This work had been increasingly important lately in Tajikistan. Once part of the Soviet Union, the now independent Tajikistan suffers from a certain anonymity — often referred to since September 11 as "one of the ‘stan’ countries." Where exactly it is on the globe may not be well known, but for CARE, calling attention to the plight of mothers and children may help put Tajikistan on the map.

Traditionally, Tajik marriages are arranged; the girls sometimes are as young as 14. They begin having children shortly after their marriage and continue year after year. Many of these women deliver at home and an unknown number of them die — so many that this one country rivals all of sub-Saharan Africa in the number of maternal deaths.

"Tajik women suffer from serious health concerns," says CARE’s director in Tajikistan, Genevieve Abel. "And some of their children die in young childhood because of malnutrition and lack of access to drinkable water."

Interestingly, Tajikistan was not always this way. It used to have access to modern health care and trained many doctors and medical professionals.

A woman in Tajikistan with her newborn baby. (CARE image)

"Tajikistan has a proud history of medical accomplishments," says Abel. "But this pride is difficult to maintain given the absence of support for health care. The increasingly alarming statistics indicate there needs to be significant change soon."

There is a high number of trained professionals in Tajikistan, so the government does not ask for modern training or technical support. Instead, they focus on acquiring equipment, medicine and textbooks. The result is that doctors and teachers are not continually trained throughout their career and are not versed in modern medical and teaching practices. Additionally, hospitals and schools are not well maintained. This has led to a generation of children who are growing up less educated, less healthy and less well-off than their parents.

"Because of the civil war and the re-adoption of Sah’ria (traditional religious study where girls are educated at home), parents are more literate than their children," says Abel. "In fact, many children are growing up now without any access to education."

Since the end of the Tajik civil war, CARE has been partnering with local Tajik communities to find solutions to these health and education problems. In fact, through CARE’s programs in Tajikistan, 140 midwives in three districts underwent in-service training with the American College of Nurses and Midwives. Additionally, community members and CARE have rehabilitated the delivery wards of three hospitals. CARE also established an education campaign to promote prenatal care and to raise awareness of danger signs during pregnancy.

"CARE is really proactive in supporting women in Tajikistan," says Abel. "CARE recognizes that the situation of women is usually much more vulnerable than men. Women are caregivers; they’re mothers, and they need to be invested in."

In fact, studies by the United Nations show that when girls and women are given access to quality education, health care and economic opportunities, there is a complementary 5 to 10 percent decline in infant mortality rates, and a 20 percent increase in wages. In other words, given a fair chance at a quality life, a woman raises the standard of living for her whole family.

"The Tajik women are fighters; they’re strong, and with CARE by their side, they’re doing well," says Abel.

Abel feels so confident about the future of Tajikistan’s mothers that she even gave her own mother an early Mother’s Day gift — a month-long visit to Tajikistan.