A Family's Hope for Good Health

Pari and her 40-day-old grandson, Elmaddin, both will benefit from Mercy Corps' child survival program in rural Azerbaijan. Photo: Mercy Corps Azerbaijan

Kamran's doing OK. At seven years old, he has healthfully made it through the critical first five years of life in his village. The youngest of six children, he is already learning to take on the duties that his family will expect of him as a young man. But his newborn nephew and his newlywed sister may not have it so good.

Kamran lives with his large family in Yelagaj, a small village located high on top of a rocky mountain in the Masalli district of southeastern Azerbaijan. In addition to its geographical isolation, the village suffers from lack of employment, poor infrastructure and schools, and a deteriorated health care system -- all legacies of the former Soviet Union and of independent Azerbaijan's lack of support for the much-needed repairs and reforms. Because of the bad conditions, many young people who manage to attend university in the capital, Baku, or another city, do not return to Yelagaj. The scarcity of newly trained teachers and health workers retuning home directly affects the amount of new information reaching the people that live there. The result: poor health Ð especially for the youngest children and their mothers.

But the people of Yelagaj have something to hope for.

In recognition of its commitment to delivering sustainable community health solutions to severely underserved populations, the United States Agency for International Development awarded Mercy Corps a five-year, $1.3 million grant to implement the Azerbaijan Child Survival project. Utilizing the same innovative spirit that defines Mercy Corps' approach to humanitarian umbrella grant management in Azerbaijan, and drawing on the successes of our Child Survival project in Central America, Mercy Corps launched this program at the end of 2001 in three remote regions of Azerbaijan: Yardimli, Lerik and Masalli.

These areas have the highest maternal and infant morbidity and mortality rates in the country. Until now, they have been largely neglected by the government and international development and relief efforts due to the concentration of efforts on people affected by the Nogorno-Karabakh conflict in western Azerbaijan.

Working in partnership with the Ministry of Health, the project aims to reduce infant and maternal illness and death and improve the quality and increase utilization of basic village-level health care in the targeted areas. The Child Survival project will directly benefit 20,000 children under five years old and 30,000 women of reproductive age, including the women, infants and young children in Kamran's family.

Because of the lack of health information and access to care, many women in the project area, like Kamran's sister-in-law, suffer from complications during pregnancy and birth such as hemorrhaging and breech deliveries. The women who beat the odds and survive these often-deadly complications, will most likely suffer from problems related to their reproductive systems well after their reproductive years.

Women, usually midwives, traditionally attend all births. But Yelagaj has no midwife, so women deliver at home with the help of their mothers, sisters, and neighbors. Newborn Elmaddin, Kamran's nephew, came into the world breech, and he and his mother almost didn't make it. "It was a very dangerous delivery. We were all very worried. We don't have a good diagnostic system in place here. It may not have been such a close call if we had detected the problem in time or had access to better care before the delivery," says Pari, mother to Kamran and grandmother to Elmaddin. "Many women in the village need treatment for problems during pregnancy and delivery but can't afford the trip into the district center, let alone the doctor and hospital fees."

Mercy Corps is training community leaders to be community educators so they can pass their knowledge on to women and families like Kamran's, giving them more access to information on topics that include healthy pregnancy, women's health and safe family planning.

Mercy Corps also provides medical training to village-level feldschers (physician's assistants) and midwives to increase their ability to treat women and children close to home thereby increasing the utilization of village clinics and establishing a prevention-based primary healthcare system.

At the heart of the Child Survival project is the work done directly with community members and leaders to provide health education and training in community participation, and to create a health information system that allows health care providers to share information. This gives a voice to families like Kamran's in deciding the health needs of the village and how to address them in a way that will have a lasting impact.

"We need a lot of things in Yelagaj. I am ready to work with Mercy Corps and my community to see what I can do to help meet our needs so that when it's time for my recently-married daughter to start a family, she and her children will have the information and access to health care they need for a healthy, long life," Pari says.