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Afghan midwives discuss planned parenting methods with AF medic

  • Published
  • By Tech. Sgt. Stacia Zachary
  • AFCENT Combat Camera Correspondent
QALAT CITY, Afghanistan --  On a semi-regular schedule, a female medic dons her body armor, helmet and weapon to walk 200 yards to the local hospital in Qalat City. These trips to the hospital encourage the midwives to have open discussions on the current challenges of medical care in Afghanistan.

"Over the last few months, I have been able to establish a good relationship with the women at the clinic," said Capt. Dawn Russell, PRT Zabul physician's assistant. "They once were very tentative in how they approached me, but now we can joke and discuss very personal subjects."

When the Afghan calendar permits, the captain will research material on subjects the midwives request and go to the female section of the hospital to educate the midwives on the topic selected for that day.

"The ladies wished to discuss family planning and what different methods were available and acceptable by the Koran," said Captain Russell, a physician's assistant deployed from 86th Medical Operations Squadron, Ramstein Air Base, Germany.

Family planning is a series of methods a woman can use to regulate the spacing and frequency of children in a family. Many Afghan women have an average of 10 children and begin having them from the time they are married to well into their "silver" years.

In the captain's research, she found that many of the methods available to women in the United States are not acceptable under the law of Islam.

"To practice birth control is acceptable with Islam practice but only certain forms," the captain said.

While the birth control pill, the shot, the sponge and birth control implants are allowed, the women must have the permission of their husbands to pursue any of these methods.

"It is very hard to get the women to use birth control," said Dr. Saliyah, a midwife at the clinic. "If the husband does not consent, then it is very difficult to get them to even consider their options."

Some women who do consider birth control do so in secrecy.

"If women do decide on birth control, the easiest methods are the pill or the shot," said Hasinah, a midwife at the hospital.

Family planning is not something actively used or embraced in Afghanistan. Many of the women's lives are put at risk with back-to-back pregnancies and the maternal mortality rates are high in the region as well.

"Family planning is really weak in Zabul," Captain Russell said. "It's up to the power of these women to educate the young mothers on what their options are and how to keep themselves healthy."

Likewise, the midwives' biggest challenge is getting the women to consider their options and to realize they do have control over becoming pregnant.
"I try so hard to educate the women when they come here," Doctor Saliyah said. "We get through to some but many are lost to us. I can only hope that the more women we talk to, the more will begin to listen."

The midwives are continually looking for new and improved ways to address different situations. Having the lectures with Captain Russell allows them the opportunity to have an open flow of communication to problem solve different challenges.

"She is very special to us," Dr. Saliyah said. "She explains a lot of approaches to medicine to us we do not use. It is a good thing when she comes to visit us."

The feeling among the captain and the midwives is mutual. There is a common respect among the two.

"Zabul has good midwives here," Captain Russell said. "We need to keep them up on the latest information available. These women are doing exceptional things with the limited resources they have -- something to be respected."