NBC Nightly News: Improving the Odds

© 2004 National Broadcasting Company, Inc.


SHOW: NBC Nightly News

DATE: February 26, 2004

TOM BROKAW: NBC News IN DEPTH tonight, the women of Afghanistan and the grave dangers they face during childbirth. Half the women in Afghanistan who die before the age of 49 are lost during childbirth. Ninety percent of the births are at home in primitive conditions. There's an international conference under way in Kabul this week to address that and other women's issues, and as I learned during my recent trip to Afghanistan, the men of that country play a critical role in all of this.

Here at a small hospital in rural Afghanistan, a young, anxious mother has just given birth. The new baby is struggling to breathe. Eventually things will improve. Across the hall, another newborn is also getting by. Her 20-year-old mother Pal Wah-shah is relieved.

Ms. PAL WAH-SHAH: (Through translator) At home babies can be injured or die, and women die.

BROKAW: But here the American government financed the hospital, and the professional help comes from the International Medical Corps. The program focuses on education, teaching Afghan women the basics about pregnancy and childbirth. The women learn everything from sanitation to nutrition, to the telltale signs of trouble. Back home, Pal Wah-shah also learned from her sister-in-law. Without medical care, she lost five babies, either at birth or before their first birthday. Pal Wah-shah was determined to give birth in a hospital.

Ms. WAH-SHAH: (Through translator) I left the house at 1:00 and got to the hospital at 4.

BROKAW: While in labor, she walked three hours in near-freezing temperatures rather than risk birth at home, a decision supported by the men in her family, and that's critically important in the local culture.

In Afghanistan, men rule. They make almost all of the decisions, including the decisions about their wives' health. They may even confer with a religious leader, a mullah, before deciding to send their wife to a hospital.

For those who do seek help, there's often a severe shortage of health-care professionals.

Dr. JEFFREY SMITH: (Foreign language spoken) Good morning.

BROKAW: At the Malalai Hospital in Kabul, Dr. Jeffrey Smith is trying to change that. He's running a woman's reproductive health program sponsored by Johns Hopkins University.

Dr. SMITH: When you bring the legs back...

BROKAW: It trains desperately needed doctors and midwives.

Dr. SMITH: If we continue the kind of efforts that we're doing now, hopefully in--in 15 to 20 years, the--pregnancy in Afghanistan won't be such a dangerous thing.

BROKAW: That seems like a long time, but in Afghanistan, nothing is easy, including changing the traditional role of women as second-class citizens. These Afghan men have taken a small step, bringing their wives to an American-run clinic.

Have you been at all encouraged by their attitudes?

Dr. SMITH: There's a growing awareness that it's not necessary for women to die during childbirth. There is a growing sense that they need to take advantage of Western medicine.

BROKAW: But professional help at childbirth is just a step. As for Pal Wah-shah, barely 12 hours after giving birth, she rode a donkey home, where, by tradition, she must stay inside for 40 days.

Now the challenge for Pal Wah-shah is to keep her baby alive. Fully one quarter of the children in Afghanistan die before the age of five.