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Female nurses bring critical healthcare to underserved rural communities

Story by United Nations Development Programme November 18th, 2016
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In a student hostel in Jalalabad, Afghanistan something extraordinary is taking place. A young woman sits on her hostel bed, bent over a textbook. This is Abida, and she is training to be a nurse in a country where most women haven’t finished primary school.

Nursing student Abida Nowroz studies in the dormitory of her nursing school in Jalalabad, Afghanistan.

Nurses are hard to find in Abida Nowroz’s home village in rural Nuristan Province in eastern Afghanistan. In this isolated region, health facilities are limited and security concerns prevent many trained healthcare professionals from working in the area.




“One of my neighbours in our village gave birth,” Abida recalls. “After delivery, she didn’t stop bleeding. Her family put her on a horse to take her to the city. She died on the way.”
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This is not an uncommon story in Afghanistan, which has one of the highest maternal and child mortality rates in the world. A lack of health facilities in rural areas, combined with a scarcity of female health workers, means that many women do not receive the healthcare they desperately need.

A female nursing student fills prescriptions at Beland Ghar Community Health Centre in Behsud district as part of her on-the-job training.

But women like Abida are set to change this situation. Along with 200 classmates, she will graduate from nursing school this year and will go to work in some of the poorest villages in her home province.




“I don’t waste a single day without learning,” says nursing student Abida. “I don’t want to see a mother die on the way to a clinic, or see her child become an orphan.”
Student nurses listen to a lecture at the UNDP/Global Fund-supported nursing school in Jalalabad.
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Set up by the Afghan Ministry of Public Health with support from the United Nations Development Programme (UNDP) and the Global Fund to Fight AIDS, Tuberculosis and Malaria, the school is training a new generation of female healthcare workers. According to WHO, around 40 percent of health facilities in Afghanistan are without female staff, a significant problem in a country where community norms often mean that women are not allowed to receive care from male health workers.




“I’m here to learn something, so I can serve my village and my country,” Abida explains. “I’m really proud to do this. I try to study as hard as I can.”
Student nurse Abida Nowroz answers a question in class.

For Abida and her classmates, school is nearly over, and now it is time to start putting what they have learnt into action.

“Now we are doing on-the-job training. After this, they’ll send us to our villages. Then we’ll practice in the village clinics. When the school is convinced we can perform well there, we’ll be given a diploma. And then we can really start work,” she said.

Abida stitches and dresses a cut in a patient’s hand. The school provides two years of medical instruction, including on-the-job training.
Students in the UNDP/Global Fund-supported nursing programme learn how to check blood pressure and other vital signs.
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In addition to two years of medical training, students at the school receive accommodation, transportation, three meals a day and a nominal living allowance. While the work is hard, Abida and her classmates know that it is a unique opportunity in a country where young women often are not permitted to live or study away from home.

“My parents were very worried about how I could live away from them,” she recalls. “But for months I fought back hard until I convinced my father to give me the green light.” Abida’s older brother even left home in protest. “He argued that as a woman I wouldn’t be able to protect myself,” she says, “and that the local insurgents would harm us if they found out.”

About 200 student nurses will graduate this year and go on to work in underserved rural communities.
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Despite these protests Abida has continued with her studies and is already making an invaluable contribution in her local community, as she returns home during the weekend to help give intravenous drips to sick children.

The training is rigorous, but Abida is  determined to carry on because nurses are hard to find in her home village.

The nursing school in Jalalabad is one of six across the country that are training more than 200 nurses. When the first class graduates in a couple of months, these new nurses will return to some of the most disadvantaged parts of Afghanistan, bringing much needed health care to women in the hardest to reach communities.

Footnote: Story by Jalaluddin Kasaat. Photos by Sayed Omer and Igor Ryabchuk/UNDP Afghanistan