A midwifery emergency

Ms. Sughra’s son Farhad is now just a few days away from his third birthday. “When he grows up, I hope he can study so he can build a good future for himself and other people around him,” she said.

Currently funded by the United States and previously by Italy, the Ahangaran family health house provides people living in the surrounding isolated communities with life-saving health services, despite its location in a remote area of Bamyan Province. 

Midwives can meet about 90 per cent of the need for essential reproductive, maternal, newborn and adolescent health needs, yet there is a global shortage of some 900,000 trained midwives. Afghanistan urgently needs an additional 18,000 to meet the demand for skilled birth attendance, a lack that otherwise endangers lives and undermines women’s and girls’ bodily autonomy on a vast scale. 

In 2021, UNFPA was supporting just over 70 family health houses in Afghanistan, a figure that – despite the extremely challenging operating environment – has swelled more than sixfold to 477 today. Since 2021, these clinics have helped more than 5 million Afghans access critical health services, especially in remote and hard-to-reach areas.