An Afghan Nurse Midwife

Strength and Courage

One of the men wanted to speak, and Razia Naeem Khliqi inclined her scarf-draped head and leaned toward him. His tired eyes spoke of pain, but his voice was steady. "The women in our village," he said softly, "are dying."

The anguished words of this young man, a volunteer Community Health Worker in the village of Shekh Ali, Parwan Province, are the reason Management Sciences for Health (MSH) is in Afghanistan. Afghan women, and their children, are dying in numbers that have shocked the world community: for every 100,000 live births in Afghanistan, 1,600 mothers die; in every 1,000 of those live births, 165 infants do not survive-arguably the worst health indicators in the world.

Mortality figures as high as those in Afghanistan can be hard to comprehend, but Razia Naeem Khliqi, Master Trainer for community health workers in rural Afghanistan, has seen the faces of the women and infants whose lives, and deaths, they represent. Since 1975, when at age 19 she received a Midwifery Diploma from the Intermediate Medical Training Institute in Kabul, Razia has worked for and among the women of Afghanistan, steadily adding to her own education and, in turn, educating others so they, too, can work to improve the health of Afghan women and their families. Razia's association with MSH goes back to 1991 and the Cross Border Project in Peshawar, where she readied Maternal and Child Health Officers for their field work as home health visitors, community health educators, and trainers of traditional birth attendants.

Razia well knows how crucial such training can be. Years ago in a village in Laghman, an untrained birth attendant cut an umbilical cord with a dirty knife, infecting both mother and child. The baby died, but the mother survived. Late in her second pregnancy, the young mother came to visit Razia for prenatal care and told the sad story of losing her first child. Razia explained the importance of using a clean knife for the procedure and, before the woman returned to her village, gave her two injections against tetanus just in case. Eight years later, a young boy entered a clinic in a refugee camp in Peshawar, where Razia was working. His family, newly arrived in the camp from Laghman, had learned of her whereabouts. He had come to thank her for his life. He had come to call her "Mother."

Today, the boy's real mother is an active and trained birth attendant in that same clinic-thanks to Razia. In a culture where it is still almost impossible for a male health worker to provide services to a woman, the need for female community health workers is critical. MSH is honored to work with courageous women like Razia Naeem Khliqi.