The Fiji Women’s Rights Movement warned today that the value of midwives in the Pacific country was being undermined because of a lack of training and proper planning, and little urgency over the creation of positions.

In a message to mark the International Day of the Midwife on May 5, the FWRM highlighted the important role that midwives play in Fiji’s health sector for mothers and their newborn babies.

“The contribution of midwives to universal health coverage in terms of sexual, reproductive, maternal and newborn health, and strategies to fill the service gaps worldwide is rarely mentioned,” said the statement.

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“The barriers they face in their professional environment are not often highlighted.”

More than 65 percent of World Health Organisation (WHO) member states were reported 2020 to have less than 50 nursing and midwifery personnel per 10,000 population (about 40 countries in the WHO African region and 25 in the WHO Americas region).

In many countries, said the statement, nurses and midwives constituted more than 50 percent of the national health workforce.

Pacific data on midwives was limited, the statement said.

Nurses resigning
Earlier this year, Fiji Nursing Association president Dr Alisi Vudiniabola warned that nurses were resigning because of stress, fatigue and lack of compensation.

The same was stressed by Shamima Ali of the Fiji Women’s Crisis Centre.

“We see that nurses are leaving for greener pastures and inexperienced nurses are being promoted to lead units in divisional hospitals which means an impact on service delivery,” said the statement.

In the same article covered by The Fiji Times, Dr Vudiniabola shared a report from one hospital where the nurse manager had been working alone, looking after 28 patients as most of the nurses were “sick and tired”.

“The same is for midwives,” said the FWRM statement. “Midwife training is undertaken with no proper planning or positions being created, or positions are often held up, further undermining the value of midwives and the urgency of their work.”

According to the WHO, healthcare provided by midwives who were educated and regulated according to global professional standards was defined as a core strategy for decreasing maternal mortality rates and improving reproductive, maternal, and newborn health.

Midwives could provide 87 percent of sexual, reproductive, and maternal health services but before that can happen, such services needed to be legislated and regulated.

“An enabling environment that allows midwives to offer this full scope of services must be provided.”

Fiji’s commitments
Fiji had made its commitment to Sustainable Development Goals 3 and 4 addressing a reduction in maternal mortality rates but this had not been implemented, said the statement.

Based on reports received, midwives with relevant qualifications like such as the Post Graduate Diploma in Midwifery, Masters in Midwifery were still earning less than F$35,000 a year.

This was the case even when the scope of their work covered areas such as ante-natal clinic consultation, public awareness, births and deliveries, post-natal, retrieval of obstetric and gynecology emergencies in the field (usually handled by doctors), pediatrics, maternal child health, and public health (including immunisation to pre-school for the child).

Midwives also undertake administrative documentation, including maintenance of data repositories, which were not used by the Ministry of Economy in formulating national budgets.

As health communities in Fiji and globally marked International Midwives’ Day today, the FWRM urged the government and the health ministry to place more emphasis on the role of midwives in the health sector.

Queen’s Service Medal for NZ midwife
In New Zealand, midwives’ advocacy was marked on International Midwives’ Day when the Governor-General, Dame Cindy Kiro, presented Pukekohe midwife Claire Eyes with the Queen’s Service Medal at a Government House investiture ceremony which also recognised several covid-19 pandemic response and other service leaders.

Eyes had also assisted midwifery in the Pacific through Rotary and had organised leadership training for midwives and nurses in Australia.

Her citation said in part: “[Claire Eyes] helped prevent closure of the Pukekohe Maternity Unit in the 1990s and secured funding to start the Pukekohe Maternity Resource Centre.

“She was president of the New Zealand Nurses Organisation Franklin Branch. She was involved with negotiations for pay parity for nurses and midwives and assisted the Ministry of Health to set up a structure for midwives providing lead maternity care.

“She was NZNO representative to the New Zealand Council of Women.”

As the Taliban has taken control of the country, Afghanistan has again become an extremely dangerous place to be a woman.

Even before the fall of Kabul on Sunday, the situation was rapidly deteriorating, exacerbated by the planned withdrawal of all foreign military personnel and declining international aid.

In the past few weeks alone, there have been many reports of casualties and violence. Meanwhile, hundreds of thousands of people have fled their homes.

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The United Nations Refugee Agency says about 80 percent of those who have fled since the end of May are women and children.

What does the return of the Taliban mean for women and girls?

The history of the Taliban
The Taliban took control of Afghanistan in 1996, enforcing harsh conditions and rules following their strict interpretation of Islamic law.

Under their rule, women had to cover themselves and only leave the house in the company of a male relative. The Taliban also banned girls from attending school, and women from working outside the home. They were also banned from voting.

Women were subject to cruel punishments for disobeying these rules, including being beaten and flogged, and stoned to death if found guilty of adultery. Afghanistan had the highest maternal mortality rate in the world.

The past 20 years
With the fall of the Taliban in 2001, the situation for women and girls vastly improved, although these gains were partial and fragile.

Women now hold positions as ambassadors, ministers, governors, and police and security force members. In 2003, the new government ratified the Convention on the Elimination of all Forms of Discrimination Against Women, which requires states to incorporate gender equality into their domestic law.

The 2004 Afghan Constitution holds that “citizens of Afghanistan, man and woman, have equal rights and duties before the law”. Meanwhile, a 2009 law was introduced to protect women from forced and under-age marriage, and violence.

According to Human Rights Watch, the law saw a rise in the reporting, investigation and, to a lesser extent, conviction, of violent crimes against women and girls.

While the country has gone from having almost no girls at school to tens of thousands at university, the progress has been slow and unstable. UNICEF reports of the 3.7 million Afghan children out of school some 60 percent are girls.

A return to dark days
Officially, Taliban leaders have said they want to grant women’s rights “according to Islam”. But this has been met with great scepticism, including by women leaders in Afghanistan.

Indeed, the Taliban has given every indication they will reimpose their repressive regime.

In July, the United Nations reported the number of women and girls killed and injured in the first six months of the year nearly doubled compared to the same period the year before.

In the areas again under Taliban control, girls have been banned from school and their freedom of movement restricted. There have also been reports of forced marriages.

Women are putting burqas back on and speak of destroying evidence of their education and life outside the home to protect themselves from the Taliban.

As one anonymous Afghan woman writes in The Guardian:

“I did not expect that we would be deprived of all our basic rights again and travel back to 20 years ago. That after 20 years of fighting for our rights and freedom, we should be hunting for burqas and hiding our identity.”

Many Afghans are angered by the return of the Taliban and what they see as their abandonment by the international community. There have been protests in the streets. Women have even taken up guns in a rare show of defiance.

But this alone will not be enough to protect women and girls.

The world looks the other way
Currently, the US and its allies are engaged in frantic rescue operations to get their citizens and staff out of Afghanistan. But what of Afghan citizens and their future?

US President Joe Biden remained largely unmoved by the Taliban’s advance and the worsening humanitarian crisis. In an August 14 statement, he said:

“an endless American presence in the middle of another country’s civil conflict was not acceptable to me.”

And yet, the US and its allies — including Australia — went to Afghanistan 20 years ago on the premise of removing the Taliban and protecting women’s rights. However, most Afghans do not believe they have experienced peace in their lifetimes.

Now that the Taliban has reasserted complete control over the country, the achievements of the past 20 years, especially those made to protect women’s rights and equality, are at risk if the international community once again abandons Afghanistan.

Women and girls are pleading for help. We hope the world will listen.

Azadah Raz Mohammad, PhD student, The University of Melbourne and Dr Jenna Sapiano, Australia Research Council postdoctoral research associate and lecturer, Monash Gender Peace & Security Centre, Monash University. This article is republished from The Conversation under a Creative Commons licence. Read the original article.