The main focus of AMCR’s work is the provision of maternity and childcare facilities in conjunction with existing community heath centres, which are often very basic. In the Panjshir valley 80 out of 5,500 pregnant women die of complications every year, so special facilities are vital in the fight to bring down the mortality rate of mother and baby. In the Panjshir Valley alone at least three more Mother and Child Health Clinics are needed. It costs AMCR on average about £30,000 to build each one.
Darra Mother and Child Health Clinic, AMCR’s third clinic project, is currently under construction. Darra is a small village, up a side valley, perched above a river which can suffer violent floods. It is connected to the Panjshir Valley by a bumpy track, at times little better than a riverbed. In June 2007 a huge storm hit the valley, triggering landslides, washing out bridges and killing 100 people. The flood, which cut Darra off from the main valley for weeks, delayed the project, leaving the builders racing to get a roof on the building before winter came. After the flood it was decided that it would be safer if the building was higher up, and it was moved another 30 metres above river level. Even given these setbacks, the delivery suite should be completed and operational by spring 2008.
Roddy Jones and contractor Rehman discuss progress in constructing the Mother and Child Health Clinic at Darra. The site of the Darra Mother and Child Health Clinic has been raised 30 metres after a recent flood, so workmen have to hand-carry materials up a steep slope.
The ambulance at the Darra health centre has to ford the river and travel over bad roads. The midwife at Darra, Hadisa Aladod, in her cramped delivery room. When the Mother and Child Health Clinic is completed next door, she will have a properly equipped delivery suite.FUTURE PROJECTS
After the Darra Mother and Child Health Clinic is completed, work will begin on another desperately needed facility. One option being considered is at Shotol, a remote village, where a basic clinic accessible only by a footpath serves some 30,000 people. The American Provincial Reconstruction Team is planning to build a road to the clinic which would enable AMCR to go ahead with the project.
Abdul Zahir Jaheed, financial adviser to the Afghan Ministry of Public Health in Panjshir province, above the Shotol Basic Health Clinic, accessible only by a footpath. Zarmina, the midwife at Shotol, in her basic consulting and delivery room
Zarmina, the midwife at Shotol, has to weigh babies in the corridor of the clinic
AMCR’s first full project was the provision of a purpose- built suite of rooms at the Rokha clinic, just inside the Panjshir valley. It has a delivery room, with hot water, electricity, and inside lavatories and showers. The lighting is solar-powered and hot water is supplied by a solar thermosiphon on the roof of the building, which means water and lighting are available at all times, with minimum cost and maintenance. AMCR has also built accommodation for two doctors on site and supplied a solar-powered vaccine refrigerator, allowing vaccines to be kept at their optimum temperature.
Roddy Jones (right) watches two helpers top up the oil for the thermosyphon, which supplies solar-heated hot water to the Rokha Mother and Child Clinic
The clinic delivers an average of 20 babies a month, provides pre-natal and post-natal checks and has an increasingly important family planning service.
Safied Chihr MCH
Further up the valley lies the town of Safied Chihr, where AMCR completed a Mother and Child Health Clinic and handed it over to the local health authority in 2006. A discreet distance from the main clinic building, it has a large, bright delivery room, with an en-suite shower and lavatory, a consulting room and a room for visitors. The specialised midwife delivers 16 to 20 babies a month, and provides a range of other services such as pre and post-natal checks, and family planning. She also advises on general health and hygiene issues.
Roddy Jones inspects the vaccine refrigerator at Safied Chihr Mother and Child Health Clinic. A mother and child in the consulting room at Safied Chihr MCH Clinic
The delivery suite cost £32,000, and was completed in just under a year. As it’s over three hours by road to the nearest hospital, this is an invaluable addition to the health and well-being of women and their children in this region.
Dr Shimal in her consulting room at Safied Chihr Mother and Child Health Clinic
Dr Shimal shows off newly-donated equipment in the delivery room at Safied Chihr Mother and Child Health Clinic. Roddy Jones outside the Safied Chihr Mother and Child Health Clinic, completed in 2006
Generous funding for the solar equipment and construction of the Centres has come from The Besom, Just a Drop and Sandy Gall’s charity. AMCR is extremely grateful for their support.
Waheed Akbari is AMCR’s Afghan project manger and is based in the Panjshir Valley and Kabul. Without his hard work and command of English, much of AMCR’s work would not be possible.
There are many, many war-widows in Afghanistan – 40,000 in Kabul alone – who are destitute and in most cases trying to bring up children. The Government of President Karzai is encouraging villages to establish “Village Forums” to identify areas of need and propose projects in which the villagers will co-operate to improve their lot. One such scheme instigated by AMCR involves the establishing of communal bakeries.
Rahilah at work in the Astana bakery
Currently each village household has its own flour, made from wheat milled in the local watermill. Women make their own dough and then spend hours baking bread twice daily. If they were able to buy bread instead, they would have more time for other essential work, such as helping in the fields.
Abdul Ghani, who manages the Astana bakery, and his wife Rahilah outside the bakery
Three of Abdul Ghani and Rahilah’s children, (from left) Mishal, 5, Maryam, 10, and Melad, 10, show off the bread made in the Astana bakery. Rabiya (left) and Shafiqa, the two women who work at the Malaspa bakery, by their oven
Communal bakeries are novel in the Panjshir valley, and so is the idea of widows working and earning an income. But these bakeries are common in the bigger towns, like Kabul where they are self-sufficient.
With this aim AMCR built five bakeries and handed them over to local communities, in the villages of Sangana, Malaspa, Sata, Tawakh and Astana. Other women have been helped to train as tailors and provided with sewing machines, giving them the chance to earn money from home.
Two of the bakeries are operating very successfully, and a third is starting to pay its way. The other two bakeries are closed at present, but it is hoped they will re-open in the future as attitudes towards women working outside the home gradually change.