Health concerns for Afghanistan's children

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LISA MULLINS: None of the candidates has convincingly addressed an issue that's as crucial to Afghan families as security is � that's the infant death rate and the chronic malnutrition of Afghan children who survive. The BBC's Hugh Sykes went to a hospital in the Afghan capital, Kabul.

HUGH SYKES: According to the World Health Organization one mother dies every half hour in Afghanistan because of birth problems and out of every 1000 babies who are born successfully nearly a fifth don't survive. The babies die either in the womb or from oxygen starvation from prolonged delivery, or bleeding during birth, or infection immediately afterwards. And many who survive birth then die because mothers stop breastfeeding too soon. Not because they want to but because men want them to. This is the senior pediatrician here, Dr. [PH] Goul Hutai.

GOUL HUTAI: Some elders in the family they believe that if they give the breastfeed to the child the child will die so they discontinue breastfeeding and they start bottle feeding and as you know in Afghanistan hygienic conditions are not very much satisfactory so children get diarrhea and that's another cause for death.

SYKES: So bottle feeding is a very bad idea in a country where there's no availability of guaranteed clean water.

HUTAI: Yes, yes it's really a bad idea for bottle feeding and better to encourage breastfeeding at least up to six month of age.

SYKES: But some mothers breastfeed for too long causing malnutrition. Because they provide only breast milk, nothing else, for babies up to one and a half years old.
HUTAI: In Afghan families, traditionally, the women they are not allowed to decide for the child or for themselves like a childbearing and also when to start breastfeeding, when to stop, and how to give the supplementary food. Usually elder of the families and men take the decision. So if the women will have more strength and more freedom of course it will put a good effect, especially when we educate the women.

SYKES: How do you get that message through to the men?

HUTAI: Difficult question. We just can argue and at least to some extent that they can decide for themselves in some aspect if not in all aspects of life.

[BABY CRYING]

SYKES: We're standing next to a little baby in cot now � tiny, tiny baby and she's got tubes attached to her cheek; attached to her wrist. What's her name? How old is she? Why is she here?

HUTAI: She's 28 days old. Her name Sarah and she's admitted for neonatal sepsis. She's unable to feed and she needs oxygen. For this she has tube in the mouth and in the nose.

SYKES: Neonatal sepsis�

HUTAI: Neonatal sepsis.

SYKES: �is what?

HUTAI: It's an infection of neonatal period � from first day of life up to one month.

SYKES: So she has to be fed and given oxygen?

HUTAI: Yes.

SYKES: And she's fast asleep. Is she strong? Will she be alright do you think?

HUTAI: She's much better now. After we started treatment with antibiotics she's doing better. Now she's much active then before and we hope that she will recover very soon and she will be alright.

SYKES: Sitting patiently next to Sarah's cot her grandmother [PH] Parveen who thinks things are getting worse for babies in Afghanistan.

PARVEEN: [SPEAKING DARI]

SYKES: She told me, I think there are more sick children here now then when I was a mother 20 years ago.

MULLINS: BBC reporter Hugh Sykes sent us that report from the French Medical Institute for Children in Kabul.