When 21-year-old Umida Kuliyeva's family rushed her to the maternity ward of her local hospital in southern Uzbekistan on September 28, there was no reason to suspect the decision would cost the young mother the life of her first baby.
But soon after she arrived at the hospital in the Qashqadaryo region of Uzbekistan, deep in one of the country's major cotton-producing districts, there were signs there could be trouble. The number of hospital staffers at work was dramatically reduced, as much of the personnel was away bringing in the cotton harvest -- an annual tradition in which citizens are essentially ordered to work in the fields as volunteers.
Umida's mother, Norgul Nurmatova, says she thought it was unusual that, upon registration, her daughter was taken not to the maternity ward on the second floor but to an ordinary room on the first floor that was not equipped for childbirth. There, a harried doctor who was just finishing his shift performed a cursory examination and said the family should return home and that Umida was still far from her delivery time.
Then the situation deteriorated rapidly.
"Her water broke, then she began vomiting continually and bleeding started," Umida's mother told RFE/RL's Uzbek Service, known locally as Radio Ozodlik, on October 3. "I pleaded with the nurses to call a doctor from the [maternity ward], but they told me there were no doctors there."
As Umida went into contractions, nurses and a few general practitioners present in the hospital tried to help her. But with no obstetricians among them, their aid was limited to shouting encouragement to the young woman to push. After hours of effort, and totally exhausted, Umida gave birth to her baby, then fell unconscious. The baby died afterward.
Umida's family is now trying to come to terms with a tragedy they say is all the more unexpected because, until she went to the hospital, both the baby and mother had experienced no complications. Umida's husband, Shohruh Nurmatov, told RFE/RL that for nine months doctors told the expectant couple that the baby's health was fine.
Exactly why the infant died is still not known, but some blame may rest with Uzbekistan's yearly practice of constraining vast numbers of its citizens, including hospital workers and other state employees, to leave their jobs and head to the cotton fields. The mass mobilization assures that Uzbekistan brings in its biggest cash crop in a timely fashion, but it also means that only a skeleton staff remains in key facilities and essential services go neglected.
For weeks every September and early October, local authorities arrange transportation to take people out to the fields that dot much of Uzbekistan. The picking day begins soon after dawn and lasts till sunset, with citizens required to bring their own food and often spend weeks in makeshift camps. State enterprises and private companies are required to continue paying their employees' salaries no matter how many days they are away, but no other compensation is provided.
A report released in May by the Australia-based Walk Free Foundation ranked Uzbekistan as the world's second worst country, after North Korea, in terms of the prevalence of state-sponsored forced labor in proportion to the population.
Umida's family believes it has been the victim of gross negligence, but so far has had no luck in getting the local authorities in Guzor district, where they live, to investigate their case.
"When we went to the hospital after the baby's funeral, they told us: 'Go away, we do not have anything to do with you,'" Shohruh Nurmatov says.
Efforts by RFE/RL to learn independently what happened have encountered the same problem Umida faced when she learned there were no doctors in the maternity award. When correspondents called the official responsible for all hospitals in Guzor district, Normahmat Kalonov, they found he, too, was away in the fields.
Speaking briefly to RFE/RL, Kalonov said he had not heard of the case because "from the very beginning of the cotton season I have been at the harvesting site in the fields."
But he denied that the hospital could have been understaffed because of the cotton harvest.
"This cannot be, because I left two physicians on duty in the hospital,” he said. "All conditions there are excellent." He then cut short the conversation and later attempts to reach him were unsuccessful.