A Local Clinic is Saving Lives
For the past four years, the clinic, which opened in 2013, has been providing health care for the residents of 24 villages in the locality. Many of the patients are mums-to-be, young mothers and their children. One of them, a young Afghan woman, explains that she is worried about her son: ‘He’s only two months old and he has developed a very odd rash on his head. I am hoping the doctor can help.’
Shah Mohammad, the young doctor on whom the woman is pinning her hopes, has worked here for the past three years. ‘The health centre is extremely important to these rural communities. Many of the locals have no way of reaching the provincial hospital in Taloqan, so before this health centre opened, they had very limited access to medical care. They only ever visited doctors in the provincial capital in emergencies, and perhaps not even then. This has changed their lives.’
The new facility was built as part of a comprehensive health programme funded by KfW on behalf of the German government. It has replaced the previous makeshift clinic and provides care for around 15,000 residents of nearby villages.
A glance at the waiting room gives an indication of the tremendous demand for its services. Shah Mohammad explains: ‘We see around 60 patients every day. Our greatest challenge is providing adequate care for everyone. I am the only doctor but I have seven colleagues to support me, including two nurses, a midwife and health assistants. We have a very heavy workload and sometimes we wonder how we can possibly look after everyone.’ However, no one is ever turned away without treatment – that would conflict with the team’s ethos, not least because every staff member knows how far many of the patients have to travel in order to access the medical care they need.
The team’s efforts are paying off: child mortality, for example, has fallen dramatically in the past few years. ‘I don’t know of a single case of a child under our care dying in the first five years of its life,’ says Shah Mohammad. And that’s not only due to the quality of care or the equipment’s high standard. It is also down to important factors such as basic hygiene awareness: ‘Much of our work involves explaining to women how to protect their children’s health through hygiene and cleanliness. Sometimes, they just need some basic tips – for example, we tell them to wash their hands before serving their children’s food. The mothers take the advice to heart.’
The Afghans are very keen to improve their own and their children’s health – evident from the fact that the women are prepared to be treated by a male doctor and their families’ consent to do so. The women show extraordinary gratitude for the care they receive from Shah Mohammad. Just occasionally, one of the female patients might feel awkward about being treated by a male doctor, but even then, they don’t go away empty-handed. ‘I work very closely with the nurses, so if one of the patients has a problem with being examined by a male doctor, I ask one of my female colleagues to take over. I explain to her how to carry out the physical examination and ask her to describe to me what she can feel. On the whole, it works very well.’
The high quality of care provided by the centre is not only the outcome of the good working relationship between doctor, nurses and midwife. Before the centre opened, all the staff attended in-service professional development programmes which went far beyond their original training and gave them the skills they need to operate the centre’s medical equipment, which is now used intensively. ‘We have an extremely well-appointed clinic, especially compared with other rural health centres. For example, we have a small laboratory of our own so we can diagnose cases of tuberculosis. That has quite literally been a life saver.’
A fleeting smile of quiet pride lights up Shah Mohammad’s face. At just 27 years of age, he is doing what he always dreamed of: he’s spending his life helping others.
Programme: Rebuilding the Balkh regional hospital in Mazar-e Sharif, with construction of a new Mother and Child Health (MCH) Centre; capacity development at the regional hospital in Mazar-e Sharif; upgrading of the provincial hospital in Feyzabad (Badakhshan); upgrading of hospitals and health centres at seven locations in Badakhshan, Kunduz and Takhar Provinces (including the Kunduz regional hospital and Tāloqān provincial hospital), support for polio eradication
Commissioned by: German Federal Foreign Office (AA), German Federal Ministry for Economic Cooperation and Development (BMZ), Japanese International Cooperation Agency (JICA), Swedish International Development Cooperation Agency (SIDA), Norwegian Government
Partner: Afghan Ministry of Public Health
Implementing organisations: Deutsche Gesellschaft für Internationale Zusammenarbeit (GIZ) GmbH, KfW Development Bank
Provinces: Badakhshan, Balkh, Kunduz, Takhar
Programme objective: To develop a well-functioning health system with a modern hospital infrastructure and qualified staff as a contribution to the country’s civilian reconstruction.