Officials in Kabul, Herat and Nangarhar are claiming a fall in numbers of children born with disabilities. But our investigation shows that the figures hardly mirror the reality.
Atiqullah Halimiat at the government-run Malalai Maternity Hospital in Kabul says that the number of babies born at the hospital with physical problems
Officials in Kabul, Herat and Nangarhar are claiming a fall in numbers of children born with disabilities. But our investigation shows that the figures hardly mirror the reality.
Atiqullah Halimiat at the government-run Malalai Maternity Hospital in Kabul says that the number of babies born at the hospital with physical problems like short arms, cleft lips and enlarged heads were 89 in 2014 and 66 in 2015. But he thinks the figures may not be correct; not all cases of birth disabilities are being registered.
Dr Nezamudin Jalil, head of the department concerned with maternal health issues in the Ministry of Health claims new surveys show a decrease in maternal and infant mortality.
Zakia Rostaq Amiri who is in-charge of the maternity ward in the Nangarhar Regional Hospital says that some 90-120 deliveries take place in the hospital every week. “At least three of the newborns are physically disabled,” she says. The total over the year may be more than 150, she estimates.
There are also hidden birth defects, he says. Among these are hole in the heart, deafness and mental deficiencies that only show up as the infant grows into childhood. The percentage of children with disabilities only goes up as they grow older.
Disabilities result from a number of factors that may be genetic or circumstantial. It may have to do with either or both the parents, or the circumstances of the delivery. According to Halimi, the birth of a child with disabilities is a life-long adjustment for parents and a responsibility for the community.
Zakia Amiriat at the Nangarhar Regional Hospital points to the generally poor levels of ante-natal care of pregnant women and their own low levels of awareness as a reason for high infant mortality and birth defects in the country.
Child specialist Dr Layequllah Obaidiin in Nangarhar says some disabilities like hole in the heart and cleft-lip are curable. He advises families to seek expert help as quickly as possible.
Turning their backs
At the Indira Gandhi Children’s Hospital in Kabul, the authorities say most birth disabilities are beyond treatment. Masoud Mohammadi, chief of the physiotherapy department told Killid in an interview that the largest disability among new-borns is brain damage because of lack of oxygen at child birth. “This problem happens due to the inexperience of the mid-wife at the time of delivery,” he says.
Dr Masoud Mohammad says he has watched families reel under the shock of seeing their new-born born with a disability and then reject the child. While the hospital may have counseled the parents, they may still kill or abandon the infant in the hospital or on a roadside.
Hafiza Omaerkhil, acting head of the Malalai Maternity Hospital says that regular check-ups during pregnancy could help in ensuring women have healthier new-borns. “Blood tests and ultrasound imaging would show whether the woman is anaemic and the foetus normal respectively,” she says.
Dr Omaerkhil says the woman has the choice of terminating the pregnancy in case of severe disabilities on the advice of the doctor. She thinks more than half the birth defects are preventable.
The stark reality is that health care is far from universal in Afghanistan. Most deliveries are at home, and a woman in labour may be rushed to the nearest hospital which may be hours away only when the situation is critical. Zahra Husaini, a resident of Herat says, “In most cases of distress delivery, the woman is likely to have lost lots of blood by the time she’s brought to the city from the district and she dies in the hospital.”
The government has to provide better health care services if the situation is to improve for mothers and new-borns. “There are areas (in the districts in Herat) where not even one clinic exists,” Husaini insists.
Quality care
Ali Khan is a resident of Surkh-Rod district, Nangarhar. He has a disabled child. He rues the fact that health facilities in the province are scanty. “Professional and specialised doctors are not available in health clinics so that we can take our children for treatment there,” he says.
The quality of health care in private hospitals is no better, he adds.
Yet, the Ministry of Health is claiming advances in health care. Dr Jalil who heads the department looking after maternal health issues claims one mother dies every two years now compared to the previous average of one death every half an hour.
Dr Jalil claims the number of deliveries by midwives increased last year. “Based on the information we have, some 60 percent of deliveries had been assisted by health workers in 2014 and the number increased to 75 percent in 2015, which reflects an improvement in delivery of health services and access of mothers to health services,” he claims. According to him, under a programme run by the Ministry of Health in three places, 68 women successfully completed training as midwives last year, increasing substantially the number of midwives in remote rural areas.
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