Afghanistan has suffered from years of conflict and stagnant economic growth. Its fledgling democratic government faces the challenge of extending its authority beyond the capital and of forging national unity throughout its landlocked and mountainous territory. Much of the health infrastructure has been destroyed, and many people in remote villages have little or no access to health care.
Reproductive health care in Afghanistan is particularly inadequate, resulting in some of the highest maternal and child mortality rates in the world. Currently, only 14 per cent of deliveries are attended by a trained midwife. In isolated rural areas, women face a one in three lifetime risk of dying during pregnancy or childbirth.
Over 4.5 million people are currently in desperate need, as a result of rising global food prices, poor harvests and drought.
HOW MERLIN IS HELPING:
Merlin began working in Afghanistan in 1994, and is now providing essential health services for vulnerable people in some of the most remote and hard to reach areas of the country. There are four international and 710 Afghans working in the country.
Training community midwives
Merlin is training midwives at its training centre in Taloqan in the north-eastern province of Takhar. Since April 2006, 43 students have graduated and are now providing essential maternal health care for more than 84,000 women. 23 students started the course in April 2008 and will graduate in 2010.
Delivering basic health care
Merlin provides basic health care to 1.2 million people in Badakshan and Kunduz provinces. This includes maternal and newborn health, child health and immunisation, public nutrition, disease treatment and control, regular supply of essential drugs, disability and mental health. To achieve this, Merlin works in partnership with a local organisation (Care of Afghan Families) and under the direction of the Ministry of Health.
Providing medical services to remote areas
From vaccination campaigns to midwife education, Merlin reaches villagers whom would otherwise have absolutely no access to health care, particularly during harsh Afghan winters when roads and mountains are impassable.
Key achievements
• On International Women’s Day (8 March 2008) five teams of all-female staff, including midwives, nurses and vaccinators from seven health clinics visited 18 villages. These teams provided reproductive health services to 1,700 women for seven days and assisted with four unexpected home-deliveries and referred eight complicated cases
• In 2007, Merlin launched a four-month rural vaccination campaign in the remote regions of Badakhshan. Villages that were more than a three-hour walk away from any health post were chosen, and medical teams spent eight days each in 17 villages, vaccinating 23, 972 women and 10,000 children against hepatitis B, measles, polio, tuberculosis and tetanus
• Merlin distributed 500 mosquito nets in Badakhshan and trained health care workers on recognising the symptoms of cases that require referrals
Donors supporting Merlin's work
ECHO, EU, USAID, UNFPA, WHO, GOAC, and numerous private donors
Read more about Afghanistan
Saving mothers' lives
24 Jan 07: Fauzia is among the first 21 women who have completed Merlin’s midwifery training programme in Takhar Province, northern Afghanistan. She now works at the hospital in her home town of Farkhar.
Basic knowledge saves lives in Afghanistan
1 Dec 05: Fatima Abdul Qaum, 38, is among more than 250 people who have been trained by Merlin as community health workers.
Reducing maternal mortality in Afghanistan
20 Jun 05: Fatima Yormamad is one of 22 young women currently being trained to become community midwives in Takhar province.
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