INTERSOS IS SCALING-UP OPERATIONS IN AFGHANISTAN
The economy crashes, hunger grows and over 24 million people require humanitarian assistance
Photo by ©Alessio Romenzi
After 40 years of conflict and political turmoil, there is currently deep uncertainty about what the future holds for people in Afghanistan. Although there has been a substantial reduction in the fighting, the situation remains volatile and it is becoming increasingly difficult for people to make ends meet. Decades of violence combined with recurring drought, COVID, the collapse of the economy, job losses and the loss of livelihoods, mean that today 24.4 million people – more than half the total population – are in need of humanitarian assistance.
One of the most-pressing concerns is the ongoing hunger crisis. Almost 20 million people are experiencing acute levels of food insecurity, and a small pocket of famine has been detected in the northeast of the country where more than 20,000 people are currently facing catastrophic levels of hunger. Children are particularly vulnerable and are among those feeling the effects the most. This year, 3.2 million children are expected to suffer from acute malnutrition, and it is estimated that one million of them will die if they do not receive immediate treatment.
Although there is food in the markets, the problem is that no one can afford to buy it anymore. Prices have risen by nearly 40 per cent in the eight months since August, the currency has lost considerable value against the dollar, and half a million Afghans lost their jobs when the Taliban – now known as the IEA (Islamic Emirate of Afghanistan) – came to power. This has led to a substantial reduction in people’s purchasing power and, as money runs out, it is becoming increasingly difficult for people to put food on the table. As a consequence, families are resorting to ever-more desperate measures to try and do so. More and more people are sending their children out to work, and more and more people are selling their daughters into early marriages as they struggle to survive.
For women and girls combined, the situation is especially bleak, as they face ever greater restrictions on their lives, their freedom of movement and their ability to participate in society. Gender-based violence is on the rise, and women’s and girls’ access to health care is becoming increasingly difficult. The health system was hanging by a thread even before the pandemic hit. Now, it is struggling to cope. Prior to August, health care in Afghanistan was largely funded by the World Bank, but this funding was cut when the Taliban took control of the country. Many hospitals and clinics have been unable to keep their doors open as a result, leading to dire consequences. There are reports that over 13,700 newborn babies have died since the beginning of the year and we fear that maternal mortality is also on the rise – a devastating backwards step, considering that Afghanistan’s maternal mortality rate was already among the highest in the world even before the events of last year.
With the needs in Afghanistan continuing to grow, it is vital that the humanitarian response is scaled-up. INTERSOS will soon be launching 12 new clinics to do just that, but NGOs cannot meet the growing needs of the population alone. Ensuring that no one falls through the cracks of the emergency response requires a concerted effort from everyone working in Afghanistan. It is vital that the governing authorities put the needs of the Afghan people first – particularly the needs of women and girls. And it is equally vital that the international community continues its support to the people of Afghanistan. We must all work together to achieve this and to prevent the crisis from deepening any further.
A counseling room at one of our health facilities in Spin Boldak District
Our intervention in Afghanistan
Our projects in Afghanistan are concentrated in the provinces of Kabul, Kandahar and Zabul, in areas where the conflict was particularly acute. In these parts of the country we support several primary health centers in the districts of Surobi, Shakardara, Ehsabz, Bagrami, Spin Boldak, Maywand, Shawalikot and Zheray as well as to Qalat hospital and Kharwaryan and Shajoy health centers in Zabul province. In the coming weeks, we will be launching 12 new health clinics in areas that were previously inaccessible due to the conflict, providing health consultations, ante- and post-natal care, vaccinations and screening for malnutrition.
Supporting the health system in Afghanistan
After the collapse of the previous government and the subsequent cut in development funding, multiple health facilities have been forced to close, and increasing numbers of people are coming to our health centres for treatment – especially in the more remote areas. In the province of Kandahar, in the districts of Maywand and Panjwaye, we manage two First Aid Trauma Points (FATPs), which are specialised health facilities, open 24 hours a day, providing life-saving assistance – especially to landmine and car crash victims. One surgeon, one anaesthetist, three nurses and one radiologist are involved in stabilising the most critical cases, reducing the risk of death and complications related to trauma, and providing diagnostic X-ray services. Cases with severe injuries requiring advanced care – amputation and rehabilitation, skull fractures requiring further examination – are stabilised and referred to Mirways Regional Hospital in Kandahar. At these FATPs, we also provide essential equipment, drugs and other medical supplies.
In addition, we currently run 12 health clinics, consisting of a doctor, a midwife, a hygiene promoter and two nurses – one of whom is a nutrition expert, the other carries out routine vaccinations for communicable diseases. Our medical teams perform rapid diagnostic tests for specific diseases such as malaria and syphilis, provide ante- and post-natal care, and transfer women with complicated pregnancies to secondary health care facilities. In these clinics, we also have a protection team, providing support to at-risk women, children, and people with disabilities – as well as two child friendly spaces where children can play and also learn the basics of education. Finally, we support the Qalat hospital through staff training and the supply of medicines.
Maternal and child health in Afghanistan
In Afghanistan only 60% of births take place in the presence of a healthcare professional and 638 women out of 100,000 die in childbirth. This is a number 300 times higher than the figure for a country like Italy, where there are 2 cases of death for every 100,000 births. As well as having a dedicated midwife in each of our health centres, we also provide counseling, vaccinations and routine treatment; we refer HIV suspected cases for advice and further tests to the regional hospital of Kandahar; we guarantee safe births and provide health care to mothers and babies through ante-natal and post-natal visits; and we distribute kits for newborns.
We also deal with the therapeutic treatment of severe acute malnutrition for children aged 6-59 months, as part of the Outpatient Therapeutic Program (OTP), and continuous screening to identify cases of malnutrition. Cases of severe malnutrition, on the other hand, are referred to the reference structures in Spinboldak, Maywand, Zheray, the Provincial Hospital of Qalat and the Mirwais Regional Hospital in the city of Kandahar, where they receive specialised treatment.
Since last year we have also been at the forefront of the fight against the COVID-19 pandemic, with the distribution of personal protective equipment, triage and training sessions for healthcare personnel and awareness of good hygiene practices. In addition to health interventions, our commitment in Afghanistan also concerns psycho-social assistance and economic support for vulnerable people, in particular women – including survivors of gender-based violence – children and the elderly.