Baharak: Ten years ago there was not a single midwife in the Afghan town of Baharak. Today there are four and the number of women dying in childbirth has fallen dramatically.
Care may still be basic by Western standards, but new midwives like Nasira Karimi mean that in 10 years Afghanistan has seen a staggering improvement in maternal health.
Experts warn these gains are precarious and fear progress could be threatened after Nato combat troops withdraw from Afghanistan by the end of 2014, when some predict the country will descend into renewed civil strife.
Karimi, 24, says stories about the horrors of childbirth convinced her to apply for a coveted place on a two-year course training midwifes to go back into their communities.
In 2000, one in 12 women died as a result of pregnancy and childbirth. In 2010, it was one in 32, according to the World Health Organisation (WHO), which ranks only 20 other countries, including 18 in Africa, as having a worse rate.
According to UNICEF, 6,500 out of 100,000 women died as a result of pregnancy, childbirth or post-delivery complications in Badakhshan in 2002, compared to a national average of 1,600.