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Author Topic:   In Iraq, giving birth is complicated by War
neptune5
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posted February 09, 2007 12:16 PM           Edit/Delete Message   Reply w/Quote
quote:
In Iraq, giving birth is complicated by war
By Annia Ciezadlo | Correspondent of The Christian Science Monitor

BAYINJAN, IRAQ – In this poor village, where sheep, goats, and wild turkeys strut through the muddy streets, everybody knows Khanim's house. Her dark stone hut is where they run when their wives and mothers are ready to give birth.
In medical parlance, Khanim is a "traditional birth assistant" - trained to help women give birth, but not qualified to be a midwife. In Kurdish, she is a "mamman" and she often holds the well-being of these village women in her hard, stubby hands.

"There are doctors, there are midwives, but we don't visit anybody but Khanim," says Kafi Karim, a weatherbeaten mother of four. "We only trust God - and her."

Like her newly democratic homeland, Khanim has dealt with major birth pains the last few years. After the 2003 war that toppled Saddam Hussein, the number of women who gave birth at home shot up to about two-thirds. Of those, 80 percent had nobody with any formal training present at the birth. Far from lifesaving emergency care, many mothers died from preventable complications.

Today, nobody knows exactly how many mothers are dying in Iraq. Violence has prevented medical experts from measuring the maternal mortality rate since late 2003, when the number of Iraqi women who died from childbirth climbed to 370 per 100,000 - triple its 1990 rates and 31 times the US rate of 12. The UN Population Fund concluded that the war and its aftermath had made an old problem "suddenly become very much worse."

Medical experts worry that even more mothers are dying, their deaths uncounted and unreported due to the violence that grips this country. So people like Khanim have become a vital force in helping usher in Iraq's next generation.

In Kurdistan, the peaceful northern region where Khanim lives, poverty and ignorance keep many mothers from hospitals. But in most of Iraq, violence keeps women at home. In Baghdad, according to a 2003 Health Ministry assessment, 1 in 5 women said "insecurity" prevented them from getting healthcare during their last pregnancy.

"In Iraq, the skills are available to handle essential obstetric care, and yet it's not being done," says Lynn Amowitz, who conducted a July 2003 study of maternal healthcare in several southern Iraqi cities. "So you have to look at what the other issues are. And it's going to be much harder for a woman who's near the point of death, who is living in an insecure area, to get to a clinic - or even for a doctor to get to a clinic."

After the war, UN experts laid out recommendations for saving mothers' lives, including mobile emergency units for mothers in distress and transportation systems to get mothers to hospitals quickly. Violence has thwarted most of these plans, save for a program training nurses, doctors, and midwives.

Until Iraq stabilizes, there's another way to save mothers' lives. But it requires acknowledging home delivery, at the risk of encouraging it. This means using birth assistants like Khanim. But without proper training and close regulation, birth assistants can unwittingly endanger their patients. If a mother has potential complications or if it's a woman's first child, birth assistants and midwives are supposed to send her to a hospital. Often, they don't.

Shler Faiq Ghreeb, a doctor, sees the results firsthand: Once or twice a month, women arrive in Sulaymaniyah's maternity hospital sick or dying because they gave birth at home when they shouldn't have. Iraq's health ministry plans to stop training birth assistants. (The ministry failed to respond to several requests for comment on this article.)

Despite the dangers, most medical experts say midwives and birth assistants are necessary, because they know that Iraqi women will keep giving birth at home. And a properly trained birth assistant can save a mother's life.

Despite the villagers' faith in Khanim, she is not infallible. Last June, doctors temporarily revoked her license for attending a young mother's first birth. After a stern lecture, she promised never to do it again, and got her license back in time to attend the delivery of Ms. Karim's child.

At 40, she's a little old for childbearing, as Khanim bluntly put it. But the delivery went off without a hitch. At noon, Karim's contractions started, but she waited until they were about five minutes apart, as Khanim taught her, to send for the mamman, who helped her deliver a baby boy named Mohammed.



(any thoughts and comments welcome)

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jwhop
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From: Madeira Beach, FL USA
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posted February 09, 2007 01:39 PM     Click Here to See the Profile for jwhop     Edit/Delete Message   Reply w/Quote
There are many such stories of hospitals and health care clinics newly built and equipped or refurbished and equipped all over Iraq...paid for by the United States. Not to mention the training of doctors, nurses and other health care workers..again, all over Iraq.

The number and locations are so numerous it's not possible to even begin to list them all.

Of course, those are inconvenient facts to those looking for something to wheeze, whine and screech about.

USAID Trains Iraqi Physician and Nurse Trainers

The Successful Training of Trainers Workshop Improves Ministry of Health Capacity

PRESS RELEASEFOR IMMEDIATE RELEASE
October 2, 2005

Today, forty Iraqi physicians and nurses representing thirteen governorates completed two ten day USAID Training-of-Trainers of Service Providers programs. Over the last ten days, these Ministry of Health trainers, learned how to teach a comprehensive health curriculum. They will use the curriculum to train physicians and nurses who staff 142 primary health care centers being constructed and equipped with USG funds throughout the country. USAID's implementing partner, The Research Triangle Institute (RTI) and subcontractor IntraHealth International held a closing ceremony today to mark the completion of the two concurrent ten day workshops. The workshop familiarized Ministry of Health (MOH) trainers with the Integrated Management of Childhood Illness (IMCI) training curriculum as well as training modules on interpersonal communication; referral and follow-up; and infection prevention, and control. The first round of training of trainers workshops conducted in June provided trainers with practice in using different training methodologies and built their skills in planning, delivering and evaluating training programs. The second round of workshops which ended today helped trainers from this first group to apply their improved training skills in using the actual curricula they will use to train service providers at the governorate level.USAID's program in Iraq improves access to quality health care and emphasizes maternal and child health services. In this, RTI's training program supports the rollout, in Iraq, of the Integrated Management of Childhood Illness (IMCI), a holistic approach to child health care which is proven to enhance child survival in the 85 countries where it is implemented.The Integrated Management of Childhood Illness strategy was developed in the mid 1990s by the United Nations Children's Fund (UNICEF) and the World Health Organization (WHO). USAID was a major supporter in the development of the IMCI strategy, and continues to implement and expand this method. The IMCI ensures a unified and systematic approach to addressing childhood illness. The cornerstone of IMCI is a set of algorithms (flow charts) and guidelines for the integrated case management of diarrhea, pneumonia, fever, measles, malaria, malnutrition and the promotion of immunization in health facilities. This ensures that service providers address not only the most obvious problems of a sick child, but monitor and treat a range of common nutritional and infectious disease problems affecting children.

Clinics in Basrah Restored
After Looting, Medical Clinic Now Cares For Almost 350,000 Iraqis With USAID Help
“The building was looted – computers and even the doors taken. USAID hired Iraqi contractors to fix everything and provide water pipes, electricity, furniture, computers, a refrigerator – everything. We did not pay for any of it” - Dr. Saja Dr. Farouk, administrator of the 11 clinics in the Al Maqal area of Basrah

Refurbished Hospital Offers Better Services

New sanitation system prevents infections, boosts patient care

“The patients used to suffer from the bad odor and it was hard to prevent infections after surgery. Last year I conducted 150 major operations. This will make it possible to fight infections in post-op patients.” - Dr. Sadiq Anad, general surgeon at the Ali Al Gharbi hospital.

Efforts To Improve Hospitals in Iraq
U.S. helps hospital move waste tanks away from patients

“There was a bad smell and unhealthy environment. Now it’s gone and there are no more bad effects on the health of the patients and staff.” - Ali Khadm, assistant hospital administrator

The Al Majar Al Kabir medical facility, located in Southeastern Iraq near the border with Iran, serves about 800 outpatients each day and seventy inpatients, some of them undergoing major surgery. USAID officials visited the hospital soon after the downfall of the Saddam Hussein regime and saw that the unsanitary storage of sewage and other waste inside the building needed to be fixed. An Iraqi subcontractor was hired to excavate the earth, lay pipes, and build new septic tanks outside the hospital compound. Fresh clods of brown earth still lie atop the lot outside this city’s main hospital after the U.S.-funded installation of a sanitary septic tank system ended years of filthy smells and wastes inside the medical facility. Before that, the septic tank was inside the hospital and it was difficult to empty it when full according to Ali Khadm, assistant administrator of this hospital. Tanker trucks now can empty the septic tanks without creating additional mess inside the hospital. The project was carried out under the auspices of the Coalition Provisional Authority.

Mobile Medical Team Helps Survivors
Young Iraqi Doctor Treats Kurdish Victims of Saddam's Nerve Gas

“U.S. assistance is paying our salaries, the cost of our vehicle, and for basic medicines such as antibiotics, analgesics and anti-parasitics. If we didn’t have the U.S. funds we could not do as much as we do -- we treat more people, provide more free medicine. If I could speak to Americans, I would say thank you for your humanitarian aid to the Kurdish people who have been suffering from torture and oppression”

Some 15 years after Saddam Hussein dropped poison nerve gas on this north eastern city and surrounding villages, USAID is helping Dr. Sinor Qadir treat people who survived the attacks. The U.S.-funded medical team is not only treating people but teaching people about sanitation and other health issues. The 25-year-old doctor is part of a mobile medical team visiting villages such as Tawela, perched in steep valleys around Halabja. The team provides medical care and training in literacy and sewing -- to help people earn a living. The project, supported by USAID with a $7,000 grant for three months and carried out in cooperation with the Coalition Provisional Authority, supports four mobile teams including Dr. Qadir's.

Ibn Al-Qiff Spinal Cord Injury Hospital
USAID brings facility back in service after sustaining damage from a terrorist bomb

Ahmed Ali Swedan, 11, lies in bed at the Ibn Al-Qiff Spinal Cord Injury Hospital after injuries from shelling in July 2003 left him paralyzed from the waist down.

The hospital, 15 KM northeast of Baghdad, was severely damaged when the adjacent UN Headquarters was destroyed in a terrorist bomb attack in August 2003. The only facility of its kind in Iraq is now only able to treat the most severe patients and that is due to the dedication of staff who have not been paid in months and work under extreme conditions. A $524,500 grant from USAID for medical equipment and supplies will help get this facility back in service providing 125 bed inpatient services and handling an estimated 25,000 outpatient visits each year. USAID works in coordination with the Coalition Provisional Authority.

Critical Health Care For Iraqi Women
Remote villages in Iraq are visited by mobile health teams

Selma Khar-Allah and her little boy Mustafa sit and wait to talk to Dr. Sinor Qadir during one of the mobile team visits to the village of Tewala.

USAID provided a grant to maintain two mobile women's health work teams in remote villages around As Sulaymaniyah (As Sulaymaniyah Governorate), Kirkuk (At Tamim Governorate), Arbil (Arbil Governorate) and Mosul. These teams provide both critical health services to over 2000 women, as well as abuse intervention and social work assistance. In addition, the access afforded to these teams provides an opportunity to address other issues of women's empowerment and trust building between often segregated ethnic and religious groups. Though largely Kurdish in composition, the teams do include an Arab volunteer to work within Arab communities. USAID coordinates with the Iraqi Ministry of Health and the Coalition Provisional Authority.

The hospital in this small southern town of Ali Al Gharbi in Iraq, just ten miles from the border with Iran, was run down. There were no toilets to use because they were always blocked up. USAID offered to fix the 26-year-old hospital which had seen no Iraqi funding in the past decade for maintenance and repairs. Working with the Coalition Provisional Authority, the aid group hired Iraqi contractors to dig a new septic system, lay pipes and refit the bathrooms with running water and electric lights. Although toilets remained the traditional squat type used in that region of the world, they were rebuilt using flush systems and smooth tile along the basins, floors and walls that are easy to keep clean.

USAID saw the damage and offered to spend $18,000 to restore the administrative building and clinic where Dr. Farouk oversees medical care for about a third of a million Iraqis. The electricity was damaged, the windows shattered and all furniture taken. In the clinic next door to her administrative building, a centrifuge provided by USAID is used in the lab for medical tests. USAID in cooperation with the Coalition Provisional Authority has also provided air conditioners and electric generators to two other clinics that were looted in the aftermath of the overthrow of Saddam Hussein in April.
http://www.usaid.gov/iraq/accomplishments/health.html

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Pluto's Muse
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posted February 11, 2007 12:32 AM           Edit/Delete Message   Reply w/Quote
The topic is In Iraq giving BIRTH IS COMPLICATED BY WAR not who has built hospitals here or there.

I wouldn't be able to give birth either when bombs are going off every second.

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BornUnderDioscuri
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Registered: Jun 2009

posted February 11, 2007 12:49 AM     Click Here to See the Profile for BornUnderDioscuri     Edit/Delete Message   Reply w/Quote
LOLOLOL! I am sorry but when that kid wants to come out, sound of bombs won't stop him/her.

Welcome back Sweet Stars

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Pluto's Muse
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posted February 11, 2007 01:16 AM           Edit/Delete Message   Reply w/Quote
Your a virgin...or so you say (RIGHT)


what would you know about child birth, depression during child birth that can cause a miscarriage and can cause problems pushing THE BABY OUT while crying about someone who has just been blown up?


Do you know how hard it is for someone to give birth when everyone around them....yup includes family members are dying every day?


But the again....I wouldn't expect you to comprehend that either

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BornUnderDioscuri
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posted February 11, 2007 01:20 AM     Click Here to See the Profile for BornUnderDioscuri     Edit/Delete Message   Reply w/Quote
And how many kids did you have?

quote:
depression during child birth that can cause a miscarriage.

Nope depression while pregnant can cause a miscarriage...when you are giving birth you cant miscarry because you arent carrying anymore...at that point its called still birth...as for my virginity (which I dont know why you are still talking about...I know you want me but Im sorry i have a bf...calm down) you dont have to be a hooker to have knowledge, its taught in any biology class. Considrer taking one...gives good insights.

quote:
Do you know how hard it is for someone to give birth when everyone around them....yup includes family members are dying every day?

No one said it isnt stressful and hard, im just saying the article emphasizes the LACK of doctors because of bombs not the inability to give birth. At which point Jwhop saying that America brings its own doctors to help applies perfectly.

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