Afghanistan is known for conflict, with new attacks in the news almost every week.
Yet there is also a ‘silent’ killer in Afghanistan. Mothers there are among the world’s most likely to die in childbirth.
Tragically, babies born in Afghanistan are also among the most likely in the world to die before their first birthday.
Why are things so hard for mothers and babies?
Over 770 hospitals and clinics in Afghanistan have closed in recent years because of fighting.
Even as late as 2015, two new health centres were damaged in the conflict.
Alongside decades of conflict, lack of investment in health care in some areas has also taken a heavy toll.
There were few maternal health centres in the country to begin with. Now many women face childbirth with no medical care before, during or after delivery.
Many have no option but to give birth at home, commonly without clean water or the help of a midwife.
Even before getting pregnant, women may also lack the nourishing food they need. This can leave them weak and more likely to get ill or face complications during the birth.
The World Bank estimates that 20 per cent of women in Afghanistan are underweight. And up to half of Afghan women don’t get enough iron in their food.
This can also lead to premature birth, with babies then sometimes too frail to survive or unable to breastfeed.
On top of this, men make most of the family decisions in Afghanistan.
Women may not be able to choose for themselves whether to get check-ups during pregnancy or to give birth in a health centre.
The Red Cross targets remote areas
Balkh province in northern Afghanistan is one of the most remote and hard-to-reach parts of the country. The situation for mothers and babies there is particularly bad.
This is why the British Red Cross runs a project in Balkh. We help tackle several factors that can make childbearing dangerous – medical care, hygiene, nutrition and attitudes.
How grandmothers can make a difference
While younger Afghan women may not have a strong voice in their families, grandmothers often do.
They are also considered influential figures in their rural communities.
Because their advice is likely to be followed, the Red Cross created and supports grandmothers’ committees in 40 communities in Balkh province.
Mothers can join too and together they learn about the importance of eating well and getting health care during pregnancy and birth.
The grandmothers can then convince the more conservative husbands and fathers – often their own sons – to let their wives and daughters get medical treatment.
We have also trained 420 community volunteers who help people learn how important it is to eat well and stay healthy. In one year they can reach over 10,000 people with important health information.
The results have been dramatic. Since the project started in 2007, thousands of women have been referred to health centres where they could have safer deliveries.
Mother-of-three Fatima noticed a big difference between the birth of her youngest child and her first two deliveries.
“Previously I didn’t know the benefit of antenatal care during pregnancy,” she says.
“However after taking part in training from the grandmother committee, I indeed realised how antenatal and postnatal care are important.”
Can chickens save lives?
Well, in a way, they can.
The Red Cross project in Afghanistan helps women and their families stay healthy by giving chickens to families who need nutritious food.
In one year, 4,340 chickens were given to 217 families – 20 birds per household.
To help them get started with egg farming, we also provided chicken feed and trained women to care for and vaccinate their birds. Supplying materials to build a chicken coop rounded off the project.
From this base, families can raise their chickens independently.
After four months, the chickens typically lay 70-80 eggs a week. Families usually eat half the eggs and sell the rest to earn money for essentials such as food and medicine.
One woman, Maria said: “Poultry is not just helping us in feeding my children.
“By selling surplus eggs, it also supports my family economically … especially in providing stationery for use in school like notebooks and pens.”
What about vegetables?
Through the same project, the Red Cross gave nearly 200 families seeds, tools, fencing materials and training to grow vegetable gardens.
Each seed pack will grow several varieties of nourishing, green, leafy vegetables that include nutrients such as folic acid, which is vital in pregnancy.
We also encourage the egg farmers and vegetable growers to share their produce so that more families get the benefits of both kinds of food.
The Red Cross helped make sure that people make best use of the vegetables. We ran maternal and child nutrition sessions using specialist training materials from Unicef.
Six months later, the gardeners said that they understood much more about eating a diverse diet.
“Previously, our main dish was rice without many vegetables,” said one man.
“So with this small project, habits have changed for us and our community.”
Read more about health care in Afghanistan.