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High infant, mother death rates cause anguish in Afghanistan
The Associated Press (apwire)     Print Article 
Published 2006-04-20 11:05 (KST)   
PAUL GARWOOD

KABUL, Afghanistan

Fayruza's doll-sized body leans limply across the forearm of her aunt, who became the infant's adoptive mother minutes after her birth three months ago.

The death of the withered baby's natural mother soon after delivery at home epitomizes what President Hamid Karzai on Wednesday called war-ravaged Afghanistan's ''great tragedy'' _ its appalling rates of child malnutrition and maternal mortality, among the world's worst.

''The morning she was born I became an aunt,'' said Shirinja, who goes by one name, as she cradled Fayruza in the cramped confines of an infant ward at Kabul's Indira Ghandi Children's Hospital. ''But by the afternoon after my sister died I had become her mother.'' The baby has spent the last 18 days in the hospital, suffering chronic malnutrition Some 600 infants and 50 mothers die on average per day in Afghanistan, says the U.N.'s child health agency, UNICEF. This country has the world's second-worst rate of mothers dying during labor _ 1,600 per 100,000. The worst is Sierra Leone.

It also ranks among the lowest for child mortality. Some 135 children die within the first year of life out of every 1,000 born.

Another 220 will die before they reach 5 years of age, compared to eight in the United States.

A quarter century of war and Taliban rule all but destroyed Afghanistan's meager health services. Deep poverty, under-spending, restrictive social customs and illiteracy have compounded the crisis.

''Our country is rebuilding itself with the help of the international community after almost three decades of conflict, war and infighting and in every sector we have problems and challenges, particularly health,'' said Dr. Abdul Salam, director of the Indira Ghandi hospital.

Almost90 percent of the hospital's patients come from remote provinces where the health problems are worst. Access to health care is limited by widespread insecurity because of militant attacks and banditry, and by the isolation of communities.

Another obstacle is poor education, particularly among women.

''Illiteracy is one of the biggest problems because people don't know how to take care of their children,'' said hospital pediatrician Hamid Mazin, 37, as he helped feed formula milk to malnourished babies. ''Women have no right to leave their homes due to village traditions, so they remain inside to the very end, even if they are having pregnancy complications.'' Afghan Health Minister Mohammed Amin Fatemi said most births are not attended by trained medical staff and are conducted in village homes often too far from health centers equipped to deal with emergencies in birth.

Training 12,000 community health workers _ half of them women _ and 6,000 midwives by 2010 is a Health Ministrygoal to deal with the child and mother death rates, Fatemi said on the sidelines of a regional health conference Wednesday, attended by Karzai.

Afghanistan's widespread poverty must also be addressed if health indicators are to improve, he said. ''We have to break this vicious cycle, where poverty causes these mortality rates and mortality rates contribute to poverty,'' Fatemi said.

Chronic malnutrition _ primarily a lack of energy and protein _ for children under 5 in Afghanistan runs at 54 percent, behind only Burundi at 57 percent.

Poverty's bitter relationship with poor child and maternal health in Afghanistan are evident inside the bombed-out ruins of west Kabul's Aliabad Hospital, once the capital's leading medical facility. Now, it is home to up to 50 refugee families too poor to afford to rent or buy a home.

Sixty-year-old Alam Gul lives with his wife Ghutai, who is roughly half his age, and their nine children, including twins, in a tiny room without electricity,running water or gas. Cold drafts blow down the corridor toward bathrooms in which cracked pipes leak human waste onto the floor from families living above.

''My children are very sick because of the dirty water, diseases and unclean state of everything,'' Ghutai said while showing The Associated Press their bereft home. ''My baby twins are ill and hungry because they don't have enough mother's milk. I don't know how we will all keep living.''
©2006 OhmyNews
Other articles by reporter The Associated Press

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