In a small village located at the western end of the snow-covered Hindu Kush mountains in Afghanistan's Bamiyan Province, Aziza Rahimi, 35, mourns the baby she lost four months ago after a harrowing birth with no medical care.
Aziza Rahimi, 35, lost her son at birth.
Rahimi, who has five other children, said that riding a donkey to the nearest hospital was out of the question when she was jolted by pain while nine months pregnant in the middle of the night.
Stumbling and bleeding, she walked for two hours to her in-laws' house after her husband was unable to find help to take them to the hospital. She gave birth there. The baby boy died shortly after.
Aziza Rahimi (right) talks to a trainee midwife.
"It was hard for me when I lost my baby. As a mother, I nurtured the baby in my womb for nine months, but then I lost him. It is too painful," said Rahimi.
'When the roads are blocked, of course there is no means of transportation. People even use donkeys to move patients to the clinics, but sometimes there is not even the opportunity for that," said Mohammad Ashraf Niazi, the head of the UNHCR's Bamiyan office.
Rahimi is not the only mother who has lost her child. For many women living in Afghanistan's rugged and remote landscapes, the distance from their homes to hospitals can be the difference between life and death.
Isolation can become a death sentence in any difficult birth, doctors and aid workers say, contributing to Afghanistan's extremely high maternal and infant mortality rates, among the worst in the world.
A young girl plays outside her home in the remote Foladi Valley.
However, a potentially life-saving improvement is on the way. Rahimi's village is one of several that have sent 40 young women to train in the provincial capital, Bamiyan, for two years as midwives, after which they will return home.
Trainee midwives attend a class in Bamiyan.
Since taking over in 2021, Taliban authorities have barred women from universities and most charity jobs, but they have made exemptions in the health-care sector. The UNHCR says local health authorities are supportive of the project.
A trainee midwife examines a woman in a hospital in Bamiyan.
The trainee midwife program has been spearheaded by the UNHCR, the UN's refugee agency, and the Watan Social and Technical Services Association, a local charity. They hope to expand the program, which also takes place in neighboring Daikundi Province.
A trainee midwife examines a woman and her newborn baby at a hospital in Bamiyan.
Many of the trainee midwives, some with small children of their own, have faced logistical and financial challenges, often having to travel huge distances or live far from home to attend the program.
A woman dresses her child at a hospital in Bamiyan.
The notebook of a trainee midwife during a training class in Bamiyan.
"We want to learn and serve the people of our village," said one 23-year-old trainee, who walks two hours each day to the hospital.
The UNHCR asked that the trainees not be named for safety reasons.
A woman in a maternity ward in Bamiyan.
Women giving birth experience a very different situation in Bamiyan's main city hospital, where the trainee midwives work alongside staff and, with the help of a trainer, learn how to assess and guide pregnant women, deliver babies, and provide postpartum care.
Women line up outside a doctor's room at a hospital in Bamiyan.
A trainee midwife arranges her head scarf in front of a mirror at a training center.
"At first, I didn't want to study nursing or to be a midwife, but after I faced problems and pains during my pregnancy, I had a desire to study midwifery," said a 20-year old trainee, the mother of an 18-month-old son who struggled to access care in her village.
She said many women and families in remote areas did not have the information and support they needed to prepare for a safe delivery.
"We have to change such thoughts," she says. "I want to go to remote areas to treat women who face problems."
The snow-covered Foladi Valley in Bamiyan.