In early October 2023, Golandam* was in the final days of her pregnancy. The 32-year-old, who lives in the village of Nayeb Rafie in Herat province, had taken to holding onto her back to ease the heavy pain she was experiencing in her swollen belly and pelvis. After being awake all night due to back pain, she hadn’t the appetite to eat any of the food her sister brought her. Finally, around 11 a.m., she remembers closing her eyes and drifting off to sleep. Moments later, an earthquake shook her house. The first tremor was mild, but the second, with a magnitude of 6.3, buried Golandam’s children, mother, sister, and nieces under the rubble.
Golandam was also trapped under the debris. When the ceiling collapsed on her, she fell forward onto the ground. Due to her swollen belly, she couldn’t move. Intense pain immediately overtook her body. Her water broke and she began experiencing labour pains in addition to breathing difficulties. Her only wish was for the fetus in her womb to survive: “I had a pain as if someone was stabbing inside my stomach. I couldn’t bear it for more than a few seconds and lost consciousness.”
Although her sister Parwana* had lost a three-year-old child in the quake, she managed to pull herself free from the destroyed house and then rescue her pregnant sister, whom she got to hospital. Doctors told Golandam that her pelvis was broken, her back was severely injured, and she’d lost a lot of blood. More agonizing was that her fetus had died inside her belly and doctors had to perform a caesarean section to remove the fetus and save her life.
“I feel half-dead; neither am I intact nor is my child alive. I think I don’t exist from the chest down,” she tells Zan Times. Golandam stayed in the hospital for nearly a month, her recovery overshadowed by tears and grief. In addition to losing her fetus, her elderly mother, and young niece also died in the earthquake. “I am hopeless. Nothing is left for me. I can’t even hold my other surviving child in my arms,” she explains. Parwana says her sister behaves like a mad person and that sometimes Golandam cries loudly and doesn’t speak at all, just staring at one thing. “It’s been a few days since we came home from the hospital. None of us are well, but she is the most affected,” Parwana explains.
The earthquakes and severe aftershocks that hit Herat in October killed at least 2,500 people and injured thousands more. At least 13 villages in the districts of Zendajan, Ghorian, Golran, Kushk Robat Sangi, and other areas were destroyed. According to UNICEF, 90 percent of the earthquake victims are women and children. In addition, the United Nations Population Fund states that 7,500 pregnant women were also affected by these earthquakes and require urgent medical assistance.
Since the earthquake destroyed their home, Golandam and her family have been living in a tent in their village, which lacks even the most basic health facilities. And with so many families also having to spend cold days and nights in tents, the impact on pregnant women has been catastrophic with many reporting that they’ve miscarried, either during the earthquakes or while fleeing the calamity.
“Recorded statistics in health centers in the city and districts of Herat show that from October 7 to the end of the month [October], 247 cases of fetal deaths have occurred, mostly in the city of Herat,” reports a physician in the Herat Public Health Department, who talked anonymously with Zan Times. This source states that 73 cases were in Herat City, 55 in Injil district, 41 in Zendajan district, 38 in Kushk-e-Robat Sangi district, 29 in Karukh, and 11 in other districts. “In Afghanistan, fetal death or miscarriage is relatively common, but most of these cases in October occurred due to severe jolts and collisions during the earthquake,” he adds, noting that while comprehensive data from across Herat province is unavailable, he believes that the miscarriage rate has soared due to the earthquakes and tremors.
Pregnancy has always been high-risk in many remote areas of Herat province that lack medical clinics, especially ones with female specialists. In those rural regions, local midwives aid in childbirth and fetal mortality statistics are rarely tabulated.
Maryam* was cooking when the first earthquake struck. The 26-year-old rushed to the protection of a hallway as she was four months pregnant. “I was terrified and worried about my child. I was running towards the backyard. Every moment, I made sure to get myself to safety, but then I remembered I hadn’t brought my mobile phone to call my husband. Now I think if the ceiling had fallen on me, God knows what would have happened to my fetus,” she explains to Zan Times.
Though she wasn’t injured in the earthquake itself, she soon began experiencing severe back pain and bleeding. “The pain and bleeding worried me that my child might have died. I thought this condition happened to me because of the fear, escape, and the severe jolts I experienced at that moment,” she says. Her husband, Faridoon*, rushed home within 30 minutes of the first jolts and immediately took Maryam to a private clinic. “It was noon, and no gynecologists were available at the clinics, considering the earthquake had occurred, which was normal. But I insisted on getting an ultrasound to see how my child was doing so we could consult a doctor later,” she says.
The ultrasound results were grim for the couple expecting their first child – the fetus showed no movement and the heartbeat wasn’t audible. An obstetrician confirmed that they’d lost their unborn child and recommended Maryam undergo a dilation and curettage (D&C). Still, Maryam was lucky to get specialist help. The destruction or closure of health centres and mobile clinics as well as the lack of obstetricians is a concern in the earthquake-hit districts. Abdul Rahim*, a village elder in Zendajan district, the epicentre of the first earthquake, tells Zan Times, “In the first two weeks after the earthquake, the situation was so chaotic that few thought about pregnant women. Most people and even aid workers were focused on rescuing the dead and wounded from under the rubble of houses. Although most pregnant women were transported to Herat city, there were no doctors or necessary facilities in the district to attend to pregnant women.”
Nazila* experienced that lack of specialist medical attention. She suffered a miscarriage while fleeing her home in Herat city. “Although I haven’t been married for long, I lost my child, and the reason was not having a doctor. All the relief efforts were focused on the earthquake-hit villages, and they ignored us, who spent our nights on the streets. Dozens of sick women were in tents on the streets and couldn’t go to the hospital because there was no care available. There were people from earthquake-affected areas like Gulran and Zendajan in the hospital,” she tells Zan Times. “Losing my child is death to me, especially since I won’t be able to get pregnant again for a long time.”
*Names have been changed to protect the identity of the interviewees and writer. Farshid Aram is the pseudonym of a journalist in Afghanistan.
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