Describe how Laila gives birth to her baby. Who is responsible for this situation?

When Laila is finally seen by a doctor, the delivery room is completely open, so that all of the women delivering can see one another. The doctor wears a long burqa, and she tells Laila that she needs an immediate caesarian section. However, the doctor whispers to Mariam that there is no anesthesia available for the procedure. Despite Mariam’s protests, the doctor insists that the hospital has very little medical equipment in general. Mariam attempts to get the name of the anesthesia so that she could go get it for Laila, but Laila just asks the doctor to “cut me open and give me my baby.” The doctor goes ahead with the procedure and Mariam is amazed by how long Laila is able to go without screaming. This shows how poor Afghanistan is and how little resources are given to women's health and reproduction.