SRINAGAR, INDIAN-ADMINISTERED KASHMIR — Arifat Jabeen has already lost one pregnancy due to severe anemia. Her oldest child’s birth two years ago was an emergency because her body wasn’t producing enough blood.
Now, nine months pregnant, Jabeen’s doctors at Lal Ded Hospital have recommended that she have a cesarean section.
“I had to face a lot of problems during my first childbirth, and I fear this time it may be the same,” Jabeen says.
The care Jabeen is getting at the hospital in Srinagar, a main city in Indian-administered Kashmir, isn’t available in her home village, Shopian, about 55 kilometers (34 miles) away. In fact, 38 percent of all pregnant women in Jammu and Kashmir, India’s northernmost state, are anemic, according to India’s National Family Health Survey 2015-16. The condition results from poor nutrition and a lack of access to proper medical care.
One 2013 report, published by the International Journal of Medical Science and Public Health, found that 91 percent of pregnant or lactating women in one Kashmir area were anemic.
Between 40 and 59 percent of pregnant women in India are anemic, according to 2011 World Health Organization data. Globally, anemia affects about 25 percent of all people.
Dr. Snober Malik, a specialist gynecologist at District Hospital Budgam, which serves rural women southeast of Srinagar, estimates that up to 80 percent of the pregnant women she sees have anemia.
It’s common for pregnancies to end in miscarriage due to severe anemia, Malik says. Hospitals aren’t fully equipped to handle the problem, she adds.
“We don’t have a proper blood bank here and always have to keep donors ready at the time of delivery,” she says.
Iron deficiency is common in a Kashmiri person’s daily diet, Malik says.
“People here usually overcook the vegetables,” she says. “As a result, the nutrients are lost.”
Even pregnant women who have access to iron tablets often don’t take them because they feel uncomfortable or nauseated – common side effects of pregnancy.
“But they have to take them,” Malik says.
The lack of awareness is starkly apparent at Lal Ded Hospital.
Seema Jan, another patient there, is 37 weeks pregnant, and she says her remote village doesn’t have any health facilities.
“No one tells us about what to eat and avoid,” she says.
Her doctors have told her that her blood supply is low, but she’s not sure what that means.
“I hope all goes well,” she says. “I am very afraid.”
Raihana Maqbool, GPJ, translated some interviews from Urdu and Kashmiri.