The midwife at the Unkhai Basic Health Clinic shows a coalition special operations forces soldier a board which describes common pregnancy complications, Sayed Abad district, Nov. 5. The soldiers visited the clinic to check on the level of training and education and to teach the mid-wife medical procedures. (Photo by Sgt. Lizette Hart)
BAGRAM AIR FIELD, Afghanistan (December 10, 2011) — Because of traditions and cultural beliefs, many women in Afghanistan are left behind when it comes to medical treatment. Most Afghan doctors are males, and women are rarely seen by them. Instead, they are frequently left to tend to their health the only way they know how: by wives’ tales passed down from their families.
A unique program was developed by coalition special operations forces to encourage the education of women and midwives: the Female Treatment Team.
The mission of the FTT was to train women as midwives for their villages and enable them to turn around and properly train others. A vast majority of the medical knowledge the Afghan women have is passed from one generation to the next, so the team made it their mission to teach the women the necessity of basic medical treatment. The FTT also stressed the importance of sending people to the hospital when they needed additional medical support, especially when delivering a baby.
“Our mission was to have female medical providers go out into the villages and train the local village women, uneducated women, on basic health care, like treating a fever or recognizing different illnesses,” said an FTT officer in charge. “We teach the women to know if they can treat them in the villages or if they need to take them to the hospital.”
The six-month FTT rotation was a new plan initiated in June 2011, and numerous teams were set up across the country to travel throughout Afghanistan to visit women and midwives in remote villages.
“It’s a pretty new concept still, but I knew we would be going out and engaging females and teach basic medical skills to these women,” said an FTT non-commissioned officer in change. “I think that giving birth at home is just so common around here, they just think they don’t need to go to a hospital or clinic.”
Prior to going to a new village, the teams would research the area to find out what the education level of the women was. A lot of the training was more basic than the FTT expected, considering the varying levels of medical knowledge across the country.
“I think our team did a great job, and we did the best with what we had because we didn’t have a whole lot of information,” the FTT OIC added. “When we go to the villages to teach, it’s pretty much off-the-cuff with whatever the women want to talk about.”
The teams were able to visit several villages during their deployment, with some village elders requiring more persuasion than others to allow the FTT to talk to and train the village women. The more remote a village, the more likely the villagers were to be conservative in their customs and traditions.
“Out here, even getting elders to acknowledge us is gratifying,” said the FTT NCOIC. “Some of the younger gentlemen interact with us, and it’s rewarding because one day these younger guys will be elders, and when they get to that position, hopefully they will be able to make the changes the current elders aren’t willing to do because they are so set in their ways. Women have a lot more to offer than these gentlemen give them credit for.”
The teams were able to build a foundation of trust with village elders and spoke with village women about their health concerns and issues. While some village elders seemed reluctant to allow the FTT into their community, the village women were more than willing to welcome the team into their homes to sit and have conversations about anything from medical training to family affairs.
“I think we’re pretty well-received, and they’re usually just curious about America, and they have a lot of questions for us about where we come from and our values and culture,” said the FTT OIC. “Once we can see the women, they’re always happy to see us.”
During their rotation in eastern Afghanistan, one FTT was able to conduct 30-40 missions in parts of the country that varied from modern and forward thinking larger villages to conservative and modest smaller villages.
“We reach out to the smaller villages since we can’t get them to come to us,” the FTT NCOIC explained. “Unfortunately, we only have about two hours with them, so we teach whatever we can in that short amount of time.”
Because of the varying levels of cultural progression within Afghanistan, the team was sometimes confronted with aversion to accepting help from outsiders. A sense of pride in their heritage and history was often a barrier when it came to teaching the women modern medicine.
“They tell us that’s how they lived for years, and all we can do is teach them, just give them the knowledge,” said the FTT OIC. “Often times, they don’t get offended by us telling them these things, but they don’t buy into it. I think if we could go back and follow-up, it would make much more of an impact.”
One of the team’s main missions was teaching basic health skills at the Sameen Akbari Girls’ School in Chamkani Village, Patktiya province. The school has around 3,000 students, ranging from ages 13-20, so the information taught by the FTT reached a larger population. The team regularly visited the school to impart knowledge onto them so it would be disseminated beyond the classroom.
“We have a birthing model, so we took that to the girl’s school and taught them how to do emergency child birth, because often times, these women just give birth in their homes,” said the FTT OIC. “They loved it, and they all practiced with the model.”
The team visited the school a couple times a week, which created lasting relationships with the teachers and students. They taught practical medical instruction such as washing hands, drinking clean water, bandaging wounds, treating common colds and fevers, female care and emergency care.
Along with visiting the school, meeting with midwives at village clinics was a common area of interest for the FTT.
Midwives go through an 18-month course to learn midwifery before returning to their village to work at the local clinic for five years. Due to cultural customs, sometimes it’s a struggle for women to gain approval from men to attend any sort of continued education, even in the medical field.
“It’s a lot more difficult for the women to get in,” said the FTT NCOIC. “Some areas are fine with it and more forward thinking, but a lot of them are still very conservative so they don’t see any reason why their women need to learn.”
After six months of trekking across Afghanistan, the FTTs are heading home. After countless hours of teaching preventative medicine and basic medical treatment, they hope the women of Afghanistan can continue to advance the health care and treatment for future generations.
“I think it’s a long road,” said the FTT OIC. “We’re the first ones, so it’s been a painful process most of the time, but I think we’ve been successful in what we’ve intended to do.”