Although doctors consider childbirth pain to be one of the most severe physical pains, often compared to bone fractures, third-degree burns, or chronic nerve pain, Salam Watandar’s findings from interviews with 10 women who experienced childbirth at Rabia Balkhi Hospital and the 102-bed Maryam Hospital indicate that, in addition to enduring severe physical pain, these women also faced inappropriate behavior, obscene and vulgar language, unprofessional treatment, and inattention from health workers at these hospitals.
Samira, a 38-year-old resident of Parwan who recently gave birth to her ninth child at Rabia Balkhi Hospital, says that she experienced neglect and inappropriate treatment. She explains that when she went to the hospital at night, the hospital officials did not accept her. After a delay in admitting her, she began to bleed. She said,
“It was during this bleeding that my child became very weak. Even though my son is sick, they dragged me out of his room. They talked so badly that you would be surprised what to say. They fought with us for a while; you would be surprised.”
Fawzia, a 35-year-old Kabul resident who has given birth four times at Rabia Balkhi Hospital, says that in addition to improper treatment of pregnant women by health workers, women are also physically assaulted.
She said, “They physically assault women who scream even a little. They don’t pay attention. They don’t even let the patient’s pain subside. I was afraid of what kind of hospital this is.”
The women interviewed in this report say that due to economic difficulties, they were forced to visit governmental health centers. However, during childbirth they encountered inappropriate behavior from staff, behavior that negatively affected their mental health.
Maryam, a 36-year-old resident of Kabul who has given birth four times at the 102-bed Maryam Hospital, says that her husband is unemployed and her poor economic situation forced her to visit the hospital for each delivery. She states that she faced mistreatment from the hospital staff every time.
She adds, “When my son was born, I went to Maryam Hospital, and I was very upset. The doctors who deliver the baby behave very badly. Their behavior has greatly affected my psyche.”
According to these women, mistreatment of patients by doctors and medical staff at some governmental hospitals, along with patients’ inability to pay childbirth expenses at private hospitals, has resulted in women facing insulting behavior when they visit governmental hospitals.
Khadija, a 28-year-old resident of Kapisa who gave birth to four of her children at the 102-bed Maryam Hospital, says that in addition to limited access to medicine, she also faced mistreatment from doctors.
“I saw a lot of mistreatment. I was in a very bad condition. They treated me very badly. My sister said that this patient was urgent. They used very bad words. They said a lot of bad things to both me and my sister. They didn’t pay any attention to me at all.” she said.
In addition to patients, this report also includes interviews with nine patient attendants who complained about inadequate care, the collection of money for transportation within the hospital by some staff members, and the lack of appropriate treatment at these centers.
Shekiba, a 41-year-old woman who was accompanying her sister-in-law at Rabia Balkhi Hospital, says that she came to the hospital from Paghman and that the hospital staff charged her hundreds of Afghanis for staying one day at the hospital. She said,
“I had 400 Afghanis, and in these two days the hospital staff took all of it from me. Later, when our patient came out of the delivery room, they asked us for sweets.”
Bibi Gul, 67, who is awaiting the birth of her third grandchild at the 102-bed Maryam Hospital, says that she is sometimes forced to pay staff to enter the hospital. She also complains about the doctors’ behavior.
“The doctors’ behavior here is terrible. I had heart surgery, and I also had surgery on my hand. They even pushed us in the corridors, and now my hand hurts badly. I can’t say anything because I’m afraid for my daughter.”
Based on Article 8 of the Medical Principles, doctors and health workers are required to provide health services in accordance with medical principles, standards, and ethics, and to refrain from any professional misconduct.
These principles prohibit providing services that are inconsistent with standards or delivered in a substandard environment, discrimination and prejudice, abuse of authority, unnecessary proximity to the patient, use of obsolete methods, prescribing unnecessary examinations and medications, negligence, stopping services without reason, causing physical, psychological, economic, or social harm, treatment without diagnosis, inappropriate treatment, use of non-scientific equipment, and issuing false certificates.
Meanwhile, a number of doctors and officials of the Medical Council, referring to the Medical Council’s principles, emphasize the importance of maintaining humane and ethical standards during treatment.
Liza Shamriz, an obstetrician-gynecologist, says that ethics in medicine are not limited to adherence to professional principles, but are at the heart of every successful treatment. According to her, “Respect, kindness, and genuine attention to patients win their trust and ensure their physical and mental health.”
She adds that without ethics, no medicine or treatment can have its full effect, and doctors must treat patients correctly and humanely, in accordance with the Medical Council’s principles.
Shakeel Yousafzai, a member of the Afghanistan Medical Council, says, “Unfortunately, due to work pressure and staff shortages in governmental hospitals, medical ethics are less respected in Afghanistan. The government should increase the number of health workers in hospitals with more patients, and the working hours of doctors should be reduced.”
The head of Rabia Balkhi Hospital, acknowledging the challenges facing the hospital, says that they are trying to continuously record patients’ and staff complaints and, after documenting them, follow them up in a practical manner.
Simin Meshkin Mohmand, the head of the hospital, states, “I am aware of the complaints from patients and their attendants. When they file a complaint, it is recorded and documented. The hospital has a monitoring team that takes action to address the issue.”
We also sought the views of officials at the 102-bed Maryam Hospital, but despite repeated calls, we were unsuccessful in obtaining their response.
However, Sharafat Zaman Amarkhil, Spokesperson for the Ministry of Public Health of the Islamic Emirate, emphasized the need to observe the ethical framework when treating patients and addressing their complaints. He says,
“If the problem is that the patient is not treated properly or medical ethics are not observed, patients can share their problems with the chairman of the Medical Council. Unfortunately, the problem is that the medical principles are not observed. We have organized seminars at the central and provincial levels to solve this.”
According to health experts, the increase in women’s visits to governmental health centers for childbirth, combined with population growth and economic challenges, has put additional pressure on obstetric hospitals. Health officials have repeatedly raised concerns about staff shortages, patient overcrowding, limited facilities, and high daily patient volumes. However, they emphasize that none of these challenges can justify violating ethical principles or treating patients unprofessionally.
Pseudonyms have been used in this report at the request of the interviewees.
Reporter: Soodaba Haidari
