Afghanistan: Working with what you have

Difficult circumstances sometimes impact our decisions. Mimansa, a midwife from Sweden, is currently working for Médecins Sans Frontières / Doctors Without Borders (MSF) in Afghanistan. She blogs...

Mimansa Manheden in the post-delivery room

The unborn baby inside of her already had a low, irregular heart beat when she arrived at our clinic. The baby was also breech – that is coming feet first.

We recommended an immediate ceasaren section in order to save the baby, but the mother refused.

As calm and gently as possible, we tried to inform her about the possible consequences of her refusal, but she was very firm in her decision.

We told her that we would not do anything against her will. We would, of course, respect her wishes. We thought that maybe she was just too stressed and therefore not capable of receiving what we were saying. But no. She kept on refusing strongly.

The reason she gave for her refusal was that her husband had passed away when she was in her fifth month of pregnancy. I did not understand this as a reason to refuse a c-section, but the staff explained for me: life for her as a single woman with a baby, with no family around her, would be, if not impossible, so unmanageably difficult. But with no child to take care of, she would have the possibility to meet a new man. Life for a single woman with no family in Afghanistan, is very, very difficult, not to say impossible.

It is an MSF principle to respect patients’ integrity, therefore in cases like this all we can do is to make sure that the patient has the right information. This can be hard to accept for the medical staff trying to take care of patients’ lives, but in the end it is the patient´s right to choose.

I learn something new every day. I get to know new things and situations. All these stories from daily life here touch me deeply.

It is the stories of the patients, but also the stories from my Afghan colleagues. It is stories about how they lead their life, in spite of the lack of  almost anything.

I can´t say it enough: I am so impressed by people’s ability to move on, always moving on. Even when the conditions seem absolutely impossible.

It touches me and I cannot say any emotion that does not pass through me.

But – most of all, and always at last, it is the feeling of gratitude.

I feel so grateful that I get to share their stories, I get to listen to, and see, their strength.

And I feel grateful that not all people on this earth are challenged with these difficult life conditions. That some have the possibility to live in peace, being able to make choices, have access to education, health care, clean air, clean water – to live in peace. Not to worry about whether your  family has been injured, or if your home will  still be there when you get home from a job that you might have……and so on.

This post is not a we-who-are-super-duper-heroes-working-in-MSF-post.

This post is my attempt to describe one part of what it is to be a field worker, working in a context of the most exposed people. And how it affects me.

Just the fact that we are present here in Dasht-e-Barchi means so much for so many. It give people hope, it helps them to believe that someone cares for these people in a country which has been suffering from war for such a long time.

It is so deeply impressive to be able to take part in of all this.

And – in spite of all this, we are also leading our ”international fieldworker” lives. Our time outside work is sometimes very challenging because of the security restrictions to where we can go and what we can do.

It can be a very challenging situation to live and work with people whom you did not choose. We come from different countries, different cultures, each and every one with his/her own habits and approaches. We have to function together and we have to trust each other. Sometimes it is exciting and so very fun – but sometimes it is for sure more than challenging.

The life of a field worker in MSF is… one can say you get good at doing the best with what you have for the moment…

So - what happened to the woman with the baby?

The child died during the labour.

The woman was discharged after a few hours.

To nothing.

But she is alive.

And hopefully, there is a possible better future waiting for her.