BABY ABDUL'S STORY

When Afghanistan collapsed to the Taliban in August 2021, pregnant women ceased prenatal care – many because they could no longer afford it, many because they could not go out in public without risk of being killed, and many because under Taliban law, women are property and medical care is not seen as important. A young couple, pregnant for the first time and in hiding in a bombed-out basement without heat or electricity, decided to have their baby on their own, because if seen in public, they would be executed. When the woman’s water broke and labor commenced, a female Afghan OB doctor came hidden in a truck to assist. They had only the light of two cell phones and the temperature was below freezing…

Afghanistan in the 1970’s mirrored the styles and attitudes in the United States. Female lawmakers spoke out in Afghanistan’s Parliament; Journalists wrote freely of events around the country; Universities flourished with student life. Girls wore miniskirts. Tourists, enchanted by the beautiful scenery, gardens, bazaars, and cosmopolitan feel of Kabul, the capital, called it the “Paris of Central Asia.” 

Present day Kabul looks nothing like the city of a half century ago. Estimated to have over 4.6 million residents prior to the fall of the Government to the Taliban this past August 2021, some estimate there are more than two hundred thousand people hiding in Kabul with relatives, friends, and in abandoned buildings. Taliban forces patrol the twenty-two districts and have checkpoints looking for journalists, teachers, and anyone who showed loyalty to the American Forces and the previous government. Once identified through facial recognition programs and biometrics, systems created and implemented by the United States, many are executed on the spot. Frequently the bodies are hung from cranes in public places. Previous men and women who served in the Afghan military are particularly at risk.

Essential emergency response programs such as fire, police, and emergency rescue cease to exist. Many diabetics can no longer afford insulin, or it poses too high a risk to try and buy it; many in renal failure can no longer afford dialysis or it poses too high a risk to go to a hospital; and many women ceased prenatal care when the country collapsed. Chronic medical conditions, left untreated, become acute over time.

The U Medical Corps, the dream of a writer/ex flight medic in the United States, and a Doctor of Internal Medicine in hiding in Afghanistan, emerged in September 2021 as an underground movement to connect Afghan patients in peril with in-country Afghan doctors and hospitals. It has grown to over 270 doctors in a variety of specialties and relationships with six hospitals.

In November 2021 several days after Thanksgiving, the U Medical Corps, supported by the Upperwood Foundation, received a request for assistance. Fair warning: the following content is disturbing…

A young couple, married barely a year, hides in the basement of a partially destroyed home. The windows have been blown out and the roof partially collapsed. At night, the temperatures drop into the thirties. The 28-year-old husband served with the Afghanistan National Army Special Forces, and his 26-year-old wife had worked as a journalist for one of the television stations. Afraid to be seen in public, the young couple never leave the basement in daylight, and rely on food and supplies provided by friends. A cell phone solar charger keeps their communication link intact. 

The young wife, pregnant for the first time, ceased her prenatal care at six months because she could no longer see her obstetrics doctor. For several weeks, friends brought her prenatal vitamins, but they became hard to find due to shortages and stopped all together mid-September. In October, two of the husband’s family members disappeared, and recent reports of female journalists and activists killed by the Taliban further cemented the decision of the young couple to remain in the basement and deliver the baby themselves.

The husband researched delivery methods on the internet for several days. He prepared with blankets from friends and medical supplies stolen from a local pharmacy. When his wife’s water broke and she started contractions, he felt ready.

Eighteen hours later, at 12:30am Kabul time, the husband called a friend to say the baby wasn’t coming, and he didn’t know what to do. The friend told them to go to the local government hospital, but the husband said if they encountered the Taliban, biometric scanning would reveal his identity and his wife’s face was easily recognizable from television. They would be killed. The friend called another friend who called another who called another. The fourth person into the link said he knew of an organization who might know someone who could help. Eventually, the sixth person in the chain reached the U Medical Corps.

Within an hour of the husband reaching out, a primary physician in Kabul called the husband and referred a female OB/GYN who followed up with both husband and wife. Afraid to go out in the dark, the U Medical Corps arranged for transport of the female doctor in a truck delivering supplies to a nearby community. Hiding under a metal frame obscured by hundreds of pounds of firewood, the female OB/GYN made it through three Taliban checkpoints undetected. Early evening in the States, the U Medical Corps also had an OB/GYN on standby in the U.S. Midwest, should the Afghan OB/GYN have to cease communication for security purposes. 

Arriving at the partially destroyed home, an exchange of code words, first via text, then via phone, led the doctor to the young couple in hiding. The two doctors, one in Afghanistan and one in the United States discussed the delivery conditions and the mother’s status via an encrypted phone app. Without electricity, flashlights from two cell phones provided the only light.

When the baby finally came several hours later, all the husband could convey through the screams was, “I can see my wife’s breath, I can see my own breath, but I cannot see my baby’s breath. I cannot see my baby’s breath.”

Despite the best efforts of the local OB/GYN and supportive input from the American physician, resuscitation was not effective. The baby was set aside on the hardened ground as the Doctor talked the father and mother through the delivery of her placenta.

Shortly before the sun came up in Kabul, the young parents and doctor buried the baby just outside the house under a pile of rocks. They named him Abdullah Yusuf.

The female Afghan doctor instructed the mother to wrap her milk laden breasts tightly with a cloth and to place cool compresses on them. She also said to take Ibuprofen. The female Afghan OB Doctor, transported from the location back in a food truck, wore a disguise and took photographs of a medicine in a local pharmacy known as Bromocryptine.

The U Medical Corps arranged for medicine to be delivered to the basement entrance within hours. One will ease the inflammation, one will dry up the mother’s milk, but nothing will ease the pain.

The husband’s last communication was “Tonight she is near to me. She cries a lot.”

“Afghanistan remains one of the most dangerous places in the world to be a baby, a child or a mother, and access to a hospital or health facility is beyond the reach of most. The country has one of the highest infant mortality rates in the world and thousands of Afghan women die every year from pregnancy-related causes, a majority of which can be easily preventable.” (UNICEF)

A prominent U.S. Board certified OB/GYN Physician with over twenty-five years’ experience delivering babies and Department Chair at her hospital offered up the following, “The already concerning maternal and perinatal morbidity & mortality in Afghanistan is now escalating rapidly with no known data points. It’s primitive. This is due to pregnant mothers no longer seeking prenatal care because of fear of the Taliban repercussions but also the lack of physicians & midwives to care for them in a clean safe hospital with necessary supplies. This is causing parents to choose home births due to the dire consequences of seeking obstetrical care. Babies and mothers are dying needlessly. The emotional impact from this will take a severe toll on these mothers and their families. I beg the World Health Organization to address this women’s health issue immediately to the Taliban. Afghanis MUST be free to not only seek care without fear but have adequate medical care available- especially emergency care.”

In December 2021, the U Medical Corps, supported solely by the Upperwood Foundation, instituted the “Safe Delivery Program” providing pre-natal care and exams, safe deliveries in a hospital setting, and postpartum care – all with no questions asked, no identification required, and no charge to the patient. To date, over three hundred babies have been born safely under the auspices of this program. ∎