Back to Khost: Embracing the Good and the Bad
Coming back to the MSF Khost maternity hospital in Afghanistan in the beginning of January, I was recognized and welcomed by a lot of people from my previous mission half a year ago, which made me feel delighted and relieved. So, this meant I was doing alright in the last mission!
Last year we assisted almost 24,000 deliveries in Khost; around 10% of them were complicated cases. As winter came, the hospital had been receiving more serious, difficult and complicated cases. I had to deal with a number of emergency cases every day.
I experienced a sad moment on the third day of my working here. On my way to the hospital, I received an urgent call from my colleagues, who were moving a pregnant woman to the operating room and performing chest compression. The pregnant woman was about to deliver but suffered a sudden crisis. We tried various resuscitation measures for 45 minutes but still in vain......She had been pregnant 11 times, had five miscarriages and six kids. She had no antenatal care before. Based on her clinical manifestations and our experience, it may have been sudden death caused by aortic dissection or amniotic fluid embolism, and that means there would have been not much we could do even if it had happened in a top hospital in Beijing.
After that, I joined my colleagues to talk with the patient’s family. The pregnant woman’s husband, a tall man about 40 years old, turned away from us and sobbed deeply. Later he told us that he and his wife had been married for many years and planned to have no more kids after this one. 
I felt so sad. That night, I chatted with my colleagues, and we recalled that maternal mortality used to be high here. Death still occurs once in a while even now. If MSF was not there, I can’t imagine what would happen to all those patients who had postpartum hemorrhage, uterus rupture, fetus asphyxia......Most of them cannot afford to go to private clinics. Without healthcare like MSF’s, who will all these mothers turn to? Thinking about these I gradually recovered from the sadness. 
During her six weeks in the mission, Aysha (second from right) was moved by how her colleagues cared for the patients.
Photo credit: Aysha Nawan
Besides bad times, there are positive moments, too. I have been deeply touched by the way our staff care for the patients. Most of the patients have never been away from home. So when they are suddenly in a hospital and an operating room, they feel helpless. Some female staff of the hospital will surely be there to hold their faces and tell them what will happen. 

MSF’s Khost maternity hospital provides free and high quality of maternal care to help reduce maternal deaths in the province. © Andrea Bruce/Noor Images
I have also been moved by the local people as well. Our blood bank is almost always full because many local people come to donate blood. 90% of them are men. Here men usually do not speak about their feelings but by donating blood, they express their love for their community. 
What will Aysha bring to the front line?
1.Chili sauce
2.Green tea and black tea
3.Handicrafts and ornaments from hometown as gifts for colleagues in the field


Aysha Nawan is an anaesthetist from Xin Jiang, China. She worked in MSF Khost Maternity hospital in July 2016 for six weeks, and returned to the mission in the new year of 2017.


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