When we began working in Afghanistan and we asked the villagers about their highest priorities, they wanted health care, especially for their children.   It was clearly a need; 199,000 children died before the age of 5 in Afghanistan in just 2009 alone. This is the second-highest child mortality rate in the world. So Trust in Education arranged for and paid a doctor to make weekly visits to the village to provide health care for the children.  Fortunately, within a few months another organization opened a medical clinic, making the doctor’s visits unnecessary.

Trust in Education also examined the viability of providing family planning assistance to the villages. Afghan families are often very large, too large in many cases to provide adequate support for the children. Afghan government and religious leaders had approved a “family spacing program” offered by the Marie Stopes organization that would provide health care training to villagers in addition to family planning. Trust in Education offered to support the cost of training at least 10 villagers, one per village.  While the maliks (village leaders) feigned support for the program, they didn’t provide names of people willing to be trained.

Many other countries have discovered that the fastest way to reduce the birthrate is to provide education to girls. In fact, the World Bank estimates that one year of female schooling reduces fertility by 10 percent, due to a whole host of behaviors that change when girls are educated.  Perhaps Trust in Education’s efforts to promote girls’ education is the best family planning assistance it can provide! The village leaders don’t seem willing to support implementation of a more direct approach.

Trust in Education has come to the conclusion that we can make the most difference in health care by helping already existing health care facilities in the country, which are woefully undersupplied.  To that end, we have facilitated donations from John Muir Medical Center, MedShare and others, which were distributed to Afshar Hospital in Kabul. We plan to continue serving as a intermediary between purveyors of health care  supplies and health care providers.