Bakhtawar is sitting on a bed in the female in-patient ward of Hazarjuft Hospital in Helmand, Afghanistan. Her name means "lucky woman" but she has been anything but lucky when it comes to preganancy and health.
In her 38 years, she has been pregnant 30 times. All but two have ended in miscarriages and stillborns. Now, in her eighth month of her 31st pregnancy Bakhtawar is feaful that again, her pregancy will end in misfortune. Several days ago she began to experience abdominal pains and early contractions. First she consulted a traditional midwife in her village. She was advised to drink lots of tea, rest and pray.
She followed the advice, but two days later, the pain had increased. Finally, she decided to try to come to Hazarjuft Hospital, an hours drive over very rough terrain from her village. She had never been to a hospital before.
"I was afraid to come and my husband was not in agreement at first," she said. "But finally he agreed that even if the baby could not be saved, they might be able to help end my pain. Last year I had a dead baby and it took over three days for the delivery. I almost died."
Hazarjuft Hospital is part of a larger network of healthcare services that Mercy Corps established in southern Afghanistan in 1986, to provide healthcare to thousands of women and children with no other health services. The initiative was part of a wider program to encourage Afghanistan's huge refugee population in Pakistan to repatriate to their communities - a goal that has only become more important in the wake of the current crisis.
The NetAid Foundation has partnered with Mercy Corps to help sustain the Afghanistan Health Initiative and enable Mercy Corps to provide vital health services to over 150,000 people for six months. The flexibility of the NetAid grant has allowed Mercy Corps to meet a gap in funding the ongoing program, while a grant from the Bureau of Population, Refugees and Migration (PRM) was being finalized.
The Helmand Province Afghanistan Health Initiative includes the Hazarjuft Hospital and four basic health units (BHUs) located in Garamser District, a clinic in Khaneshin district and a large network of Community Healthcare Workers (CHWs). The system includes pharmacies, laboratories and qualified medical staff that perform minor surgeries and deliveries, and provide outpatient services. Funds from NetAid are being used to pay local doctors and nurses, train community health workers, purchase basic medical supplies, and maintain clinics. Without support of these services there would be virtually no access to professional healthcare for the hundreds of thousands of destitute people living in this region.
By the end of the day, Bakhtawar reports that her pain has subsided and the contractions have stopped. Doctor Mahwash, the female Mercy Corps doctor treating her, has prescribed that she remain in the hospital another day to be monitored, but she is positive about Bakhtawar's pregnancy. "The treatment is working well," she says.
Bakhtawar, after so much misfortune, is cautiously optimistic. When asked if she will come to the hospital again, she replies: "I will return to the hospital to deliver my baby. If it lives, I will continue to come to the hospital for treatment."