“This article is dedicated to all mothers who have had to endure the nightmare of delivery on their own, and every woman who has gone miles through war-torn areas with life inside her and to the unspoken power of motherhood that cannot die when the world has forgotten her”

They say that reality is bitter, and I got the chance to drink that same bitter poison and taste its flavour during the fieldwork for my master’s thesis. Although my thesis was on primary health care (PHC), the direction of my story changed the moment my ears absorbed the accounts of the accidents in a small village hidden among these beautiful valleys.”
All of us feel so happy whenever we make plans and arrange trips to far off, mountainous places. We grow restless with excitement to go there, to soak in the beauty of nature’s gracious gifts, to drink in these lovely valleys and carve this same beauty deep into our hearts.
But have we ever paused to listen to the truth and the untold stories of those incomplete little lives, cradled in the arms of the very mothers who live in these beautiful valleys?
The contractions began at 2 AM one night in December when the temperature in village had gone down to minus fifteen degrees. Instead, a woman who was 8 months pregnant and already bleeding following the diagnosis of placenta previa had to make a decision that no woman would ever wish to make in her life, whether to deliver the baby at home where no medical assistance would be available, or to drive the 50 kilometres to the closest hospital through snow-blocked roads.
Her husband wrapped her up in three shawls and some army truck--the only vehicle that was allowed to cross the barbed wire that had been placed around their village. The journey took six hours. Three army checkpoints. Two times they were shell shocked and had to seek refuge in bunkers along the road. The woman became unconscious with the loss of blood by the time they got to the Government Medical College.
She survived. Her baby girl did not. She would have been our first daughter," woman whispers, her voice carrying the weight of a grief that no mother should know. But, in these mountains, daughters have to struggle to be born.
The story of this woman is nothing unique, it is the systematic deception of motherhood in the border areas of India. According to recent studies that were published in the Journal Healthcare Treatment Development (JHTD), the number of women with reproductive health problems in the border regions of Jammu and Kashmir is horrifying: an estimated 73 percent of women have reproductive health problems, with 39 percent of them exhibiting the symptoms of reproductive tract infections. The figures are applied to materialized realities where pregnancy is a death lottery. A study on the Poonch district published in the International Journal of Advances in Medicine revealed that the Maternal Mortality Rate (MMR) of the district is 104 deaths per 100,000 live births, the highest in Jammu and Kashmir. In contrast, the state capital Srinagar has an MMR of 47 which shows how geography dictates that motherhood is a death sentence.
During my field work in Sonamarg Primary Health Care Centre, I came across a 26 year old woman who was 7 months pregnant and severely anemic, she had never seen a doctor throughout her pregnancy. She said that the ASHA worker visits when she can, but even then, when the snows fall, she is unable to reach us. It is only a hope, when time will come, that the road will reopen.
The connection between maternal mortality and conflict is evident in the dramatic figures. In the days when there were increased tensions between two countries, there was an increase in cases of birth complications that demanded emergency attention by 43 percent in the areas. The infant mortality rate in these areas 24 per 1,000 live births is far over the state average of 17 as well the psychological stress of not being able to live without fear poses extra danger. These are the findings of research conducted in war-touched countries of the world that showed levels of stress hormones in pregnant women who are in conflict zones equal to that of war veterans. This persistent stress exposes children to the risks of preterm births, underweight births and pregnancy related hypertension.
The financial issues that lead to poor maternal health are highly evident. The most of women are illiterate, a number of them are extremely anaemic and most of them are unable to afford adequate food during pregnancy. Basic foods, transport to health facilities, and delivery care that is privately delivered are very expensive that cannot be afforded by families who earn only 200-300 hundred rupees a day. Border and remote areas like this face similar economic struggles, which makes safe pregnancy and childbirth even harder for women.
The overlap between geography and climate forms more levels of maternal risk. Sonamarg and its surroundings are literally well enclosed in the months of winter. During these periods, pregnant women face impossible challenges: attempt dangerous journeys through snow-blocked passes or deliver without medical assistance.
Mothers are not given proper care in the border areas of India due to lack of awareness; it is the most signifying symptom of a more fundamental policy failure. The policies are formulated in the manner that all villages have roads, clinics, and safe transportation, yet in crisis-hit border belts. In such landscapes, pregnant women are simply bleached out of the narrative of development, casualties of a phenomenon known as by experts, policy abandonment, - not due to their location or appearance, but due to their locality and border demarcation.
When the state is determined to save the lives of mothers, it should think about powerful plans and concrete ideas. Emergency funds to support pregnant women in case of collapse of the local systems, mobile delivery units, which can access snowed-in or cordoned-off hamlets, and temporary winter health posts. Risk-averse measures which would ensure safe passage of the medical staff during lockdowns, as well as community birthing centres operated by trained local women, would imply that the survival of a mother would no longer rely on her pin code. Or it might became a choice to continue letting Indian borderland mothers die in the dark.

Email:------------------------kamranbhatt029@gmail.com