Afghanistan is the worst place on Earth to be a mother, with more women dying in childbirth in the country than anywhere else on the planet, according to a leading British medical charity.
The mountainous country tops a grim league table of the 10 deadliest places on Earth to give birth, according to Merlin, the charity providing medical aid in fragile and crisis-hit countries.
Extreme weather, a rugged terrain and a lack of roads mean many rural women in Afghanistan cannot reach health centres, the charity said.
Many pregnant women are forced to take donkeys to hospital but end up giving birth and often dying during the long journey to medical help on the side of rugged paths.
Merlin said it wanted to see urgent investment to make up for the shortfall in health workers in conflict and crisis countries.
The charity has highlighted the plight of women in Badakshan province, in the far north-east of Afghanistan, which it says recorded the highest ever maternal mortality rate in 2002 of 6,500 women dying for every 100,000 babies born.
Merlin runs two midwifery training schools in Kunduz and Takhar provinces in the north of Afghanistan as well as running 25 mobile health teams in Badakshan able to travel to far-flung villages.
Merlin director of health and policy Linda Doull said: "Only years of working in these challenging areas leads to such intimate understanding of why women are dying.
"Certainly more skilled birth attendants are key to survival, as is ensuring women can reach the clinics.
"Merlin is tackling both these issues through training midwives and running mobile medical teams who trek for hours to reach isolated villagers."