Afghanistan has suffered chronic instability and conflict throughout its modern history. Its fledgling democratic government faces the challenges of extending its authority beyond the capital and forging national unity. 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 death rates in the world. Currently, only 14 per cent of deliveries are attended by a trained midwife and over one in five children dies before the age of five years old. In isolated rural areas, women face a one in three lifetime risk of dying during pregnancy or childbirth.
HOW MERLIN IS HELPING:
Merlin is working with the Ministry of Health in Afghanistan and local NGO Care of Afghan Families (CAF) to provide essential health care for vulnerable people in some of the country’s most remote and hard to reach areas.
To tackle Afghanistan’s appalling maternal and newborn mortality rates, we’re also training midwives in Takhar and Kunduz provinces.
In addition, Merlin is addressing the problem of malaria in Afghanistan: distributing bed nets, delivering diagnostic training and materials, treating patients, and participating in a malaria research programme, coordinated by the London School of Hygiene and Tropical Medicine.
Delivering basic health care
We are helping 800,000 people in Kunduz
Merlin is delivering basic health care to the 833,300 strong population of Kunduz province. Our range of services includes maternal and newborn health, child health and immunisation, public nutrition, disease treatment and control, regular supply of essential drugs, and reaching out to marginalised groups including those with disabilities and mental health issues. Currently supporting more than 40 health facilties across the province, Merlin-run services have been further developed since September 2009 to include delivery of health services to the nomadic Kuchi population and the Kunduz detention centre.
Training community midwives
By mid-2010, we will have trained 132 midwives, benefitting over 600,000 people
Since 2004, our Community Midwife Education (CME) programme in Takhar and Kunduz provinces has supported the training of 134 midwives who are now practicing with regular supervision in health facilities, bringing essential maternal and newborn health care to 84,000 women in rural villages. Currently, 46 students are undergoing their 18-month training course, which involves classroom-based learning, laboratory-based skills practice and supervised practical experience in clinical facilities.
Providing medical services to remote areas
We are reaching at least 197,000 people this year through mobile clinics
Merlin mobile units reach remote and isolated villagers who would otherwise have no access to health care, particularly during harsh Afghan winters when roads and mountains are impassable. Our mobile teams, composed of nurses, vaccinators and health educators, travel to reach isolated communities in the northern provinces of Kunduz and Badakshan where lack of access to health care services has resulted in some of the worst health indicators in the country.
Malaria research and prevention
The weakness of Afghanistan’s health system and the lack of proper diagnosis, treatment or control mean that rates of malaria in the country are high. Merlin is supporting a vast research programme coordinated by the London School of Hygiene and Tropical Medicine aimed at identifying the best methods of malaria screening and prevention in the Afghan context.
We are also implementing malaria prevention and treatment measures, as well as running community education sessions on the disease and distributing thousands of long-lasting mosquito nets to pregnant women and children under five. Along with our preventive work, Merlin has also established and is running malaria labs across Badakhshan and Kunduz provinces in order to test and treat those with the disease.
Swine flu (H1N1) monitoring and response
A significant number of H1N1 cases have been confirmed in Afghanistan. Merlin is responding to and mitigating the risks associated with the disease in Kunduz and Badakhshan provinces. We are training health workers and carrying out community health education sessions to raise awareness of the disease. When cases are confirmed through the lab tests, we refer patients to appropriate hospitals for treatment. Over 15,000 people have attended these health education sessions in Kunduz.
Key achievements
• In Takhar through our community midwives education programme we are benefiting 44,128 pregnant women and their families, reaching a total population of over 1.1 million people.
• In 2009, 40,000 children under two were vaccinated against diphtheria, tetanus, whooping cough and hepatitis B, and a further 20,000 women were immunised against tetanus
Donors supporting Merlin's work
EU, JHPIEGO, GAVI, UNFPA, WHO, Gates Foundation, Healthnet and numerous private donors
Read more about Afghanistan
Afghanistan: Saving mothers in the remotest areas
2 Feb 10: To survive in the remote areas of Afghanistan is hard. To survive childbirth here is even harder.
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.
|