Goats and soda: NPR

The Afghan midwife describes how a woman died in birth, with her child. Snow was in her village and could not reach the hospital. Just weeks ago, the health clinic closed in its village. If it is open, the midwife helped her.

Other midwives, based in hospital, told NPR that their facilities believe that women are rushing from remote areas where clinics were closed after it was too late: mothers and infants often die, as the midwives say.

They say that these maternal and breastfeeding deaths are partly as a result of a tricking of the fragile health system in Afghanistan: the sudden closure of the US International Development Agency by the Trump administration, which is Once more than 40 % save From all aid to this deep poor country, which includes about 40 million people. The World Health Organization said In a statement More than 200 clinics in Afghanistan were closed as a result of lowering US financing.

“The US Agency for International Development should not leave Afghanistan. We have been destroyed,” says Fatima, 27 years old, who has worked in the care of the mother over the past seven years.

This made the clay worse, the main European donors also announced discounts for their foreign aid programs.

“It seems that other donors are following the United States – what Trump did is to give everyone a license to give up financing aid,” says Heather Barr of Human Rights Watch. I focused on Afghanistan for decades.

Indeed, American aid discounts caused 206 health facilities To close it in Afghanistan, according to the World Health Organization in late March. He said a report without Urgent intervention, About 200 other facilities will be closed by June, affecting about 2.4 million people.

To give a sense of repercussions, by February 19 – just one month after Trump’s opening and announced the suspension of the United States Agency for International Development – more than 320 health facilities were closed. By March 4, about 153 facilities managed to reopen them with the scratch of charities between the money, according to what it said Sultani generations, The head of communications for those in Kabul. But within two weeks, 39 other health facilities closed, According to the World Health Organization.

Who carries the greatest burden

Sultani told NPR via e -mail: “The reduction of health care” threatens the most weak women – women, children, the elderly and gunmen – who are now facing the risk of disease, the death of malnutrition and preventive mortality. “

The midwives spoke to NPR, provided that their identity was not disclosed because they were criticizing the Taliban and worried about their personal safety. It was also not authorized to speak to the media by the foreign fundamentalist institutions that employ them.

Most of the institutions affected by the US Agency’s International Development Discounts, from United Nations organizations to small charitable societies, have repeatedly refused to comment on the record about the effects of discounts on their work. He told three NPR relief workers, provided that his identity was not disclosed, that representatives of the various Afghan charitable institutions are concerned that if they speak publicly, they will wear the anger of the Trump administration even while trying to negotiate the resumption of some aid.

Complications and deaths

Until now there are no data available on deaths and serious complications related to pregnancy and childbirth since health facilities began to close in February – and it may never be. But the five midwives with which NPR spoke of stories about women who appear in regional hospitals in labor and with complications that are sometimes fatal to the mother and child. The midwives believe that some of these complications could have been treated if women reached the mother’s care early in their work.

Fayezi, 25, is a midwife worked in a clinic in an isolated mountainous area in the West Hirat Province. She says that the villagers were very happy with a clinic in their area because the closest health facility was four hours away from the treacherous, unpaid roads.

Fayezi, who adds that the clinic- like many other recently closed facilities- there was a lot of people coming, “and adds that the clinic- like many other other similar facilities that were recently closed- provided nutrition that suffers from malnutrition and their mothers as well as vaccines.

A few weeks ago, “when the clinic was closed, you remember that” people were really annoyed. “She says the village elders begged the public health employee to reopen the clinic, but” there was no grant “to finance its reopening.

Fayezi says since the closure of the clinic, she got a word stating that the mother and her child had died in childbirth. She says she was “snow and raining, roads were banned”, and there was no way to reach the nearest health clinic. Fayezi says she believes that she would not have died if they had reached health care. She indicated that there was no single death from the mother when she worked at the village clinic.

The doctor who worked in the closed clinic NPR told that even if the roads were open, his patients did not have a way to reach the city. Even for the village clinic, he said: “Families were walking or riding animals like donkeys.”

Other women have reached distant health clinics – only to die with their children.

One woman, generous, who worked to care for the mother for decades in a regional hospital, tells NPR that she sees Deaths because the mother’s care services “were managed by foreign NGOs – no longer working.”

A pregnant woman was martyred bleeding to death on the way to the hospital. Karima believes that a woman is likely to save if she has a clinic closer home. Another woman needed an emergency caesarean, but she arrived too late – her child died.

Another midwife in the western province of Hairat, Sumaya, told NPR that one of her rural patients has exceeded its date to be delivered. The clinic in her area was closed, so the woman traveled to Medina to give birth – but her child had headed in her womb, causing her death. It is known as the ancient ancient syndrome – a fatal condition that may occur in 5 % to 10 % of births but can be treated if it is diagnosed in a timely manner. From the point of view of the midwife, “the woman lost her child because there was no one who provides her career in society.”

Fatima, and The midwife, who works in the deep Farah District, says she sees horrific cases of women who are too late to hospital.

They reach a critical condition: children are stuck in the middle of the road – they go out, but the legs are besieged, or legs, while the heads remain [inside the birth canal]In those cases, Fatima says that the children died.

Fatima says she believes that she only sees a minority of cases. She says in her experience in working in conservative poor societies, “Most women who are born at home,” and if they die, their deaths are not registered. She says that some women who give birth at home because families cannot afford a taxi to the hospital – many Afghans do not have their own cars.

Fatima says that there are cultural issues as well – which are getting worse under the rule of the Taliban, which strongly restricted the freedoms of women and girls. She says that some families “refuse to allow women to leave the house” even when she is in labor. Instead, they say, they are doing the task of elderly relatives to help in delivery. And when these women or their children die, family members “reject these deaths as” the will of God. ”

Another blow

In this context, Fatima and other midwives say, the US Agency for International Development was a blow to women who are already having a lot of hardship.

Even before these cuts in 2025, health care in Afghanistan was always weak, especially for women. It worsened after the Taliban seized power more than three years ago from a Western government. International aid has decreased, even when the Taliban began to increase the rules that prevent most women now from leaving their homes without a male guardian, preventing women from most professions and banning most women and girls from studying after the sixth grade.

Even a pilot program to train young women to work as nurses in society and midwives, the Taliban government was closed in February last year, Acts apparently on the orders of the group’s spiritual leader, Haibatullah Akhundzada.

More and more countries make discounts

The Trump administration’s discounts sparked the Domino effect of some kind: shortly after the announcement of these cuts. On February 25, the British Prime Minister Sir Care Starmer He declared his country It will almost half Its budget for external aid. He said that a decision was taken to convert resources to defense spending in response to the call of the Trump administration to NATO allies to contribute more money to defense.

The main international donors followed international aid. France said it intends Cut off its external aid With a rate of up to 40 %; Holland Foreign discounts also announced. Belgium announced Reducing 25 % In external aid. Switzerland I announced smaller discounts – It moves that Norwegian Relief Committee Describing in a statement that it “predicted a significant decrease in the assistance available for the most vulnerable aid in the world.” The statement followed the news in December that the world The second largest donor to help at that time, Germany, It would reduce two billion dollars in foreign aid with its economy contract.

Fatima, Afghan midwife, The discounts in external aid described this way: “No one gives the priority of a woman’s life.”

With additional reports by a larger Varba in Paris, Richie Kumar in Istanbul, Zahl Ahmad in Toronto. Ghani mentioned from Freemont, California.