Maternity in Badakshan Province
Students at Community Midwifery Education Program observe the mock delivery by an instructor, Faizabad in Badakshan province, Afghanistan, Saturday, May 12, 2007. Afghanistan has the second highest maternal mortality rate in the world only after Sierra Leone. An astonishing number of 25,000 women die from obstetric causes per year, or 1 woman dies every 27 minutes. A UN report released in 2000 indicates that the national MMR in Afghanistan was 1,900 per 100,000 live births, whereas it was 17 in the United States. Ragh district in Badakshan province showed the highest mortality risk ever recorded in human history, with 64% - more than half of women - of reproductive age died during 1999 and 2002. The causes of deaths were analyzed mainly in two parts: direct and indirect. Direct causes include haemorrhage, obstructed labour, cardiomyopathy, sepsis, obstetric embolism, and pregrancy-induced hypertension; and the indirect causes were tuberculosis, malaria, and obstetric tetanus. Geographical and economical factors also contribute to high mortality in a place like Badakshan where most people have limited access to transportation thus making it harder for women to reach proper health care centers.