[Freetown, Sierra Leone; September 22. Image via Getty]

Amnesty Secretary General International Bangladeshi-born Iren Khan (C) talks to a woman lying on a bed after she paid a visit to a hospital on September 22, 2009 in Freetown. Irene Khan, will lead a high level mission in Sierra Leone from 18 to 25 September 2009 to launch a campaign to reduce maternal deaths in the country, which has one of the highest maternal death rates in the world. AFP PHOTO / ISSOUF SANOGO (Photo credit should read ISSOUF SANOGO/AFP/Getty Images)

[Freetown, Sierra Leone; September 21. Image via Getty]

An aunt of a nine-month-old Maya (R), whose mother died in a taxi at the hospital parking shortly before giving birth reads a document of Amnesty International on September 21, 2009 in Freetown. Irene Khan, secretary general of Amnesty international will lead a high level mission in Sierra Leone from 18 to 25 September 2009 to launch a campaign to reduce maternal deaths in the country, which has one of the highest maternal death rates in the world. AFP PHOTO / ISSOUF SANOGO (Photo credit should read ISSOUF SANOGO/AFP/Getty Images)

David Zucchino of the LA Times writes,

Women have virtually no options in Afghan tribal culture. It would be scandalous for a woman to live alone or pursue a job on her own. They are dependent on men for food, clothing, shelter and status — and often must give up their children when seeking divorce. Girls have to be at least 16 to get married, but the law is widely ignored.

Women for Afghan Women, a shelter in Kabul and one of six in the country, provides safe harbor and help with divorce or housing to women and girls fleeing abuse or forced marriage. Seventeen-year-old Shabana sought refuge there after a man kidnapped her, forced her to marry him, and kept her prisoner in his home. She says, "He knew I had no one to protect me, and he took advantage." The shelter's youngest occupant ever was a five-year-old rape victim. Many occupants fear they would be killed if they ever went back to their husbands or families, and shelter employees have received threats and even beatings. But board member Esther Hyneman (pictured, right) says, "We're making progress every day. You can't change hundreds of years of cultural tradition overnight."

Yet another problem for Afghan women is maternal mortality — one in eight Afghan women die in childbirth, the second highest rate in the world. Rita Henley Jensen reports that the Congressional Women's Caucus is holding a briefing on the issue today, hopefully chipping away at long-standing international indifference to the problem. The UN, too, has issued a report on women in Afghanistan, highlighting the violence they face. Jensen says the report "described the nation as one where rape is widespread and victims are more likely than perpetrators to receive punishment."

Shelters like Women for Afghan Women may help individual victims, but Jensen argues that Afghanistan needs policy changes too — including an examination of whether the presence of US peacekeeping troops "enhances or threatens the security of women in war-torn Afghanistan." "How can U.S. women help in all of this?" she writes. "It's not an easy question, but it's the right one to keep asking until the best answer finds its way to a solid, humanitarian, political consensus about the troop buildup and so much more."

Image via LA Times.

Afghan Victims Of Abuse Find Refuge [LA Times]
Safety Of Afghan Women Comes Up For Question [Women's eNews]

The Washington Post article focuses (in, it must be said, classic first-world style) on uniquely Sierra Leonean aspects of Marah's plight. The doctor who finally performs her C-section is an ophthalmologist, not an obstetrician, because of the scarcity of doctors in Marah's remote area. The article mentions bugs in the operating room not once, but twice. Marah's husband has to run out and buy her a catheter, and other operations have apparently been delayed while husbands buy rubber gloves for the doctors. Okay, we get it, Sierra Leone is a backward country where hygiene is poor and human life takes a backseat to money. Here in, the U.S., women give birth to healthy babies in nice hospitals full of flowers. Right? Right?

Seriously, the Post article offers a heart-wrenching look at a preventable death, and rightly draws our attention to the country with the highest maternal mortality rate in the world. But let's not forget that the US ranks worst among industrialized nations in maternal mortality, or that black women in the US die in childbirth at four times the rate of whites. Marah's story is worse than that of many American women, but not all, and it's worth remembering that, when it comes to maternal mortality, our "developed" country may not have come as far as we think.

In Sierra Leone, Every Pregnancy Is A 'Chance of Dying' [Washington Post]

Earlier:
Pregnant Women In Poverty Often Die Needlessly
Midwife Nurses in Mozambique Fight Maternal Mortality

Saving Mothers, One At A Time [NY Times]

Birth Of A Surgeon [PBS]