BBC investigates Afghan maternal deaths after US aid cuts

When Shahnaz entered the labor, her husband Abdoul called a taxi to transfer them to the only accessible medical facility.

He says, “It was in severe pain.”

20 minutes’ drive, the clinic was in the village of Shish Bulge in Badakhshan County in northeastern Afghanistan. The place where their two children were born.

Abd al -Shahnaz sat next to her, as they went to the gravel paths to reach help.

“But when we got to the clinic, we saw that it was closed. I did not know that it had been closed.”

Warning: Readers may find some details in this article sad.

The Sheesh Pol clinic is one of more than 400 medical facilities closed in Afghanistan, and it is one of the poorest countries in the world, after the Trump administration reduced almost all American aid to the country earlier this year, in a radical and surprising step after the US State Agency (United States) dismantled.

One -storey brown with four small rooms, and white coating its walls, the Sheesh Pol clinic has stickers at the US International Development Agency with information and directions for pregnant women and new mothers.

It does not seem much, but in the mountainous terrain that is not respected in Badakhshan, where the lack of access was a major reason for the high rates of mothers’ high mothers from a historical point of view, the clinic was a critical life artery, part of a broader program that was implemented during the period of US -backed government in the country, to reduce the deaths of the mother and the United States.

She had a trained midwife that helped about 25-30 births every month. He had stocks of drugs and injections, and provided basic health care services.

Other medical facilities are very far from the village of Abd, and it was not without danger to Shahnaz to travel on rough roads. Abdul Malda also did not have to pay for a longer flight – renting a 1,000 Afghan taxi ($ 14.65; 12.70 pounds), or nearly a quarter of his monthly income as a worker. So they decided to go home.

Abdel -Abd said: “But the child was coming and we had to stop by the road.”

Shahnaz threw their daughter in the car. Soon after, she died, bleeding abundantly. A few hours later, before she was named, their child died as well.

Abd said: “I cried and cried. It was possible to save my wife and my child if the clinic was open.” “We have had a difficult life, but we were living together. I was always happy when I was with her.”

He does not even have a picture of Shahnaz to stick to it.

There is no certainty that the mother and child have survived if they were treated in the clinic, but without it, they did not stand on the chance, which confirms the undeniable effect on US aid discounts in Afghanistan.

For decades, America was the largest donor to Afghanistan, and in 2024, American funds constituted 43 % of all aid coming to the country.

The Trump administration justified its withdrawal, saying that there are “reliable and long -term fears that funding was benefiting terrorist groups, including … the Taliban”, which governs the country. The US government added this as well They have reports clarifying At least $ 11 million was “mitigated or the Taliban enriched.”

The report referred to by the US State Department It was made by the Special Inspector General to rebuild Afghanistan (cigar). He said that $ 10.9 million of taxpayers’ money in the United States had been paid to the Taliban government by the USA’s International Development Partners in “taxes, fees, duties or facilities”.

The Taliban government denies that aid money was going in their hands.

“This claim is not true. Aid is provided to the United Nations, and through it to the NGOs in the provinces. They determine those who need help and distribute them themselves. The government is not involved,” said Sohael Shaheen, head of the Taliban Political Office in Doha.

The policies of the Taliban government, especially its restrictions on women, are the harshest in the world, means that after four years in power, it is still not recognized by most of the world. It is also a major reason, the donors were increasingly walking away from the country.

The United States insists that no one dies due to aid discounts. Shahnaz has not been registered and her child’s death was anywhere. No countless others.

The British Broadcasting Corporation has documented at least half of a half scales or devastating accounts in the areas where the US -backed clinics closed the United States Agency for International Development.

Next to the grave of Shahnaz, the villagers who gathered around us pointed to other wipers. Both of them are women who have died in birth in the past four months – Daulaat Begi and Javhar. Their children survived.

Not far from the cemetery, we met Khan Muhammad, whose wife, Gul Jean, 36, died at birth five months ago. Their infant child died, God has spent three days.

“When she became pregnant, she would go to the clinic for examination. But in the middle of her pregnancy, she was closed. During birth, she had a lot of pain and blood loss,” said Khan Mohamed. “My children are sad all the time. Nobody can give them the mother’s love. I miss her every day. We had a sweet and loving life together.”

About five hours drive from Shish Paul, in Kawjani, another village where a clinic backed by the United States Agency for International Development closed, Ahmed Khan, Midamo’s father, who suffers from sadness, showed us the room in their house clay and clay where she died to generate the child Karima.

He said: “If the clinic is open, it might have survived. Even if it dies, we will not regret knowing the two paths, doing their best. Now we left with regret and pain. This America has done this to us.”

In another house a few corridors, Bahisa tells us how terrifying it is to give birth to the house. Her other three children were born in the Kajani clinic.

“I was very afraid. At the clinic, we had midwife, medicines and injection. At home I had nothing, no pain relievers. I was unbearable pain. I felt that life was leaving my body. I became numb.”

Her daughter, who is called Fakha, died three days after her birth.

The closure of clinics in the villages has increased patients in the maternity wing at the main regional hospital in the regional capital, Fayezabad.

Access to this, through the treacherous scene in Badakhshan is risky. We showed a horrific picture of a newborn child, who was delivered on his way to Fayezabad, who cut his neck before he reached the hospital.

We visited the hospital in 2022, and while it was extended at the time, the scenes we saw this time were unprecedented.

In each bed, there were three women. Imagine that you went to labor, or just the abortion, not even a bed for yourself to lie down.

This was what Zora Shiwan, who suffered from abortion, was to bear.

She said, “I was bleeding and I had no place to sit. It was really difficult. With the time when the bed was free, the woman could die bleeding,” she said.

“We have 120 beds in the hospital. We have now admitted from 300 to 305.”

While the patient’s load swelling, the hospital also faced sharp discounts in its financing.

“Three years ago, our annual budget was $ 80,000. Now we have $ 25,000,” said Dr. Hamad.

By August this year, there were many mother deaths that were recorded as was the case last year. Which means that at this rate, the mother’s deaths may increase by up to 50 % over the past year.

The death of newborns has already increased by about a third in the past four months, compared to the beginning of the year.

Razia Hanifi, a hospital head, says she is stressful. “I have been working over the past twenty years. This year is the most difficult, due to overcrowding, resource lack and lack of trained employees,” she said.

But there are no upcoming reinforcements due to the restrictions of the Taliban government on women. Three years ago, all higher education, including medical education for women, was banned. Less than a year ago, in December 2024, training on midwives and female nurses was also banned.

On a secret site, we met with two students who were in the middle of the training when it was closed. They did not want to know for fear of revenge.

Anya (the name was changed) was in the university graduate courses when the Taliban took over. When they were closed in December 2022, they started training on midwife and nursing, as it was the only remaining path to obtain education and job.

“When this was also banned, I became depressed. I was crying day and night, and I couldn’t eat. It is a painful situation,” she said.

“There is already a shortage of midwives and nurses in Afghanistan. Without more training, women will have to give birth at home, putting them at risk,” said Carishma (called change).

We have asked Sohael Shaheen of the Taliban government how they can justify the prohibition that effectively frustrates health to half of the population.

“It is our inner case. These are our issues, how to deal with it, how to consider them, and how to make decisions, and this is an internal thing. This is up to leadership. Based on the needs of society, they will make a decision,” he said.

With their arrival at the highly restricted medical services, through a wave after a wave of overwhelming strikes, for women of Afghanistan, their right to health, and the same life, are at great risk.

Additional reporting, photography and video

The upper picture shows a slave with his daughter and son in Shish Paul.