BBC investigates the mother’s Afghan deaths after reducing US assistance

When Shahnaz started working, her husband Abdul called a taxi to take them to the only medical facility available to them.

“She was experiencing a lot of pain,” he says.

A 20 -minute car, the clinic was in the village of Shesh Paul in the northeast Badahshan province in Afghanistan. They were born there, their two bigger children were born.

Abdul sat next to Shahnaz, comforting her as they moved over gravelly tracks to reach help.

“But when we reached the clinic, we saw that she was closed. I didn’t know she had closed,” he said, his face was destroyed by agony.

Caution: Readers can find some details in this article that are not in difficulty.

The Shesh Paul Clinic is one of more than 400 medical establishments that have closed in Afghanistan, one of the most overwhelming countries in the world since the Trump administration has reduced almost all of the United States in the country earlier this year, in a drastic and sharp move after dismantling the US Agency for International Development (USAID).

One -storey structure with four small rooms, white paint peeled off its walls, the Shesh Paul clinic has USAID posters glued everywhere with information and guidance for pregnant women and new mothers.

It does not seem much, but in the mountain, unforgivable terrain of Badahshan, in which lack of access is the main reason for the historically high mortality rate of the mother, the clinic was a critical rescue line, part of a broader program implemented during the term of the US-backed government in order to reduce the death of the mother.

There was a trained midwife who helped about 25-30 deliveries every month. He had a stock of medicines and injections, and also provided basic health services.

Other medical establishments are just too far from the village of Abdul and was not at risk of traveling on uneven roads. Abdul also had no money to pay for a longer trip – renting a taxi cost 1000 Afghans ($ 14.65; 12.70 British pounds), approximately a quarter of his monthly income as a worker. So they decided to return home.

“But the baby was coming and we had to stop from the side of the road,” Abdul said.

Shahnaz delivered her little girl in the car. Shortly thereafter, she died and bleed abundantly. A few hours later, before being baptized, their baby also died.

“I cried and screamed. My wife and child could be saved if the clinic was open,” Abdul said. “We had a difficult life, but we lived together. I was always happy when I was with her.”

He doesn’t even have a picture of a Shahnaz to hold on to.

There is no security that the mother and the baby would have survived if they had been treated at the clinic, but without it they had no chance, emphasizing the undeniable impact of US assistance cuts in Afghanistan.

For decades, America has been the largest donor in Afghanistan, and in 2024 the US funds make up 43% of all the help of the country.

The Trump administration justifies his withdrawal, saying that he has “credible and long -standing concerns that funding is taking advantage of the terrorist groups, including … the Taliban” that run the country. The US Government additionally added that They had reports that claim that at least $ 11 million “were cut off or enriching the Taliban.”

The report that the US State Department is referring to was made by the General Inspector for the Reconstruction in Afghanistan (Sigar). It says $ 10.9 million in US taxpayer money was paid to the Taliban government by USAID partners in Taxes, Fees, Liabilities or Utilities.

The Taliban government denies that the money for help has entered their hands.

“This statement is not true. The aid is provided to the UN and through them to NGOs in provinces. They identify who needs the help and distribute it themselves.

The policies of the Taliban government, especially its restrictions on women, the most ranked in the world, mean that after four years in power, it is not yet recognized by the greater part of the world. This is also a key reason that the donors are increasingly moving away from the country.

The United States insists that no one has died due to redundancies. Shahnez and her baby’s death do not record anywhere. They are neither countless others.

The BBC has documented at least half a dozen first -hand, devastating accounts in areas where USAID -backed clinics have closed.

Right next to the tomb of Shahnaz, peasants who gathered around us pointed to two more graves. We were told that they were both women who have died at birth in the last four months – Daulat Begie and Javhar. Their babies survived.

Not far from the cemetery we met with Khan Mohammed, whose wife, 36-year-old Gul Yang, died in birth five months ago. Their boy Safiula died three days later.

“When I get pregnant, she will go to the examination clinic. But after the middle of pregnancy, she closed. During birth, she experienced a lot of pain and blood loss,” said Khan Mohammed. “My children are sad all the time. No one can give them the love of a mother. I miss every day. We had a sweet and loving living together.”

Approximately five hours by car by Shash Paul, in The quarrels, another village in which the clinic, supported by USAID, Ahmad Khan, the Maidamo father, the Maidamo father, showed us the room in their home and clayey at home where she died, giving birth to baby Karima.

“If the clinic was open, she could survive. And even if she had died, we would not regret that the medics tried best. Now we are left with regret and pain. America did it,” he said, tears roll on his face.

In another home of several strips, Bahis tells us how terrifying it is to be born at home. Her three other children were born at the Cawgani Clinic.

“I was so scared. We had a midwife, medicines and injections at the clinic. I had nothing at home, without painkillers. It was unbearable pain. I felt my life was leaving my body. I became numb,” she said.

Her girl named Fakiha died three days after she was born.

The clinics closure in villages have led to a surge of patients in the maternity ward of the main regional hospital in the provincial capital Faizabad.

Getting to it through Badahshan’s insidious landscape is risky. We were shown a terrifying photo of a newborn baby, which was delivered on the way to Fiazabad and whose neck clicked before reaching the hospital.

We had visited the hospital back in 2022 and while she was stretched then, the scenes we saw this time were unprecedented.

There were three women in each bed. Imagine that you have been involved in birth or just went through a miscarriage and don’t even have a bed to you to lie in.

This is what Zuhra Shewan, who suffered a miscarriage, had to endure.

“I was bleeding heavily and I didn’t even have nowhere to sit. It was really difficult. While the bed was free, a woman could die bleeding,” she said.

Dr. Shafik Hamdard, director of the hospital, said: “We have 120 beds in the hospital. We have now allowed 300 to 305.”

While the patient’s workload swells, the hospital also encounters sudden cuts in financing.

“Three years ago, our annual budget was $ 80,000. Now we have $ 25,000,” said Dr. Hamdard.

By August this year, there were as many deaths for the mother as it was last year. Which means that at this rate, mother mortality can increase by as much as 50% compared to last year.

The death of newborns has already increased by approximately one -third in the last four months, compared to the beginning of the year.

Razia Hanifi, the hospital’s midwife, says she is exhausted. “I have been working for the last 20 years. This year is the most difficult because of overcrowding, the shortage of resources and the shortage of trained staff,” she said.

But no reinforcements are coming because of the limitations of the Taliban government for women. Three years ago, all higher education, including medical education, was banned for women. Less than a year ago, in December 2024, it was also forbidden training for midwives and women.

In a discreet place, we met two students who were in the middle of the training when it was closed. They did not want to be identified for fear of repression.

Anya (changed name) said they were both in graduation courses at university when the Taliban took. When they were imprisoned in December 2022, they started training in midwife and nurses, as this was the only time left to get an education and work.

“When that was also forbidden, I became depressed. I cried day and night and failed to eat. It’s a painful situation,” she said.

Karishma (called changed) said: “There is already a shortage of midwives and nurses in Afghanistan. Without being trained, women will be forced to give birth at home, which will put them at risk.”

We asked Suhail Shaheen to the Taliban government how they can justify prohibitions that effectively restrict health access to half of the population.

“This is our internal problem. These are our problems, how to deal with them, how to look at them, how to make decisions, this is something internal. It depends on the guidance. Based on the needs of society, they will make a decision,” he said.

With their access to medical services, severely restricted, by wave after wave of crushing strokes, as women in Afghanistan, their right to health and life itself is at serious risk.

Additional reporting, photography and video: Aakriti Tapar, Mahfouz Zubaide, Sanjay Ganguly

The top image shows Abdul with his daughter and son in Shash Paul.