A lifeline for remote communities

Mobile health teams helping to reduce maternal and child deaths in the Central Highlands of Afghanistan

Pregnant women and mothers in the remote village of Ali-Beig, Bamyan province central Afghanistan, attend consultations with a mobile health team that visits them once a month. These teams are a lifeline for isolated communities where the closest health facilities are often hours away.
© UNICEF Afghanistan/2016/Karimi

By Sahraa Karimi

BAMYAN, Afghanistan, 10 April 2017 — “Many children are orphans here. Many men live without their wives. That’s because they couldn’t reach health facilities when they gave birth or when they were sick,” says 80 year-old Mohammad Mussa, a lifelong resident of Baqalak village in the Central Highlands of Afghanistan.

Mohammad, who lost his wife during childbirth decades ago, knows the stories only too well.

“I witnessed the death of many villagers, young women, and children. Even my own wife,” he recounts. “My wife died while giving birth to our child because I couldn’t take her to a clinic.”

The village of Ali- Beig village, nestled in the Fuladi Valley surrounded by the soaring mountains of the Central Highlands region of Afghanistan. With communities scattered across vast distances and no basic infrastructure to connect them, large sections of Afghanistan’s rural population still lacks access to basic health care services. 
© UNICEF Afghanistan/2016/Karimi

When winter settles in across Bamyan province, heavy snow blankets every pathway of this remote and mountainous region, making the nearest health care facilities inaccessible for at least six months.

“We had pregnant women who we carried on donkeys to try to reach the nearest clinic, which is a four hours away. Many of them and their children died. Winter is so harsh here that the snow totally separates us from the rest of the world,” he says as he takes a deep breath.

But access to health facilities is a challenge on clear summer days, too. With communities scattered across vast distances and no basic infrastructure to connect them, large sections of Afghanistan’s rural population still lacks access to essential health care services.

Bringing health care to isolated communities

UNICEF-supported mobile health teams provide essential basic health services to remote and isolated communities, with a special focus on maternal and neonatal care. A mobile health team is typically composed of a midwife, a nurse, and a vaccinator who provides routine immunizations to children and tetanus vaccines to pregnant women. © UNICEF Afghanistan/2016/Karimi

Against this backdrop, UNICEF-supported mobile health teams are often the only lifeline for women and children in some of the country’s most remote districts. While it is still hard for them to access some of the villages in the depths of winter, they provide health and referral services to isolated communities.

A team is typically composed of a midwife, a nurse, and a vaccinator who provides routine immunizations to children and tetanus vaccines to pregnant women.

Today, they are in the village of Ali-Beig, nestled in the Fuladi valley and surrounded by the soaring Koh-i-Baba Mountains, the western extension of the Hindu Kush mountain range that stretches into northern Pakistan. They visit the village at least once a month.

Fatima, 34, holds her baby boy after visiting the mobile health team in the remote village of Ali-Beig in the Central Highlands. He had been running a fever and received the medications he needs. Fatima would not have been able to take him for treatment on her own: the nearest health facility is more than a four-hour drive away. 
© UNICEF Afghanistan/2016/Karimi

Holding her baby boy, 34-year-old Fatima has just returned from the village mosque where a mobile health team for Reproductive, Maternal, Newborn and Child Health (RMNCH) has set up for the day.

“My son has been running a fever for several days now. Thanks to the mobile health team I could take him in for a check-up. He’s been given medicines and I hope he recovers soon,” says Fatima, frowning with motherly concern. “If they didn’t visit our village, I am sure I wouldn’t have been able to go to the clinic, which is too far away”.

Women from neighbouring villages also come to Ali-Beig when they know the mobile health team is in town.

Saving lives with guidance, treatment, and vaccines

“I came for medical check-ups during my pregnancy a few months ago. The midwife advised me to visit her after delivery too, so I am back,” says 24-year old Masooma who recently gave birth to a baby girl.

Masooma suffers from iron deficiency anaemia, a widespread condition affecting nearly one third of adolescent girls in Afghanistan, which goes on to cause serious health consequences in women of reproductive age.

A young girl in the village of Baqalak, Yakawlanag district, in the central Highlands of Afghanistan. Thanks to monthly visits by mobile health teams, every child in the village under the age of two has been immunized. © UNICEF Afghanistan/2016/Karimi

“When Masooma was pregnant I told her that she must deliver in a clinic. It would have been dangerous for her and her baby if she had delivered at home,” says Soqra, a midwife who joined one of the Bamyan mobile team nearly a year ago. With more than ten years of experience, Soqra has been helping women, especially expecting mothers, in most remote villages across the province.

Alongside the neonatal and maternal health care, the teams play an essential role in immunizing remote communities who often cannot travel long distances to get vaccinated.

The results are indisputable: To date, every child in the village under the age of two has been immunized.

“If our children are healthy, they can study better and become better people,” says Sharifa, 55, another long-time resident of the village who lost two of her children to measles in the past.

“I am happy that our children and young mothers are not suffering like we did in the past.”

Rajab, 42, and his wife have eight children: “These mobile [health] team visits are essential for us. There are clearly less mothers and children dying in our villages,” he says. Baqalak village in Yakawlanag district, Central Highlands, Afghanistan. © UNICEF Afghanistan/2016/Karimi

RMNCH (Reproductive, Maternal, Newborn and Child Health) and other mobile health teams in the Central Highlands region are supported by generous donations from the people and the Government of the Republic of Korea and the Japan Committee for UNICEF, for the implementation of the Basic Package of Health Services in Afghanistan.

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