Babies are being born in tents in earthquake-devastated Eastern Afghanistan with rock falls and boulder-strewn roads making the journey to hospital perilous for pregnant women, Save the Children said.
An estimated 11,000 women in the earthquake-affected areas are currently pregnant and could give birth in tents in coming months, where temperatures regularly fall below freezing in winter, escalating health risks for newborns1.
About nine out of 10 families - in the districts hit hardest by the series of devastating earthquakes that struck Eastern Afghanistan in late August and early September have moved into tents, either in camps or in their villages after their homes were either destroyed or severely damaged. About 39,000 children are living out in the open2.
The towering, barren mountains and narrow valleys are dotted with clusters of temporary shelters that provide little protection from the cold as temperatures start to drop.
Pari* was in the final days of her pregnancy when the 6.0-magnitude earthquake struck in the middle of the night on 31 August, forcing her from her home in the mountains. With roads blocked by rock falls, she walked for about six hours, finally arriving at a mobile health clinic run by Save the Children.
She was reunited there with Nafisa*, a midwife who had supported her throughout the pregnancy. Her son - her first child - was born five days after the earthquake in a canvas tent that is now home for her family.
Pari said:
"I became pregnant after [trying for] 16 years. I was so happy, I cried when I became a mother.
"We didn't want our child to be born in a tent, in such conditions. We wanted to be in our own home. Now we are living in an emergency situation - that's why I feel so sad."
This was the first time that midwife Nafisa had done a delivery in an emergency with Save the Children's mobile health team, and she has since delivered another baby in the camp. The women she supports in these remote valleys are normally referred to district hospitals to give birth, but now tents have become delivery rooms.
Nafisa said:
"The night the earthquake happened, everything changed, especially in this area, as it was the most affected. We came here and set up our tent. Yes, we had plans for expectant mothers, but this was an emergency situation. A midwife or doctor must be prepared for anything.
"In situations like this, I imagine the baby is my own child, and I do everything I can to help. I wasn't very nervous; I was happy that I was able to support a mother during childbirth in such a situation."
Pari arrived in the camp with just the clothes she was wearing after losing everything in the ruins of her home.
She told Save the Children:
"We need clothes for my baby and myself. Other people brought some clothes for the baby, because we didn't have anything to dress him in. We need a proper home, especially as winter is coming."
Snowfall could cut off some earthquake-affected communities, potentially for weeks. Aid is being delivered to these remote areas via a precarious, rocky track carved into the side of the mountain, only wide enough for one vehicle to pass at a time. It takes two hours to travel 22 miles (35 km) from a paved road to one of the areas where Save the Children is working. There is also the constant threat of rockfalls, and some villages are still only accessible on foot.
Save the Children works in the affected provinces, so was among the first international organisations on the ground in Kunar where most of the nearly 2,000 confirmed deaths occurred. The humanitarian and child rights organisation is providing health care, water and sanitation services, household, baby and hygiene kits, multipurpose cash assistance and childcare centres in the earthquake-affected areas.
The UN estimates that nearly half a million people are in need of assistance following the earthquakes which created massive displacement, with more than 8,000 homes destroyed or damaged2.
Samira Sayed Rahman, Programme Development and Advocacy Director, Save the Children in Afghanistan, said:
"No baby should take their first breath in a tent. No child should be without shoes, warm clothes or heating as winter approaches. It's now a race against time to ensure that babies, children and their families in the earthquake-affected areas can survive the harsh winter ahead.
"Cold weather exacerbates health risks for babies and children. It weakens immune systems and heightens susceptibility to acute respiratory infections, including pneumonia.
"Without winter-proof, heated shelters, children are also at risk of hypothermia as temperatures plummet. Coupled with existing limited access to health and nutrition services, and the isolation of the affected areas, winter will be a precarious time, especially for children.
"Urgent funding is needed to ensure that winter does not add to the already high death toll in Eastern Afghanistan."
Save the Children has been working in Afghanistan since 1976, including during periods of conflict and natural disasters. We have programmes in 9 provinces and work with partners in an additional 11 provinces. We deliver services spanning health, nutrition, education, child protection, shelter, water, sanitation, hygiene and livelihoods.
