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May 20, 2012 - 4:51:44 PM |
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Maternal, child health focus of Bamyan conference
By U.S. Navy Petty Officer 1st Class Bill Steele, 7th Mobile Public Affairs Detachment
Dec 22, 2011 - 5:22:29 PM
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Blackanthem Military News
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| Dr. (Col.) Kamal Abdullah, Head of the Malaysian Contingent 3 International Security Assistance Force Dental Team, begins his talk on dental care at the Maternal Child Health Conference Dec. 17, at Kiwi Base. According to Kamal, no basic dental treatment infrastructure exists in Bamyan province. (U.S. Navy photo by MC1 Bill Steele, 7th Mobile Public Affairs Detachment) |
BAMYAN PROVINCE, Afghanistan — In an effort to reduce poverty in one of the most impoverished provinces in Afghanistan, a group of about 40 medical experts and government officials gathered at Kiwi Base, Dec. 17, for a conference on maternal and child health, a key indicator of development.
The conference, which was organized by the Malaysian Contingent 3, International Security Assistance Force, part of the New Zealand Provincial Reconstruction Team, covered a range of issues related to the topic, from anemia in pregnant mothers to water-borne illnesses in small children.
The purpose of the meeting was to share information and build connections among the partners trying to solve these problems, said Dr. (Maj.) Zaki Mokhtar, head of MALCON 3’s medical teams.
“Maternal child health is a big problem in Bamyan,” Zaki said.
In Bamyan, the MALCON 3 medical teams perform medical and dental health outreach in district villages and provide nurse and midwife training at health centers, among other services.
In addition to MALCON 3 and the New Zealand PRT, conference attendees included representatives from United Nations agencies, non-governmental organizations, physicians from Bamyan-area hospitals, and advisors to the Afghan Ministry of Public Health. Guests also included donors from Japan and South Korea.
Dr. Zaki said that the Malaysian Contingent organized the conference because poor communication between the agencies was hampering progress toward improving maternal and child health care in Bamyan.
“We didn’t know what data they were collecting or what findings they were getting,” Zaki said. “The coordination has not been so good.”
Better coordination in places like Bamyan will be critical if Afghanistan hopes to reach its goal of reducing mother and child mortality rates, which are among the highest in the world.
The numbers are sobering. According to the 2010 Afghan Mortality Survey, released in November, one in 13 children in Afghanistan die before their first birthday, one in 10 children die before age five, and an Afghan woman dies from pregnancy-related causes every two hours.
Though no Bamyan-specific mortality data exists, experts at the conference agreed that the problem is probably worse here than in other areas of Afghanistan. Bamyan is largely rural and remote, and most pregnant women and small children have limited access to skilled health care, if at all.
“Transportation is a big problem,” said Dr. Burhan Rahmani, a Bamyan province health advisor to the Ministry of Public Health. “Even women who live a half mile from a health facility don’t go because they can’t get transportation.”
On the flip side, many doctors don’t want to work in, or travel to, the peripheral villages of Bamyan, Rahmani said. The result is that most rural health care facilities have staff with limited capabilities and inadequate training.
But even with the best facilities and doctors available, Rahmani acknowledged that most women in isolated parts of Afghanistan prefer home delivery, a fact borne out by the statistics: only 9 percent of births are attended by a skilled laborer.
This is significant because the leading cause of maternal deaths among Afghan women is excessive bleeding following delivery. The root cause is anemia, caused by a lack of proper nutrition.
To address this issue clinically, the Ministry of Public Health, supported by U.S. Agency for International Development, has been distributing a safe, inexpensive drug called Misoprostal to prevent post-partum hemorrhaging, which has been used effectively in many developing countries. So far, the scope of coverage has been limited to central Bamyan and Yakawlang district, said Dr. Mohamad Reza, a PPH Program Advisor with USAID.
In his lecture entitled, “Community-Based Prevention of Post-Partum Hemorrhaging,” Reza said that more money would help pay community health workers to get on their motorcycles and distribute Misoprostal to other distant areas, and also to educate pregnant women and the community elder that PPH is a serious problem that needs addressing.
“Right now everything is volunteer [level],” said Reza. “The budget needs to be expanded to all Bamyan districts.”
Zaki pledged his support and said that the Malaysian Contingent would assist with health promotion in the areas it covers, and called on the donor partners to also support the initiative.
“If we can pass this message, how to reduce PPH, they might not even have to use the drugs—they know how to control [the problem] already,” Zaki said.
While many at the conference warmed to the PPH initiative and other proposals to improve maternal and child health, such as training midwives to perform cesarean sections and installing water filtration systems in villages, their long-term sustainability was questioned.
“It all comes down to resources,” said Atiqullah Amiri, a UNICEF program officer in Bamyan. “Without proper resources we [Afghans] can’t maintain the health care facilities the same as now. That is for sure.”
How the Ministry of Public Health and local Bamyan officials will manage health care in the near term is a pressing issue since Bamyan is currently one of two provinces undergoing transition whereby the Afghan government will soon take the lead on all issues across security, governance and development.
Zaki reminded the group that Afghanistan has set target reductions of 15 percent for maternal mortality and 20 percent for child mortality by 2020 as part of its Millennium Development Goals to eliminate poverty.
All the more reason, he said, for the parties concerned to swiftly improve their coordination of the Maternal and Child Health program, a U.N. World Health Organization-sponsored initiative.
“It’s vital that we start somewhere, especially in the context of Bamyan province, and that we work towards achieving this goal,” Zaki said. “This conference is just a small step in that direction.”
ADDITIONAL PHOTOS:
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| Mr. Haakawa Moseray (center), Regional Coordinator for the United Nations Population Fund for Bamyan province, asks a question at the Maternal Child Health Conference Dec. 17, held at Kiwi Base. Moseray conducts reproductive and demographic surveys in the region. (U.S. Navy photo by MC1 Bill Steele, 7th Mobile Public Affairs Detachment) |
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| A group of military and civilian public health officials pose for a photo during the Maternal Child Health Conference Dec. 17. The one-day conference held at Kiwi Base, brought together public health experts and other government officials to discuss medical issues affecting women and children in Bayman. The conference was organized by the Malaysian Contingent 3 International Security Assistance Force medical team, part of the New Zealand Provincial Reconstruction Team based here. (U.S. Navy photo by MC1 Bill Steele, 7th Mobile Public Affairs Detachment) |
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| Dr. Mohamad Hamid Nazim, clinical manager at Bamyan Provincial Hospital, gives a lecture on respiratory infection in children at the Maternal Child Health Conference Dec. 17, at Kiwi Base. Acute Respiratory Tract Infection is the number one killer of children under the age of five in Afghanistan. (U.S. Navy photo by MC1 Bill Steele, 7th Mobile Public Affairs Detachment) |
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| Dr. (Capt.) Azimah Noor, head of Medical Team 3, Malaysian Contingent 3, International Security Assistance Force, gives a lecture on maternal mortality rates at the Maternal Child Health Conference Dec. 17, at Kiwi Base. Azimah leads MALCON 3’s training of nurses and midwives in rural districts of Bamyan province. MALCON 3 is part of the New Zealand Provincial Reconstruction Team based here. (U.S. Navy photo by MC1 Bill Steele, 7th Mobile Public Affairs Detachment) |
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| Dr. (Maj.) Zaki Mokhtar (right), public health physician and head of Medical Teams for the Malaysian Contingent 3 International Security Assistance Force, gives a tour of MALCON 3’s medical storeroom to Dr. Burhan Rahmani, provincal health advisor for Bamyan province. Rahmani works for MSH/TECH-SERVE, an implementing partner for USAID, as an advisor to the Afghan Ministry of Public Health. (U.S. Navy photo by MC1 Bill Steele, 7th Mobile Public Affairs Detachment) |
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