Doctor Confronts Maternal Mortality in Afghanistan

By Army Pfc. Elisebet Freeburg
Special to American Forces Press Service

May 8, 2009 - The young Dari interpreter standing by the desk translates the words of the American doctor to the young woman, as she sits quietly. An examining table stands against one yellow wall in the small room. Various tools and medical equipment are positioned around the room. Thickly lined with black eyeliner, the young woman's brown eyes light up. Her soft smile widens, and she leans forward in her seat. Her husband will not take another wife. After three barren years, she is finally pregnant.

Army Col. (Dr.) Kathryn L. Hall-Boyer treated women and children on separate visits April 14 and 21 to the Afghan National Army Kandahar Regional Hospital women's clinic at Camp Hero as part of Operation Hearts and Minds. Hall-Boyer is the Joint Sustainment Command Afghanistan surgeon here.

"[The mission's purpose] is to provide ongoing medical care to women and children who have limited alternatives to receive medical care," Hall-Boyer said.

Hall-Boyer, an assistant professor in the emergency medicine department at Emory University, Georgia, has worked in the medical field since 1979. She provided care in similar clinics while deployed to Bosnia.

"This clinic people can keep coming back to every week," she said. "There is continuity for the women here."

Air Force Col. (Dr.) David Lannen of Task Force Phoenix Assistance Group contacted Hall-Boyer and told her that the clinic, established in June, needed female doctors.

The clinic provides laboratory services, X-ray and ultrasound. Hall-Boyer provided predominantly women's health services and family planning.

"Women in Afghanistan have one of the highest mortality rates in the world," she said. "It's because they don't receive medical care during their pregnancy."

Most women arrived with several children in tow. As the clinic staff and visiting physicians examined their mothers, the children received cookies and coloring books from female U.S. soldiers in the waiting room.

"For the children who came, it was predominantly checking for acute illnesses," Hall-Boyer said. "Colds, coughs and diarrhea are most common."

In spite of the work of the clinic staff and visiting physicians, not all needs can be met for the 55 to 85 women and children who arrive, on average, for treatment.

"One patient had a gynecologist problem that she really needed a specialist for," Hall-Boyer said. "Families don't really have money to spend on girls. They have limited resources to seek help elsewhere."

Another concern at the clinic is the lack of medical records.

"People have no idea what they've been treated for," Hall-Boyer said. "So I may give them the same treatment that's not working for them."

Although the physicians and staff cannot always cure every illness, the positive influence of coalition forces in Afghanistan can be seen when some women arrive for a second opinion.

"Some patients have seen Afghan doctors," Hall-Boyer said. "But they want to hear from American doctors."

Future visits as a continuation of Operation Hearts and Minds are planned.

(Army Pfc. Elisebet Freeburg serves with Joint Sustainment Command Afghanistan.)