FAIZABAD, October 20 (Online): Lying in the hospital bed with her baby on her breast, Momagul is one of the lucky ones. Her husband allowed her to go to hospital, her home was only 20 kilometres (12.5 miles) away, and she received medical attention in time to save her life. "She was bleeding heavily after delivery, and we gave her a blood transfusion," said Dr. Hajira Zia, head of gynaecology and obstetrics at the Maternal Care Hospital in Faizabad, Afghanistan.
In the remote and mountainous province of Badakhshan, of which Faizabad is the capital, more women die in childbirth than any other place in the world.
Despite having the right to vote in Afghanistan's first direct presidential poll held recently, many women here are still fighting for a more basic right -- life.
Some 6,500 mothers in every 100,000 die giving birth in the northeastern province compared with 2,200 in Kandahar, 400 in Kabul and only 12 in the United States.
Afghanistan is one of the worst places in the world to become pregnant.
A UNICEF survey in 2002 put maternal mortality in four Afghan provinces at 1,600 per 100,000 live births, twice as bad as the African country of Niger, 12 times worse than neighboring Iran and 130 times higher than the United States.
In this part of the world, healthcare often takes second place to honour, and men are reluctant to allow their female relatives to be attended to be strangers.
"There are some districts in Badakhshan where husbands don't give permission for their wives to come to the city to see a doctor and there are no doctors in their villages, so they die," said Dr. Anis Akhgar, director for women's affairs in the province. Geography is another big obstacle in Badakhshan, and other remote parts of Afghanistan, where donkeys are a sought-after form of transport.
In districts such as Rah, which are snowed in throughout the winter, even with permission from their menfolk women are unable to treck over the perillous mountain passes to reach a hospital when they are pregnant.
Poor nutrition and intermarriage lead to birth defects and osteoporosis, and with contracted pelvises due to a lack of calcium many women in this mountainous province die in labour, Zia said.
The Maternal Care Hospital was built with funds from UNICEF and foreign aid agencies with 10 beds, and Zia and her staff often treat 30 patients at a time with no incubators or high-tech equipment.
But since the French charity Medecins Sans Frontieres (MSF, Doctors Without Borders) shuttered its operations in July this year after five of its staff were murdered in western Afghanistan, Zia has even less to offer those who do make it to hospital.
"After MSF left, we had medicines for a month, but now everything is gone. There are no drugs, so the best I can do is write a prescription for one of the pharmacies in the bazaar, but the drugs there are expensive and the patients can't afford them, so they die," she said.
Sitting in her office both Zia and Akhgar said the election was a good thing, but little had really changed for women since the fall of the Taliban.
"I don't feel safe to walk outside without a burqua on," said Zia, sitting under a picture of her wearing a suit, her head bare, receiving an award for medical services at Johns Hopkins University in the United States.
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