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NATIONAL POLITICS & POLICY | Rep. Waxman Opens Investigation of HHS-Funded Women's Hospital in Kabul

NATIONAL POLITICS & POLICY | Rep. Waxman Opens Investigation of HHS-Funded Women's Hospital in Kabul
[Dec. 7, 2007]

Rep. Henry Waxman (D-Calif.), chair of the House Committee on Oversight and Government Reform, on Thursday opened an investigation into possible mismanagement of the Rabia Balkhi Women's Hospital in Kabul, Afghanistan, the Atlanta Journal-Constitution reports (Young, Atlanta Journal-Constitution, 12/7).

HHS in November 2002 started a maternal and child health campaign in response to a UNICEF-CDC survey that found Afghanistan had a maternal mortality rate of approximately 1,600 deaths for every 100,000 live births, one of the highest in the world. Former HHS Secretary Tommy Thompson and officials from the U.S. Department of Defense and Afghanistan's Ministry of Public Health in April 2003 opened the renovated Balkhi Hospital. About $23 million has been spent on the project.

After a 67% increase in infant mortality at the hospital, officials at CDC and the Afghan health ministry began questioning an HHS training program that encouraged physicians to perform caesarean sections without proper training or basic medical supplies. The c-section rate and postoperative infection rate at the hospital increased by 45% and 66%, respectively, according to CDC data. In addition, infants delivered by c-section at the hospital are nearly four times more likely to die than those delivered vaginally.

A contractor's assessment of the hospital found that Afghan physicians at the hospital often did not have basic knowledge of anatomy and physiology and lacked skills needed to resuscitate women and infants. In addition, the hospital routinely lacked basic supplies, including surgical gloves and antibiotics. Officials also have cited problems associated with the hospital's training program (Daily Women's Health Policy Report, 11/20).

Waxman in a letter to HHS Secretary Mike Leavitt requested documents about the hospital's training program. Waxman said that a Nov. 18 Journal-Constitution article about the hospital "raises serious questions about how the Bush administration responded to concerns raised about dismal conditions at the hospital," adding, "Millions of dollars have been spent on this initiative, and those funds should have been spent in ways that most effectively improve the quality of care for Afghan mothers and their babies."

HHS spokesperson Bill Hall said the agency will review Waxman's letter. Hall added that the agency has "worked diligently in extremely difficult and dangerous circumstances to provide the women and children of Afghanistan a sense of hope through [its] work at" the hospital. According to the Journal-Constitution, a team of four experts from HHS are in Kabul assessing the hospital and the reasons for the increased deaths (Atlanta Journal-Constitution, 12/7).

Waxman's letter is available online (.pdf).