Daily Times

The Taliban are active in the region and roads are often dangerous after dark, so when 25-year-old Asmad Fahri felt her contractions begin at night she knew she would have to wait until daybreak to begin the three-hour journey to the hospital.

Finally she is resting, her infant tightly swaddled and asleep between her knees.

On average new mothers are kept in the ward for six hours, but she has asked to leave after just three, to ensure she reaches home before darkness falls again.

Most only have time to lift the long layers of clothing hiding their bodies and wedge their coloured veils between their teeth, too rushed even to change into MSF’s standard red pyjamas.

The Khost Maternity Hospital (KMH) opened at the end of 2012 in a medical desert in the conflict-riven country with one of the highest infant and maternal mortality rates in the world.

It was an overnight success, with nearly 12,000 deliveries in its first full year in 2013.

By 2017 that figure had nearly doubled, to 23,000.

This year the hospital is on track to deliver 24,000 babies, says Dr Rasha Khoury, a Palestinian gynecologist who is medical officer at the site.

Behind her, a young mother of twins searches her skirts and hands her a folded banknote. It is a traditional gesture of gratitude after delivery, at times required in some hospitals but politely declined here. “It’s forbidden,” insists Khan.

– More deadly than war –

The UN and the World Bank put maternal mortality at around 396 deaths per 100,000 live births in Afghanistan.

But the figure is disputed, with experts pointing out it is an improbable fall from the 1,600 per 100,000 recorded in 2002.

Such a decline would mean Afghanistan would have reached its Millennium Development Goal set by the UN some five years early, a study published in the medical journal the Lancet noted in 2017.