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A midwife student listens to the heartbeat of a baby in the delivery room as a woman prepares to give birth at Bamyan provincial hospital in Afghanistan, 2009. Photograph: Paula Bronstein/Getty Images

For years, declining death rates among pregnant women have been hailed as one of the great gains of foreign aid in Afghanistan.

In reality, however, Afghan women dying in pregnancy or childbirth may be more than twice as high as numbers provided by donors would suggest.

Since 2010, published figures have shown maternal mortality rates at 327 for every 100,000 live births, a significant drop from 1,600 in 2002. Yet recent surveys give a different picture.

In one unpublished study, the Afghan government found an average level of maternal deaths between 800 and 1,200 for every 100,000 live births, according to aid workers in Kabul who have seen the research.

If accurate, this would mean that women in Afghanistan despite more than 15 years of international aid aimed at improving maternal mortality figures may be dying from maternal complications at rates similar to those found in Somalia and Chad, and only surpassed by South Sudan.

In another review, the UN Population Fund (UNFPA) found as many as 1,800 maternal deaths a year in the remote Afghan province of Ghor. Nine out of 11 provinces had higher death rates than the number normally used by donors.

Both the UNFPA mortality numbers and the governments own survey have yet to be released. A spokesman for the ministry of public health said the survey was not ready to be publicised yet, and declined to discuss findings.

The countrys emphasis on training midwives in recent years is slowly building numbers. Yet, despite this improved capacity, driving up numbers of health personnel is only half the solution, according to Bannet Ndyanabang, UNFPAs Afghanistan representative: Training is not the only thing. They have to be deployed in the areas where they are needed. It doesnt matter that you have health centres if theyre not staffed with skilled personnel. [Midwives and nurses] have to be given incentives to work in rural areas.

One reason for the discrepancy in the figures is a lack of reliable data. Collecting such information in Afghanistan is notoriously difficult. Worsening security prevents even officials from the ministry of public health, let alone foreigners, from travelling to rural areas.

In a recent audit of $1.5bn (1.2bn) donated by the US to Afghan healthcare, the Special Inspector General for Afghanistan Reconstruction the US congressional watchdog criticised the use of unreliable data to prop up claims of progress in Afghanistan.

According to Sigar, missions are required to be transparent and communicate any limitations in data quality so that achievements can be honestly assessed. In all cases Sigar reviewed, USAid did not disclose data limitations.

Sigar said similarly selective data use lay behind USAid claims that life expectancy in Afghanistan has risen by 22 years. More recent surveys by the World Health Organization show relatively modest increases of six and eight years for men and women respectively.

A USAid spokesperson said: In Afghanistan, a country suffering from decades of conflict, reliable health and population data is scarce and difficult to obtain. USAid strives to use the best available data for programming decisions and invests to improve data quality for measuring progress. This commitment includes our continued support for independent nationwide surveys on the state of the health sector. These surveys, and the methodology they use, are publicly available.

More reliable data is available, however.

While numbers used by international donors were based on samples from three of the 360 districts in existence at the time, the UNFPA survey was much more extensive, covering 70% of households in 11 of the countrys 34 provinces.

The UNFPA did not survey southern and eastern provinces, where rates are almost certainly high because conflict and poor infrastructure make healthcare inaccessible to millions of women.

In addition, a 2013 study by the Institute for Health Metrics and Evaluation at the University of Washington reported 885 annual maternal deaths in Afghanistan. According to the researchers, that was an increase of 24% on a decade earlier.

In Afghanistan, reality often conflicts with official statistics. The UK government, for instance, claims that 85% of Afghans are now covered by basic health services.

Yet, in a 2014 Mdecins Sans Frontires report, four out of five Afghans said they did not use their closest public clinic because they believed the quality of services and availability of staff was so poor. According to the UN Office for the Coordination of Humanitarian Affairs, 9 million Afghans are without access to basic health services.

Healthcare has also been a key priority for the British government in Afghanistan, though its not clear exactly how much money goes specifically to reducing mortality among pregnant women.

Since 2002, the UK has provided more than $1.7bn (1.4bn) to the Afghanistan Reconstruction Trust Fund, which allocates a significant portion to healthcare. Healthcare for mothers is a key priority, the UK embassy in Kabul said.

In a country where reliable data is so elusive, a stronger focus on monitoring progress, and further investment in it, is desperately needed, or the benefits of the large amount of aid going into healthcare will remain unclear.

Original post:
Maternal death rates in Afghanistan may be worse than previously thought - The Guardian

In President Trumps inaugural address he promised that America will start winning again, winning like never before. He said while the U.S. defended other nations borders, it spent trillions and trillions overseas while Americas infrastructure has fallen into disrepair and decay.

A major theme of Trumps campaign was that he wanted a muscular military but was going to be less interventionistand more pragmatic in the application of military force. But in his tone since being sworn in and his picks for secretary of defense, CIA chief and national security adviser he has signaled an end to the kind of ambivalence and nuance that was the hallmark of the Barack Obama years.

Trumps flood of executive orders, including one that bars entry to the U.S. for 90 days to nationals from certain countries in the Muslim world, represented a kind of blunt-force trauma exercise. Injusta few hours thousands of protesters took to airports around the country in solidarity with the foreign travelers and green card holders.

A federal court orderoverturned part of what Trump had ordered, giving relief to thoseindividuals stranded in transit. The Trump ban resulted in the 19-hour detention at New Yorks John F. Kennedy International Airport of Hameed Khalid Daweesh, an Iraqi who for a decade put his life on the line acting as a translator for the U.S. military, As the New York Times recounted, a tearful Daweesh asked What I do for thiscountry? They put cuffs on. You know how manysoldiers I touch by his hand?

Just nine days into Trumps tenure the first counterterrorism mission ordered by the new president resulted in the death of a member of the Navys elite SEAL Team 6 and the wounding of three other troops as they executed a raid in Yemen. The MV-22 Osprey aircraft that sent to rescue the SEAL team could not take off after it landed and had to be destroyed on the ground by U.S. fire so it would not fall into enemy hands. Is this what winning like never before looks like?

Over what is now a generation we have thrown trillions of dollars into that region only to see the conflict widen and engulf more and more nations, setting off the worst refugee crisis since World War II. Trumps predecessormade a major effort to extricate us from the wars in Afghanistan and Iraq, but he was dragged back inbecause he did not want to be the president that lost either one. Even as Obama vowed to avoidU.S. boots on the ground, they werefoundall over the place, from Yemen to a dozen countries in sub-Saharan Africa.

Obamawas no doubt handicapped by alternative facts that came in the form of rose-colored intelligence briefings that falsely led himto believe that the U.S. and its allies had ISIS in check. Real success and a satisfactory conclusion in both places has repeatedly eluded two presidents of opposing parties, the loss of thousands of American lives and the infliction of untold misery on the civilian population and significant environmental damage.For years both theaters of combat have been hotspots for the circulation of American alternative facts, often embraced by mainstream media.

By the time the formal December 2011 Iraqi withdrawal was upon President Obama, he had to resort to his own version of Bushs 2003mission accomplished at Fort Bragg to mark the formal exit of the U.S. military from a half-finished conflict.

We knew this day would come. Weve known it for some time. But still there is something profound about the end of a war that has lasted so long, said Obama. Its harder to end a war than begin one. Everything that American troops have done in Iraq all the fighting, all the dying, the bleeding and the building and the training and the partnering, all of it has landed to this moment of success.

Just a few years later Obama declared our combat mission in Afghanistan was ending, and the longest war in American history was coming to a responsible conclusion.

By 2015, Obama was forced into anabout-face after the Taliban seized the northern city of Kunduz and held it for two weeks. The United Nations reported the Taliban were as prevalent throughout the country as they had been at any time since 2001.

As the world braces for Trumps rhetoric to manifest into hot lead. it is important for the public to be aware how significantly things have deteriorated on the ground in Afghanistan over the last several years. If Trump wants to display his geopolitical turnaround skills, that should be at the top of his to-do list. The latest news paints a pretty dire picture.

Though more than half of all U.S. reconstruction dollars have gone toward the Afghan National Defense Force (ANDSF), it has lost territory to the insurgency, according to the latest analysis earlier this month fromJohn Sopko, the U.S. special inspector general for Afghanistan reconstruction. As of Aug. 28, 2016, only 63.4 percent of the countrys districts were under Afghan government control or influence, a reduction from 72 percent as of Nov. 27, 2015.

Ourdecade-long effort at nation-building in Afghanistan has been a spectacular failure for which no one has been held accountable, other than perhaps former secretary of state Hillary Clinton. For the corporate news media, the key to reconciling this vast gap between our evident failure in Afghanistan and the bipartisan hype about our military being the greatest in the world is simply not to not cover what is going on there.

In his first week on the job, Trump is making clear there is anew sheriff in town who just cant be bothered with nuances. After he was sworn in, the new president went to CIA headquartersto promise a more robust and muscular approach to Americas ongoing war on terrorism. We have not used the real abilities that we have. We have been restrained, Trump said. Were going to be winning again and you are going to be leading the charge.

Based on Trumps remarks, that charge could be back into Iraq, where the president lamented that the U.S. initially erred because we should have kept the oil. He appeared to leave the possibility open: Maybe well have another chance.

In Trumps off-the cuff remarks, warns Adil Najam, dean of Boston Universitys Frederick S. Pardee School ofGlobal Studies, he helps makes the same case made by Islamic radicals like ISIS that the U.S fought the war in Iraq for oil. Trumps comments could be used for their narrative.

What this may signal, Najam believes, is a more transactional approach to countries like Iraq and Afghanistan.Trump in essence is saying, if you want our security what do we get for it? Under Bush, the approach was that we were giving Iraq democracy [and] not taking their oil, whereas the current president will try to demonstrate that he can strike a better deal with Iraq. Doing so with Afghanistan may be more difficult.

Andrew Bacevich, a historian and author of several books, including The Limits of Power: The End of American Exceptionalism, is a West Point graduate and former Army colonel. He served in the Vietnam War and right up through the early 1990s, and asserts the U.S. is in deep denial about its failures in prosecuting its war on terrorism in Iraq and Afghanistan. We have not won this war, Bacevich told a Boston University audience in 2014. We are not winning this war and simply pressing on is unlikely to produce more positive results this year or the year after.

To insist on accountability is to go out on a limb, said Bacevich, whose son, an Army lieutenant, was killed in Iraq in 2007. You would open yourself up to the charge of not supporting the troops, or of being an isolationist, or in not believing in American global leadership and, worst of all, in not believing in American exceptionalisms unique calling to save the world.

Bacevich believes the American public has been insulated from the ongoing global war on terrorism in Iraq and Afghanistan because the U.S. relies on a voluntary military and Washington has been hesitant to raise taxes to pay for the hundreds of billions needed for the widening war on terror.

In a recent email exchange Bacevich said he hopes Trump gets down to basic questions that have not been asked for years. I want him to ask a very fundamental question with regard to U.S. military policy, especially in the Islamic world, Bacevich wrote. And the question simply is, is it working? Are we winning? When will this war, this semi-permanent war, come to an end? Because I think if you confront those questions directly, you cannot help but reach the conclusion that our military endeavors have failed. And only when we acknowledge that they have failed does it become possible then to consider alternatives to simply pressing on.

In his flurry of executive orders Trump has set a 30-day deadline for the U.S. military and national intelligence agencies to give him a plan to takedecisive actionto defeat ISIS. Despite assurances to Congress from his national security team, Trump apparently endorses torture, telling David Muir ofABC Newslast week that he absolutely believeswaterboarding works. It appears the president wantsto double down on a failed U.S. policy while at the same validating ISISpropaganda that America is an anti-Muslim nation whose only enduring loyalty lies in its greed for oil.

Cant wait for next week.

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Alternative facts in the Middle East: Obama has left Trump a disaster in Afghanistan - Salon

Afghanistan is in the lead after winning the first two matches in the five-match development squad tour to Zimbabwe.

Afghanistans A cricket team on Sunday beat Zimbabwe A by 55 runs in the second of five One Day International (ODI) matches.

On Friday, Afghanistan made a fine start by beating Zimbabwe A by five wickets in their first match of the Afghanistan Development Squad tour to Zimbabwe.

Afghanistan, on Sunday meanwhile, scored 208 runs from 47.3 overs but the target was reduced to 182 runs as per the Duck and Lewis method after the game was interrupted due to rain.

Zimbabwe had won the toss and put Afghanistan A in to bat first a move that left Zimbabwe unable to chase the given target. They lost all their wickets after scoring 126 runs from 27.5 overs.

Shafiqullah, from Afghanistans team, scored the highest number of runs on the batting side for his team and notched 50 runs off 53 balls.

The next match of the series takes place on Tuesday at the Harare Sports Club.

Read more:
Afghanistan A Team Defeats Zimbabwe A By 55 Runs - TOLOnews

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The Russian government is cooperating with the Taliban terrorist movement in Afghanistan under a broader strategy to undermine U.S. goals and make a peaceful exit as difficult as possible, The Wall Street Journal reports.

Moscows cooperation with the Taliban is conducted under the guise of conducting counter-terrorism operations against the Islamic State. ISIS has a nascent presence in Afghanistan, and has historically clashed with the Taliban.I have already said earlier that we and the Taliban have channels for exchanging information, a high Russian official told The Washington Post in 2015.

Afghanistans security and political situation is increasingly deteriorating. After former President Barack Obama ended the U.S. combat mission in 2014, the Taliban made unprecedented gains across the country. The Afghan Security Forces the U.S. is supposed to be supporting in the fight against the Taliban are monumentally corrupt, and losing thousands of soldiers per month.

Their [Russias] narrative goes something like this: that the Taliban are the ones fighting Islamic State, not the Afghan government, Americas top General in Afghanistan told reporters in a December Pentagon briefing. He continued,This public legitimacy that Russia lends to the Taliban is not based on fact, but it is used as a way to essentially undermine the Afghan government and the NATO effort and bolster the belligerents.

The strategy is reminiscent of U.S. strategy in Afghanistan in the 1980s, when the U.S. supplied weapons to anti-soviet rebel groups in a bid to entrench the Soviet Union in a prolonged conflict. The U.S. supplied hundreds of millions of dollars of weapons to rebel groups for nearly 8 years. In some cases the weapons ended up in the hands of Islamic extremists, and were used by the Taliban to take over the country in the late 1990s. Texas Congressman Charlie Wilson spearheaded the funding for the program and became intimately involved. His experiences were later dramatized in the film Charlie Wilsons war.

Russia has also stymied efforts by the U.S. backed government in Kabul to fold a former terrorist into the peace process. The Afghan government offers a reconciliation program to terrorists willing to stop waging war against them, in exchange for ability to participate in the political process. A crucial element of this process involves removal of a former terrorist from the United Nations sanctions list, something Russia has used its power to stop.

Russias strategy in Afghanistan is remarkably similar to its course of action in Syria. Russia supports Syrian President Bashar Al-Assad under the auspices of a counter-terrorism mission, when in reality they get to reassert itself on the global stage and maintain a steadfast ally. In Afghanistan, Russia can thwart U.S. efforts towards a peaceful exit and gain influence with important actors who are U.S. enemies.

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Original post:
Moscow Pulling A Charlie Wilson On US In Afghanistan | The Daily ... - Daily Caller

Highlights

Returns from Pakistan

From 22-28 January 2017, a total of 1,100 undocumented Afghans spontaneously returned or were deported from Pakistan through Torkham border (Nangarhar province) and Spin Boldak border (Kandahar province), according to the Border Monitoring Team of the Directorate of Refugees and Repatriation (DoRR). This is a 30% decrease in returns from the previous week. Of the total, 1,032 were spontaneous returnees in family groups and 68 were deported individuals. This brings the total number of undocumented Afghan returnees from Pakistan to 5,884 since 1 January 2017.

During the reporting period, IOM assisted 906 (82%) undocumented Afghan returnees from Pakistan, including 97 unaccompanied migrant children, a significant increase from previous weeks. The support provided includes meals and accommodation at IOMs Transit Centers near the border, household supplies and other Non-Food Items (NFIs) for families, special assistance to Persons with Specific Needs (PSNs), and other assistance from partners as per the adjacent table.

Situation Overview

IOM is responding to a substantial increase in the return of undocumented Afghans from Pakistan and Iran. Since 1 January 2016, over 728,000 undocumented Afghans have returned due to diverse push factors, including deteriorating protection space in Pakistan. Many of those returning have lived outside of Afghanistan for decades, and will need support from the government and humanitarian actors both on arrival and as they seek to reintegrate into a country already struggling with widespread conflict and displacement.

While returns have declined in line with seasonal trends during winter, previous surges in returns have been unpredictable and an estimated 1.1 million undocumented Afghans still remain in Pakistan. IOM is prepared to respond to increased needs and is appealing for additional funding to continue its emergency response programming.

Excerpt from:
82% of returnees from Pakistan (906 individuals) assisted - ReliefWeb