December 01, 2014

It is 4:00 in the morning.

Awakened by a phone call, the Doctors Without Borders/Médecins Sans Frontières (MSF) team hurries to the maternity ward. The district of Dasht-e-Barchi in West Kabul is sleeping, but inside the hospital the urgency, anxiety, and excitement are palpable.

When these workers first set foot in the hospital earlier this year, the brand new 42-bed maternity ward where they now stand was an empty building. Nine months later, the launch of the project has been not unlike a complicated delivery. Now, a couple days after the opening, a young patient suffering from complications has arrived in the middle of the night.

In the delivery room, Mina, the seventeen-year-old patient, lies on the bed. She has already been in labor for hours. She is silent, but her face is contorted in pain. Her baby is too big to be delivered normally, and she will need an emergency caesarean section.

Complications like this are common, but, in Afghanistan, the number of medical facilities equipped to manage such problems is woefully small, even in the capital. Most women and their families cannot afford to pay for private medical consultations and end up giving birth in their own homes. In the case of complications like this one, and in the absence of trained medical assistance, giving birth can be fatal.

The team in MSF’s new maternity ward focuses on such complicated births, and on saving the lives of mothers and babies who have nowhere else to go to receive specialized care. Located in a buzzing marketplace behind a gas station, Dasht-e-Barchi hospital and three small satellite health centers are the only options for public health care in the district.

The population of this neighborhood of Kabul is estimated to have grown tenfold over the past ten years, and now has more than one million inhabitants. The public maternity hospital supported by MSF will not be able to cater to all the health needs in the area, but the team expects to see more than 130 complicated cases a month out of an estimated 600 normal deliveries, and welcome as many lives.

Mina will need to be operated on soon. MSF midwife Daniela transfers her to the operating theater team, Renate the nurse and Diana the gynecologist. These two women have a combined 115 years of medical experience, honed through many years of working at MSF facilities around the world.

The lights are blazing in the operating theater. Everything—from the probe to the anesthesia machine—is brand new. In the past week, during the dress rehearsal, every piece of equipment, electrical circuit, water pump, and infection control instrument was tested.

Launching a new MSF project relies heavily on this kind of behind-the-scenes preparation. The logistical team worked for months to rehabilitate the maternity building in the existing public hospital, striving to achieve the high standards for which MSF facilities are known throughout Afghanistan and the world.

At 5:00AM, a baby cries—it’s a seven-pound boy. Mina is safe and she catches her breath. She hasn’t thought of a name yet, but, because of the care she received, she has time to decide.  

MSF has worked in Afghanistan since 1981. In Dasht-e-Barchi, MSF will work hand-in-hand with the Ministry of Public Health (MoPH) to support the maternity department of the district hospital. MSF also supports the MoPH in Ahmad Shah Baba hospital in eastern Kabul and Boost hospital in Lashkar Gah, Helmand province.

In Kunduz, MSF runs a surgical trauma center, providing lifesaving surgical care to people in northern Afghanistan. In Khost, in the east of the country, MSF operates a maternity hospital. In all locations, MSF provides lifesaving medical care free of charge. MSF relies only on private funding for its work in Afghanistan and does not accept money from any government.

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