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July 16, 2004

Changed Perspective

Strategic Leadership Seminar Inspires New Visions for an Afghan Health Official 

Mehrafzoon Mehr Nesaar, director of Women's and Reproductive Health for Afghanistan

Mehrafzoon Mehr Nesaar, director of Women's and Reproductive Health for Afghanistan

“Afghanistan,” says Mehrafzoon Mehr Nesaar, “is a land of mountains and mountains and mountains. The man whose wife is dying knows she is dying but can't do anything: no road, no hospital, no doctor. The nearest help is two or three mountains away.”

Nesaar, MD, is the director of Women's and Reproductive Health for Afghanistan's Ministry of Health, and her challenges are crushing. Three years of drought on top of 20 years of war have made motherhood unsafe in Afghanistan, where an average of 1,600 women die from childbirth for every 100,000 live births. In the northern province of Badakhshan, that figure is estimated to be more than 6,500 deaths per 100,000. (In industrialized countries, the maternal mortality rate is 12 for every 100,000 live births.)

Nesaar, who is also a practicing OB/GYN specialist in her country,  has been in the U.S. since June 19 attending seminars put on by the Johns Hopkins Bloomberg School of Public Health. First she took part in a Reproductive Health & Development seminar at the School, and then, since July 5, has been attending the Bill and Melinda Gates Institute for Population and Reproductive Health seminar on Strategic Leadership in Population and Reproductive Health. She was one of 20 high-level health officials from 18 countries who came to the School of Public Health for the course.

 Nesaar’s whole perspective on health care has undergone a sea-change. “This course has turned my life upside down,” she says. “Before, I knew something was wrong with my thinking but I didn't know what. It turns out I was thinking health is provided by the Ministry of Health, by doctors and nurses. But no! I learn here that health is provided by the mother, the household, the community and the government, all jointly working together.”

She stresses that it has been good, too, to learn that Afghanistan is not the only developing nation weltering in poverty and collapse. “The participants here have the same sufferings, the same problems of poverty and disease. They too are facing lots of dragons—the dragon of corruption, the dragon of poverty, the dragon of war.” (Importantly, she learned from other participants that Afghanistan can dawdle no longer in mounting its fight against AIDS.)

The conference has energized her and set her idealism ablaze. “Before, I just wanted to reduce maternal mortality in my country. Now since I realize mothers are the main producers of life and health, I am committed to completely eliminating maternal mortality in Afghanistan. If even one death of a mother is acceptable, then which family should lose its mother and wife?”  —Rod Graham