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SHEBERGHAN, Afghanistan -- The maternity ward at the government hospital in Sheberghan, the capital of northern Jawzjan Province, is always packed. Women from across Jawzjan and neighboring provinces brave the summer heat and travel long hours to secure an appointment with the province's most famed and respected midwife, Saira.

For nearly half a century, Saira, 70, has helped the regions women and saved many lives. She is now a local legend.

Aziza, 35, traveled over two hours from her home district of Char Bagh in the neighboring province of Sar-e-Pol to meet with Saira. Like many other women, she had heard nothing but positive things regarding the well-established midwife.

We come to visit Saira often because of her extensive experience. She is an expert in her field of work, she told Radio Free Afghanistan. If patients are sick, she knows about the major side effects and dangers that could potentially arise. She takes excellent preventive measures. Her experience is commendable, which is why we choose to come here when needed.

Another woman who speaks highly of Saira is Zarmina, a businesswoman from the outskirts of Sheberghan. Like Saira, Aziza, and many Afghans, she goes by one name only.

Zarmina tells Radio Free Afghanistan that she is always impressed with Sairas work in the maternity ward. It's been many years that I have been sending patients to go and visit Saira, and they always come back to me very pleased and satisfied, she said.

Midwife Saira has been named Shiberghans number one leading midwife of the past decade. She says she is honored for the recognition and hopes to continue to make a difference.

My sister and I were two of the first midwives who went to the capital city of Kabul to get training in the 1970s, she told Radio Free Afghanistan. It has now been 49 years since my graduation, and I have gained a lot of experience practicing, she added. It has been a great pleasure to serve my people in Sheberghan, she said of her hometown that has witnessed a tumultuous four decades during the various cycles of war in the country.

Saira has seen a sea change in peoples attitude toward healthcare and gynecological services. When I first began, many people in the villages would not welcome a midwife, she recalled. But now most women in the province consult midwives for pre- and postnatal healthcare.

She does the utmost she can when assisting her patients around the clock. Oftentimes, she delivers babies free of cost, gives free examinations for mothers, and offers free medicine. She says most of the women who visit her are poor, so it's the least she can do.

I have delivered many babies for free, especially for women who are poor. This is why many poor patients choose to visit me often, Saira said.

Midwives and nurses in Afghanistan take on large responsibilities. In a country where health services are limited and the segregation between men and women deprives women from seeing male doctors, midwives act as unsung heroes. They provide women and newborns with the basic healthcare they desperately need.

Many mothers in Afghanistan suffer from a lack of basic care such as proper nutrition and survival is often their biggest challenge. On top of that, rampant instability and widespread violence make survival for mothers and their newborns another obstacle to overcome.

In May, a maternity ward in Kabul's Dasht-e-Barchi hospital was subject to a brutal attack when a gunman fired inside the hospital, killing countless mothers and newborns. The incident received international outrage and horrified the nation.

The United Nations even blamed the Taliban and Afghan security forces for "deliberately" attacking healthcare workers and facilities, leaving Afghan mothers and patients to face increased dangers amid a conflict that has reached unfathomable levels of violence.

But despite the myriad problems, Afghanistan has seen steady growth in the number of midwives available.

Abdul Sabur Nariman, a spokesman for the Public Health Ministry in Kabul, told Radio Free Afghanistan that today more than 7,000 trained midwives are serving Afghanistans estimated 32 million people. They have played a large role in decreasing maternal deaths and infant mortality rates. In 2001, the infant mortality rate in Afghanistan was 89 per 1,000 live births, which was one of the highest in the world. Today, it stands at 48 per 1,000 live births.

Officials in Sheberghan say they are witnessing more encouraging signs. According to them, maternal and infant mortality rates in Jawzjan Province specifically have decreased since last year.

Midwife Najiba Rahmani, head of Jawzjans maternity and health department, tells Radio Free Afghanistan that daily, we have more than 15 deliveries, and yearly we have around 5,000 deliveries where 159 of those receive extra assistance because of abnormal or unforeseen circumstances during the delivery.

Jawzjan has a population estimated at about 550,000, according to officials from its health department, served by hundreds of midwives.

Last year, more than 5,000 babies were delivered at Jawzjans main hospital. Still, nearly 67 percent of mothers opt to deliver their babies at home despite the risks that come with it.

Nilly Kohzad wrote this story based on Radio Free Afghanistan correspondent Alem Rahmanyars reporting from Sheberghan, Afghanistan.

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