By : Alexandra Guy/GICJ
Reproductive health in Afghanistan is on the brink of collapse. The takeover of Kabul by the Taliban in August 2021 endangered the already-limited access to safe birth delivery and pregnancy supervision for Afghan women. The UNFPA estimates that there could be 51 000 additional maternal deaths and 4.8 million unintended pregnancies by the end of 2021 if this situation persists.
Hospitals, medical facilities and midwife schools closed for 'security reasons' and some women had to give birth alone at home. Although the medical system has rapidly reopened, the situation for women is still extremely unstable. The UN and the international community promised to hand $1,2 billion to Afghanistan, and the United Nations Fund for Population Activities tries to limit the risks for mothers and children through its field actions. However, Afghanistan is still undergoing humanitarian crisis, and people suffer from insecurity and malnutrition. This put at risk the life of mothers and children.
The healthcare system in Afghanistan was far from perfect before Taliban takeover. Women lack knowledge concerning maternity and pregnancy due to the little services available. In addition, the mountainous territory prevents easy and safe access to medical facilities for rural women. The UNFPA family houses have been created to tackle this issue. They provide integrated sexual and reproductive health services, including for adolescents and youth, promote gender quality, and realizes data analysis of the situation in the country. But with 172 family houses in remote areas, it only services 10% of the population. 40% of deliveries happen at home, and more than half of women and babies do not have access to post-natal supervision. In 2009, according to the UN Children’s Fund, the mortality rate for mothers in Afghanistan was the second highest in the world. Although it is still one of the most dangerous country in the world for pregnant women, the situation was slowly improving. The takeoever of the Taliban could erase all improvement.
The role of midwives is particularly threatened. Taliban rules and principles state that women cannot work. Nevertheless, the midwives’ professional activities are also prohibited to men, as it enters in women’s privacy. This poses an evident problem. Also considering the fact that women cannot leave their house without a male guardian, the activities of both women giving birth and women assisting these births are limited. Thus, for now, the Taliban accepted that midwives go to work, but separate events show that this decision is not unanimous. Moreover, midwives’ jobs are now unpaid. Consequently, some midwives fear to go to work or leave the country, and some mothers must give birth at home. We remind that all women should be able to work if they want to. All midwives should be paid for their professional activities, at the same amount as a man would, and should practice in a safe environment.
The insecurity of the midwife profession in not the only obstacle for pregnant women giving birth. The access to medical institution is limited by the insecurity of the situation. Once arrived, the medical system running out of funds, women are not given proper medication, painkillers or food. To limit this health disaster, the UN have made an emergency appeal for $606 million to the international community.
Geneva International Center for Justice (GICJ) expresses deep concerns about the recent worsening of the situation in Afghanistan. We urge the international community to respond to the United Nations appeal for financial humanitarian aid. We welcome the UNFPA initiative and support their will to expand their action to more than 1000 family houses in Afghanistan. All women should have access to a safe birth system and to all the knowledge necessary for her well-being during and after pregnancy.
Justice, Human rights, Geneva, geneva4justice, GICJ, Geneva International Centre For Justice
