Connect with us

Global Affairs

‘The Taliban killed a midwife who refused to leave a woman in labour’ | Afghanistan

Voice Of EU

Published

on

When Afghanistan’s first midwife-led birth centre opened in the impoverished district of Dasht-e-Barchi in western Kabul this year it was a symbol of hope and defiance.

It began receiving expectant mothers in June, just over a year after a devastating attack by gunmen on the maternity wing at the local hospital left 24 people dead, including 16 mothers, a midwife and two young children.

For Zahra Mirzaei, its launch – along with a second birth centre in the east of the capital – marked the culmination of a decade advocating for women’s birth rights.

As president of the Afghan Midwives Association (AMA), Mirzaei was instrumental in establishing the midwife-led units promoting an ethos of respectful, bespoke care away from an over-medicalised setting.

“In our country this approach to pregnant women is groundbreaking and there was a great feeling of hope when we opened our doors,” she says.

“Women who had previously experienced undignified, low quality care in poorly staffed hospitals were pleasantly surprised to discover there is another way of doing things.”

The units in Dasht-e-Barchi and Arzan Qimat were established with technical support and training from the Europe-based Midwifery Unit Network (MUNet) and funding from two NGOs which we cannot name for security reasons.

A woman is supported in active labour by three midwives.
A woman is supported in active labour at a birth centre in Arzan Qimat. Photograph: Nooria Omidy/Handout via Hannah Summers

In the initial weeks the centres, staffed with a total of 75 midwives, were each welcoming 10 to 13 newborns a day. But as word spread, increasing numbers arrived and this soon climbed to 25 to 30.

By late July, Mirzaei was preoccupied with how to manage the rise in cases. But her work was overshadowed by a growing awareness of the Taliban’s military offensive, which had gathered unexpected pace.

News of the Afghan government’s imminent collapse amid the withdrawal of US troops was, to Mirzaei, personally and professionally shattering.

“Suddenly everything I had worked tirelessly for was under threat,” she says. As a Hazara Shia and a longstanding campaigner for women’s rights, the 33-year-old knew she and her three children were at risk.

“Previous Taliban governments have killed thousands of Hazara people without any reason. Also I knew my feminist work and belief in women’s equality would never be accepted by the Taliban regime,” says Mirzaei, who in 2020 was named one of 100 outstanding female nurses, midwives and leaders providing health services in difficult times by Women in Global Health.

As the US and its coalition partners scrambled to airlift thousands of people from the country, warnings were filtering through from Mirzaei’s home town that she was a potential Taliban target.

On the day Kabul fell, plunging the country into turmoil, she left her office for the last time, fleeing in such a hurry she was unable to collect her shoes. “We didn’t expect the situation to escalate so fast,” she says.

Later that night she was woken by the sound of her eight-year-old daughter sobbing: “I went to her and she said: ‘Mummy, I’m scared that when I’m 12 the Taliban will come and take me to get married and I won’t be able to go to school.’ That was so painful to hear that I promised there and then to get us out.”

After calling every contact she could think of, she heard from a friend in the US who could help. Mirzaei left home with her family at 1am on 23 August, still wearing the flimsy slippers in which she’d fled her office.

They spent a harrowing 12 hours waiting in a sewer near the airport before being rescued by US troops and airlifted to Qatar. From there they were transferred to a refugee camp in southern Spain.

Mirzaei in a refugee camp in Spain
Mirzaei, who is now in a refugee camp in Spain, says she was was heartbroken to give up the role of president of the Afghan Midwives Association. Photograph: Katie Cox/The Guardian

Speaking from the Spanish naval base in Rota, Mirzaei explains how leaving Afghanistan also meant, regrettably, stepping down as president of the AMA.

While she was heartbroken to give up the role, she remains a member of the advisory board and is working remotely to support the organisation including her successor – a woman from a different ethnic group who is more likely to be accepted by the regime.


As the eighth girl of 10 siblings, Mirzaei understood from a young age that boys and girls were not seen as equal. “I had two brothers but my father wanted more boys and it made me sad girls were not allowed to reach their full potential in our community.”

Growing up in the province of Sar-e Pol, where poverty was widespread and literacy rates were poor, 16-year-old Mirzaei found education opportunities were limited.

An encounter at the local hospital set her on the path to becoming a midwife. In the waiting room she witnessed a woman desperately searching for a midwife only to be abused by a health worker.

“This incident really affected me – the way they treated her was shameful. When I saw the doctor I asked her what a midwife was and why it was so important.

“I liked the sound of midwifery – it spoke to the feminist in me. That kind doctor changed my life by explaining how I could enrol on a community education midwife programme.”

A year later Mirzaei graduated with a diploma having already joined the AMA as a student. “I was inspired by its plans for improving the profession. For me the most important thing was for women to receive evidence-based, respectful maternity care.”

But starting out as a hospital midwife in 2006 she was concerned by what she saw.

A midwife supports a woman breastfeeding her newborn baby.
Early breastfeeding, skin-to-skin contact and delayed cord clamping was encouraged at the units Mirzaei helped to create. Photograph: Nooria Omidy/Handout via Hannah Summers

“There would be 150 deliveries a day in a hospital with only four or five midwives. Women would be left to give birth in the corner or in the toilet. The most painful thing was seeing how exhausted the midwives were – they couldn’t support pregnant women emotionally and there was even physical abuse.”

While women in remote areas typically give birth without medical assistance, or sometimes with a midwife, childbirth in urban hospital settings is highly medicalised.

“These facilities are staffed by doctors who don’t seem to know their job description because they are overrun dealing with straightforward births,” says Mirzaei. “The care is dehumanised and the use of hormone drips and episiotomies is routine practice.”

Afghanistan has one of the highest maternal mortality rates in the world, although the number of women dying in childbirth has slowed from 1,450 per 100,000 live births in 2000 to 638 in 2017, according to UN data.

In 2012 Mirzaei became a provincial director for the AMA and later moved to Kabul to coordinate a midwives’ mentorship programme for the organisation.

She joined a small but growing cohort to achieve a BA in midwifery after graduating from Zawul Institute of Higher Education in 2016. Two years later she was elected president of the AMA and made it her mission to establish midwife-led units.

The model would move away from medical interventions towards a focus on active birth, skin-to-skin contact and early breastfeeding.

In 2003 there were just 467 midwives operating in Afghanistan – the severe shortage brought about by the Taliban’s ban on educating girls and women during the preceding years. This figure has since grown to 6,376 currently in clinical practice.

A 2018 Afghanistan Health Survey found just a fifth of pregnant women had received the recommended four antenatal care visits and fewer than 60% of births were overseen by a skilled healthcare professional.

There were 119 attacks by terrorist groups on healthcare facilities in Afghanistan in 2019, according to the World Health Organization. Then in May 2020 came the massacre at the maternity ward of the Dasht-e-Barchi hospital.

Among the dead was a midwife colleague of Mirzaei, Maryam Noorzad. “She was killed because she refused to leave a woman alone in labour. The baby was coming and after it was born a gunman entered and killed all three of them.”

Not only was the attack a horrific crime against pregnant women, babies and hospital staff – it was also a devastating assault on decades of work to reduce maternal and newborn mortality in Afghanistan.

Despite the security fears, the AMA wanted to establish one of the midwife-led units in the same district to plug the gap left by the attack on the hospital, where there had been 16,000 babies born in 2019. Many of the midwives who survived the 2020 attack were among the highly trained staff taken on by the AMA to run the new centres.

A newborn baby on a maternity ward in Herat in February
A newborn on a maternity ward in Herat in February. It is feared decades of work to reduce maternal and newborn mortality in Afghanistan could be threatened by the Taliban’s return to power. Photograph: Jalil Rezayee/EPA

The success of the centres relies on one-to-one care and requires numbers to be kept at a manageable level. To meet the demand it was Mirzaei’s ambition to open more units across Kabul and beyond.

But for now, at best, her dream is on hold. The centres closed after the Taliban takeover and while one has recently reopened many staff remain too fearful to go to work. Some midwives have already been interrogated by the Taliban for moving around without a chaperone.

The UN Population Fund (UNFPA) has estimated that without immediate support there could be 51,000 additional maternal deaths between now and 2025.

In Spain, Mirzaei is preparing to fly to the US to start the next chapter of her life. Her immediate future is uncertain but she has accepted an offer to study global maternal health at City, University of London, which she’s had to defer until she can arrange a visa.

“Every day I open my phone and look at photos that were taken at our birth centres. It gives me hope. Their immediate success rests on the wider political situation but we will not cease our efforts to do everything we can for girls and women in Afghanistan.”

  • Many midwives who have campaigned for women’s rights in Afghanistan now find themselves targeted by the Taliban and have been forced into hiding, while others are at risk because of their ethnicity. The Association of Radical Midwives is raising funds to help those seeking to settle in the UK. To donate please visit this crowdfunding page.

Source link

Global Affairs

‘They see it in corridors, in bathrooms, on the bus’: UK schools’ porn crisis | Pornography

Voice Of EU

Published

on

Barnardo’s works directly with children who are victims of abuse or display signs of harmful or risky sexual behaviour. In 2020-21, they worked with 382,872 children, young people, parents and carers.

In a recent survey of their frontline workers across England and Wales, staff reported a rise in the number of children participating in acts they have seen in pornographic videos, despite feeling uncomfortable or scared. They describe porn as having a “corrosive” effect on child wellbeing.

Child sexual abuse expert Sarah works with children who are displaying signs of inappropriate sexual behaviour. She also trains other professionals who work with children

“I started out as a primary school teacher eight years ago, and I’ve been worried about children seeing porn ever since. Children don’t have to be able to type to see porn – it can be sent to them or shown to them on someone else’s phone. They see it at school, in the corridors, in the bathrooms, on the bus. There is just no censor on any of it – one video leads to another. If you can imagine it, it exists as porn, and children are seeing it.

“I am working with a teenager who was sexually abused by a family member. This young person had been exposed to porn and it was perpetuating what the abuser told them – that this is normal, that it’s not abuse.”

She is particularly concerned, as are her colleagues, about the increasingly extreme nature of the porn freely available on mainstream sites.

“A common role play theme on porn sites is intra-familial abuse – on mainstream sites you will see fetishisation of grandad and granddaughter sex, or stepfathers and stepdaughters. This may lead to a young person not disclosing or getting the support they need. From both angles it is dangerous; it puts the child at risk and encourages the perpetrator.

“The impact of porn shows in children harming others or themselves because they either don’t understand or are so ashamed of sexual urges. Shame is very prevalent and is often hidden.

“We are working with a seven-year-old who has been exposed to porn and is now displaying sexualised behaviour. They had free rein on a device, and someone hadn’t deleted a browser history. Once a young person sees porn, they may feel a need to come back again and again – porn is designed to meet a need. That is a form of sexual abuse against that child.”

Brian* is a senior social worker who has worked with children for over 30 years

“Unfortunately, porn is a feature for the majority of the children who come into our service. The children we support are very damaged. They would be likely to have experienced multiple forms of abuse – sexual, physical and domestic. Porn in and of itself is not the cause of their behaviour but it becomes a compounding factor when it hits that history of vulnerability.

Adult sex offenders can give children a distorted rationalisation for their behaviour, and the messages that are given through porn then fit with that distortion.

Lucy* has worked within the field of child sexual abuse for 16 years.

“We know children find porn distressing – they are telling us that themselves. We have done research with children in schools so that we have a cohort to compare our vulnerable children to, and they are saying the same thing.

“This is not what could be described as erotic or soft porn. They may start on porn sites and quickly begin to see very hardcore material. Or [extreme material] lands in their social media feeds, and they can then feel compelled to go back and look again.

“Children are less able to manage sexual arousal, and this material is designed to be arousing. Lots of children can feel guilty and distressed by what they see. We have 14-year-olds telling us they have to watch it as soon as they wake up. They describe being preoccupied with accessing porn to an extent that impacts upon their day-to-day life.

“We also regularly work with children with learning disabilities, another group vulnerable to the harm of porn. They may be shielded from sexual information and then reach 13 or 14 and take away the wrong learning from porn. They may learn that no means yes, that if you persist, women will enjoy forced sex. These messages are harmful for any child but for children with learning needs or who have developed unhealthy beliefs around sex as a result of abuse, it’s particularly bad.

“After lockdown, we began to get more calls from parents where there is no other obvious trauma, just the exposure to porn. I’ve been doing this 16 years, and children have far more access to porn now.”

* Names and some details have been changed to protect identities

In the UK, the NSPCC offers support to children on 0800 1111, and adults concerned about a child on 0808 800 5000. The National Association for People Abused in Childhood (Napac) offers support for adult survivors on 0808 801 0331. In the US, call or text the Childhelp abuse hotline on 800-422-4453. In Australia, children, young adults, parents and teachers can contact the Kids Helpline on 1800 55 1800, or Bravehearts on 1800 272 831, and adult survivors can contact Blue Knot Foundation on 1300 657 380. Other sources of help can be found at Child Helplines International

Source link

Continue Reading

Global Affairs

French centre-right tilts toward Pécresse

Voice Of EU

Published

on

Valérie Pécresse, a moderate conservative who has likened herself to former British and German leaders Margaret Thatcher and Angela Merkel, has emerged as a front-runner in primaries in France’s centre-right Les Républicains party, Reuters reports. “I won’t flinch. I have a project for a clean break, a project for the unashamed right,” she said Thursday, ahead of elections against liberal incumbent Emmanuel Macron and far-right contenders in spring.

Source link

Continue Reading

Global Affairs

Poland plans to set up register of pregnancies to report miscarriages | Poland

Voice Of EU

Published

on

Poland is planning to introduce a centralised register of pregnancies that would oblige doctors to report all pregnancies and miscarriages to the government.

The proposed register would come into effect in January 2022, a year after Poland introduced a near-total ban on abortion.

This has raised serious concerns among women’s rights activists, who believe that in light of the abortion ban, the register could be used to cause legal difficulties for women who have self-administered abortions.

The draft legislation is part of a wide-ranging project to update the medical information system in Poland.

“It’s about control, it’s about making sure that pregnancies end with birth,” Natalia Broniarczyk, an activist from Aborcyjny Dream Team told the Polish weekly Gazeta Wyborcza.

The plan prompted online protests. A social media initiative titled “I’d like to politely report that I am not pregnant” encouraged Polish women to email photos of their used sanitary pads, tampons and underwear to the Polish ministry of health.

The ministry has strongly denied the project amounts to a centralised pregnancy register, with a spokesperson saying the changes are simply part of wide-ranging digitalisation project that will update the way data about a multitude of conditions, including allergies, is stored.

The spokesperson said doctors always had information on pregnancies, but before it was stored on paper by hospitals, rather than centrally by the government.

The concerns of activists about the register grew considerably after a bill proposed by the government that would establish an “institute of family and demographics” passed first reading in the Polish parliament by one vote on Thursday.

The institute would aim to monitor family policy, pass opinion on legislation and educate citizens on the “vital role of family to the social order” and the importance of “cultural-social reproduction” in the context of marriage. The institute would have access to citizens’ personal data and prosecutorial powers in the realm of family law, prompting worries it could be used to enforce the country’s strict abortion law.

The project has drawn widespread criticism from Polish academics and civil rights advocates.

“Maybe just call it the ‘Red Center of Rachel and Leah’,” a feminist organisation from Łódź said in an Instagram post, referencing Margaret Atwood’s dystopian novel The Handmaid’s Tale. In the novel the Rachel and Leah Center is a training facility for women designated to be “breeders” by the authoritarian regime.

The committee of demographic researchers at the Polish Academy of Sciences has issued a statement expressing concerns that the “pro-natalist propaganda” would take precedent over scientific research at the institute.

“The project aims exclusively to promote traditional model of family,” Adam Bodnar, Poland’s former ombudsman for citizen rights, told the Polish news website Oko.press. “It could also become a tool against those who fall outside this model, for example those who do not conform to heteronormative norms.”



Source link

Continue Reading

Trending

Subscribe To Our Newsletter

Join our mailing list to receive the latest news and updates 
directly on your inbox.

You have Successfully Subscribed!