The challenges of giving birth to a premature baby in Afghanistan

A pediatrician with Doctors Without Borders (MSF) recounts a mother’s uncertain wait in the neonatal intensive care unit of a hospital in Mazar-i-Sharif, Afghanistan

When I left Portugal at the end of September to work as a pediatrician on a new MSF project in Afghanistan, I was concerned about the environment and wondered what life would be like in this mountainous country in the heart of Asia. He has worked with Doctors Without Borders in South Sudan and Yemen. The stories and experiences that await me in Afghanistan will rekindle my passion and remind me of my deep joy and mission as a pediatrician with Doctors Without Borders.

inside Mazarishari Regional HospitalIn Balkh Province in northern Afghanistan, I witnessed firsthand the incredible strength and resilience of the families and children who came to the center.An inspiring story is shekiba22, with her daughter Atoosa.

Shekiba, a proud mother from Chimtal district (an hour’s drive from Mazar-i-Sharif), gave birth prematurely to her beautiful daughter Atoosa in the ward at just 28 weeks. -i-Sharif, managed by the Ministry of Public Health. Born weighing just 1.2 kilograms, Atusa’s arrival marked the beginning of a long and arduous battle for survival. Due to her underweight and poor physical condition, she was admitted to the Neonatal Intensive Care Unit (NICU) of the MSF support hospital.

Premature babies must be hospitalized for long periods of time, which can be very difficult for their families. As the Mazar-i-Sharif Center is a regional hospital, we receive premature and sick newborns from various towns in northern Afghanistan. Many mothers spend weeks alone in the hospital with their children, away from their families and homes. At Mazar-i-Sharif Hospital, we not only treat newborns born in the hospital’s maternity ward, but also those who are transferred from other medical centers in Afghanistan’s northern provinces.

What made Shekiba and I even closer was that her children were one of our first children to be admitted to the NICU and they spent a lot of time in the hospital, which gave us time to bond. For two months, pHe spends every waking moment watching his children, sometimes he has trouble falling asleep. The pain of seeing a baby relying on assisted breathing and not knowing if he or she will make it through is excruciating, and Shekiba sometimes gets frustrated and bursts into tears. But in those desperate moments, she found emotional support from other mothers as well as caregivers and medical staff.

With the help of an interpreter who specializes in medical translation who helps me at work, I tried to talk to her during breaks and get to know her better. He told me about his joys and problems, and what it was like growing up with nine brothers and sisters. It was also in Mazar-i-Sharif that she met her husband and decided to start a family. We developed an even stronger bond while I was in the hospital. Shekiba often asks me when her daughter will be released from the incubator – which she has been sharing with another baby for weeks – but Most of the time I couldn’t give her the answer she wanted to hear..

Shekiba and her baby Atusa in the premature ward of Mazar-i-Sharif Hospital. Orian Zella

The Neonatal Intensive Care Unit (NICU) is a specialized area equipped with specialized medical equipment and trained medical staff for the care of seriously ill infants and premature infants who require intensive care. The care provided in the Neonatal Intensive Care Unit (NICU) is tailored to the specific needs of the newborn and often includes support for infants who are premature, have low birth weight, have perinatal problems, or have congenital anomalies.

The Neonatal Intensive Care Unit was carefully prepared with the support of Médecins Sans Frontières and has been open to patients since October. There are more patients than beds. Today, we have over 60 children in our NICU, which can only accommodate 27 children, but so many babies have to share one bed. This is not an ideal situation, but sometimes we run into situations like this when the context has huge needs. In Mazar-i-Sharif, approximately 540 babies are admitted to the Neonatal Intensive Care Unit (NICU) every month.

When I told Shekiba that her baby had stabilized and could be transferred from the neonatal intensive care unit (where she had been for a month) to the prematurity unit, she could not hide her joy. He immediately reached for his phone and made a call. The translator told me that the voice on the other end of the phone belonged to her husband. “We will be discharged soon!” Shechiba announced.

She told me that whenever she was sad, she would hold her baby in her arms and it made her feel better. She draws strength from her love for her daughter and her hope for a future full of precious moments and wonderful memories: “I can’t wait to comb her hair, braid it, take her to school and talk for hours. ”

Shekiba became stronger during her stay in hospital and dedicated herself to providing support and comfort to other mothers facing similar challenges to hers.

As I write these words, I have not left the hospital for two months, Shekiba returns home. Atusa’s weight has reached 2 kilograms. We shed some tears. We discharged her and expected not to see her in the hospital again anytime soon except for routine checkups.

As in other low-income countries, preterm birth is the leading cause of neonatal morbidity and mortality in Afghanistan.Therefore it is extremely important Comprehensive medical care for premature infants. These fragile babies require careful care and specialized treatment, which is why our work in Mazar-i-Sharif is vital to saving these young lives.

Monica Costella, a pediatrician with Doctors Without Borders. Orian Zella

The work we do at this hospital is intrinsically linked to compassion and dedication. It’s a privilege to witness people’s determination to thrive in the face of adversity. The resilience of these children and their families in the midst of chaos is a testament to the indestructible human spirit.

*Monica Costella He is a pediatrician with Doctors Without Borders in Mazar-i-Sharif, Afghanistan.

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