Afghanistan

New midwife’s first call of duty: Emergency response to earthquake ‘Women were in shock, many of them were pregnant’

Paktika, Afghanistan – Minaz Bibi had just finished a midwifery course and was waiting for her deployment to a community health center when she received an unexpected call to report for an emergency duty: to support the humanitarian response to the earthquake that devastated the provinces of Paktika and Khost last June.

As a new midwife, Ms. Bibi was looking forward to assisting pregnant women safely give birth in the delivery room. She did not expect that the first baby she will deliver after finishing her midwifery training will be in a disaster setting in Gayan District, one of the areas worst affected by the earthquake. It was also the disaster that made the ongoing crisis in Afghanistan more complex, adding to the hardship of people who are already suffering.

Weeks after the June 22 earthquake, Ms. Bibi still remembers the first childbirth she assisted that challenged her skills as a midwife.

“There was a woman who was nine months pregnant. She was injured and lost family members and relatives in the earthquake,” Ms. Bibi recalled. “She was in a state of shock and fear.” The woman went into premature labor. It was the first delivery that the midwife assisted without the support of a mentor.

Working with another newly trained midwife in a temporary tent clinic set up in Gayan, Ms. Bibi was anxious but did her best to ensure that the mother would safely deliver the baby. “Good thing that there was another midwife to support me. We successfully delivered the baby,” she said.

The mother was fine after the delivery but needed psychosocial support to help her get through the psychological stress she suffered from what she witnessed during and after the earthquake.

“Other women were also in shock with the sight of dead bodies - including those of their loved ones - being recovered from beneath the rubble,” the midwife said, adding that many of the women were pregnant.

More than a thousand people died during the earthquake, which affected about 362,000 people and damaged or destroyed some 4,500 homes. UNFPA estimates that the affected population include almost 87,000 women of childbearing age (15-49), with more than 8,000 who are pregnant.

Describing the setting in which she worked, Ms. Bibi said: “We used a temporary tent to offer maternal health services. Up to 15 patients came daily. During the night, our accommodation was a nearby clinic in the district center.”

Ms. Bibi completed her midwifery training last June under the Community Midwifery Education (CME) program supported by Canada through UNFPA. She will be deployed to the Family Health House in Sharana, which is still under construction and expected to be completed by the third quarter this year.

Reflecting on her experience supporting the emergency response to the earthquake, she said it was an eye-opener on the importance of having midwives to provide skilled birth attendance, antenatal and postnatal support for women and their newborns. Ms. Bibi said there was at least 1 baby born every day during the first 10 days of the earthquake.

At the same time, she underscored the critical role of psychosocial support services for women during an emergency.

“The presence of midwives and offering maternal health and psychosocial support services is very important in such emergencies; I personally experienced this. It helps a lot to have midwives to save mothers and babies,” she said.