MELISSA BLOCK, host:
The security situation in Afghanistan presents alarming obstacles for public health. Many Afghans lack access to clean water and sanitation. Child mortality rates are among the highest in the world.
Those and other indicators mean that Dr. Suraya Dalil�is fighting an uphill battle. She is Afghanistan's acting minister of public health, and she's practiced medicine through the last 20 years of turmoil in her country. Dr. Dalil also received a master's degree in public health from Harvard.
She was here in Washington recently and she told me about some improvements in Afghanistan in child and maternal health.
Dr. SURAYA DALIL (Minister of Public Health, Afghanistan): Nine years ago, skilled birth attendants - deliveries are attended by skilled staff - was only six percent. Today, that is 25 percent.
BLOCK: And numbers of women who die in childbirth?
Dr. DALIL: Number of woman who dies in childbirth is still high. Every 30 minutes a woman dies in Afghanistan from pregnancy and childbirth.
BLOCK: Every 30 minutes?
Dr. DALIL: Yes. Ten years ago, the lifetime risk of dying from pregnancy and childbirth was one in nine women in Afghanistan. Today, it's one in 11 women.
BLOCK: So you see some progress. You must imagine you're a long way from where you would want to be.
Dr. DALIL: Exactly. Nine years ago, we only had around 350 health facilities, clinics and hospitals. Today, we have around 1,800 health facilities.
BLOCK: When you think about the security situation in Afghanistan and places where the Taliban are resurging, how much does that complicate the work you're trying to do, both for the people you're trying to help and in terms of training the next generation of health care workers?
Dr. DALIL: It affects. In the last nine months that I'm in office, I have witnessed that health staff are being arrested. One of our provincial health directors was killed. One of our drivers was killed. We have seen those casualties and the impact of conflict.
At the same time, people in Afghanistan - when I went, I have been in one-third of the country in the last nine months. I have went into those provinces myself. And when I go and ask them what makes a difference in their life, what they want the government to do for them? I ask women and I'll ask - I ask the families. And they say school for their children and clinics. They're asking for education and they're asking for health services.
At the same time, when we provide health, that also gives a sense of security and trust that helps trust relationship between the communities and the central government. And not providing health will also undermine security and peace and stability.
BLOCK: How much of the county would you say is really inaccessible to you right now, in terms of the work you're trying to do, places where you can't provide public health to people?
Dr. DALIL: Many places are accessible to us. Many places we can go. But that -in some places we can go easily, in some places we have to negotiate. We have to go to influential leaders. We have to go to influential community elders. But we can go to many places in Afghanistan.
BLOCK: But there would be some places where you cannot go?
Dr. DALIL: Still, yes. There are some places that we cannot go, especially in the south.
BLOCK: When we hear about the resurgence of the Taliban and negotiations that are underway to try to rehabilitate Taliban, there is a lot of fear, of course - and you've heard it much more than I have, of what happens to progress made, for example, with the rights of women. What do you see on a daily basis that makes you concerned about that? How do you see that shaping up?
Dr. DALIL: We have made tremendous achievements for women in Afghanistan in the last nine years. However, the challenge for us is to sustain those achievements and to expand those achievements for women. I have three daughters. And I want a better future than what I and what my mom used to have.
BLOCK: And how confident are you that that future that you want for them that is better than what you saw and what your mother saw, how confident are you that that is the future of Afghanistan right now?
Dr. DALIL: I will work for that. I will play my part to make sure that my children and children of Afghanistan, and girls in Afghanistan, have a better future than what we used to have. I think it's everybody's responsibility in Afghanistan to make sure that that happens.
BLOCK: Dr. Dalil, thank you very much for coming in.
Dr. DALIL: You're welcome.
BLOCK: Dr. Suraya Dalil is the acting minister of public health for Afghanistan.
NPR transcripts are created on a rush deadline by a contractor for NPR, and accuracy and availability may vary. This text may not be in its final form and may be updated or revised in the future. Please be aware that the authoritative record of NPR's programming is the audio.