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The birth of hope

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Using a doll - which looks more like a gingerbread man with a tube coming from its stomach - Kuchi demonstrates how to treat the newborn. She carefully shows the women how to make two knots in the umbilical cord, a distance apart, and then cut in between.

While the procedure looks simple enough, thousands of Afghan infants die each year of tetanus acquired from cutting the cord.

If pregnant women don't have one of these ready-made kits, Kuchi says, they need to make one. Boil the string. Wash the cloth and plastic and hang them out to dry. No one who hasn't just washed her hands should be allowed to touch it. In a pop quiz, Kuchi asks a few women to reenact what they just learned.

"If the time comes and we're away, then you can help each other," Kuchi tells them. When in doubt, she says, send for her.

Many families, however, will not - or won't have the option. Some are afraid of having to pay costs they assume are associated with employing a midwife. Kuchi and Musleh, however, do not take any fees. Their visits are paid for by Terre des Hommes, a Swedish aid organization.

"Most of our patients want to have the child at home," says Kuchi. "This way, they can rest there and they don't have to travel and pay for the transportation."

In more remote, rural areas of Afghanistan, where the mortality rate is the highest, there are very few trained midwives, and the lack of transportation makes getting help almost impossible; some villages are accessible only by donkey.

Moreover, many families are unable to recognize an emergency when it occurs. Training by the midwives gives them a better sense of when to know it's time to ask for help.

Toward the end of Kuchi's visit, the women have more questions. One wants to know why she can't conceive - and many others want to know how they can stop.

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