Afghanistan COI Repository

Afghan Red Crescent, Kunar (31 December 2022) [EN/Dari/PS], 31 December 2022

“For the past 20 days, the mobile health team has examined 1225 people, dressed 48 people and has provided medical consultations to 1474 people in nearby different villages of Naari district of Kunar province. In addition to central & complex hospital. ARCS also has 46 Permanent & hundreds of mobile health clinics in 34 provinces of the country, which are providing round-the-clock health services to vulnerable people and provide free of cost health services to thousands of citizens on daily basis.”

 

HealthNet TPO (HNI), HealthNet TPO stands with women’s right to work and continues life-saving activities following ban on women working for NGOs in Afghanistan, 30 December 2022

“Women are at the heart of HealthNet TPO. They are our doctors, our nurses, our midwives, counsellors, social workers, lab technicians, community health workers, finance officers, project managers and many more. It is through our female colleagues that we can reach women and children, the most vulnerable group in Afghanistan, to improve their health and wellbeing. Most women can only be helped by female health professionals. Without them, we will be unable to provide life-saving aid, preventing women from accessing healthcare. The recent ban on women working for NGOs comes on top of the closure of secondary schools and the ban on women attending universities. Not allowing women to study and to work is detrimental to all. Female workers are critical to the provision of humanitarian aid and healthcare in Afghanistan. The ban limits humanitarian access and will have a devastating effects on the future of the country. Afghanistan needs more female doctors and nurses, not fewer. The lives of women and children are at stake. Currently, HealthNet TPO can continue all health activities within health facilities managed by the organisation as our female colleagues have not been prohibited from working here.

This must not change. However, our female staff within our offices who play an essential part in the functioning of the organisation and the delivery of our health projects have been affected as well as our health activities that support women and children directly within their communities. HealthNet TPO cannot and does not want to function without the full and safe employability of its female colleagues. The organisation is committed to working with (I)NGOs, the UN, donors and all relevant stakeholders to ensure this situation is resolved so that we are able to return to supporting the Afghan people across society, helping them to meet their urgent needs, rebuild livelihoods and create a peaceful, healthier future. About HealthNet TPO in Afghanistan HealthNet TPO supports the people of Afghanistan since 1994, improving the lives of millions of people through projects focussed on health, mental health and disease prevention and control. The organisation runs 23 projects in 19 provinces across the country delivering basic and specialised healthcare, mental health and psychosocial support services and emergency health interventions. More than 6,200 staff work for HealthNet TPO in Afghanistan, 2,016 of whom are female. In 2021, 2.3 million people received treatment through 135 primary and secondary health centres. Amongst many achievements, the organisation treated more than 66,000 children under five for severe acute malnutrition and provided emergency humanitarian support to almost 600,000 vulnerable people particularly women and children. In the early 2000’s, HealthNet TPO was a driving force in transforming the female health workforce in Afghanistan to improve the mortality rates of women and children. Through our training programmes for female midwives, nurses and health professionals we helped to save lives and improve the health of women and children and continue to do so.”

 

MSF, Afghanistan: MSF condemns the ban on women working for NGOs, 29 December 2022

““More than 51 percent of our medical staff [in Afghanistan] are women,” said Filipe Ribeiro, MSF country representative in Afghanistan. “We are talking about nearly 900 doctors, nurses, and other professionals who strive every day to give thousands of Afghans the best care possible. MSF operations couldn’t exist without them. This newest directive is just another step in a systematic attempt to expunge women’s presence from the public domain—to everyone’s detriment.” Female workers play a critical role in the provision of humanitarian assistance and health care services in Afghanistan—a country where people are mostly dependent on humanitarian aid and face extreme poverty in part fueled by skyrocketing unemployment. No organization—however big or small—can deliver assistance to communities in need without the participation of women. The consequences of this latest decree will hit vulnerable groups the hardest, such as female patients and children, for whom it will become even more difficult—if not impossible—to see physicians.

For the time being, all of MSF's activities have been maintained as our female colleagues continue to work unhindered in the health facilities managed by MSF and the Ministry of Health. This must not change: Prohibiting women from working would effectively prevent women and girls from accessing health care. Excluding women from the work force is against every principle of humanity and medical ethics to which health professionals subscribe. “If women are prevented from working in health facilities, and if women can only be treated by women, then it will be virtually impossible for them to access health care,” said Ribeiro. “As a result, no health care provider, including MSF, will be able to deliver medical services in Afghanistan.” “Over 90 percent of our medical staff in Khost Maternity Hospital are females,” said Ribeiro. “They assist with the delivery of 1,800 babies every month. If this policy is fully implemented, more mothers will face additional—perhaps insurmountable—barriers to prenatal and postnatal services. They’ll have nowhere to go.” In addition to the closure of secondary schools in March 2022, the Ministry of Higher Education recently announced the decision to ban women from attending private and public universities. This will undoubtedly worsen the situation in the long-term. “The health care system in Afghanistan struggles to meet people’s basic needs,” said Ribeiro. “If patients can’t get treatment today, what will happen in the future when half of all potential medical students are not allowed to study. In Khost, we already find it challenging to fill all necessary positions, including gynecologists who are extremely scarce across the region. We need more female doctors, not fewer.” In order for essential services to be available to all genders, they must be delivered by all genders. That is why MSF in Afghanistan remains committed to serve all those in need of medical care, by maintaining our current teams as they are. In Afghanistan, MSF runs seven projects focused on secondary health care in Helmand, Kunduz, Herat, Khost, Kabul, Kandahar, and Bamiyan. More than 1,700 medical professionals work for MSF in Afghanistan, 894 of whom are female, 835 are male. In 2022, MSF teams provided more than 250,000 outpatient consultations, 42,000 inpatient admissions, 71,000 emergency room admissions, 11,000 surgical interventions, and 35,000 deliveries. Across MSF’s projects, there were 5,000 children enrolled at the ambulatory therapeutic feeding centers, 7,000 children admitted to the inpatient therapeutic feeding centers, 9,500 measles patients treated, 22,000 consultations for drug-sensitive tuberculosis, 2,000 drug-sensitive tuberculosis patients started on treatment, and 80 drug-resistant tuberculosis patients enrolled on treatment.”

Médecins du Monde (MDM), Afghanistan: Médecins du Monde suspends activities and calls for the lifting of the ban on women aid workers, 28 December 2022

“On December 24, Médecins du Monde and other non-governmental organizations (NGOs) working in Afghanistan received a letter from the authorities stating that women were no longer allowed to work for national and international NGOs in the country. Médecins du Monde strongly condemns this decision and has decided to suspend its activities in Afghanistan. As Afghanistan faces economic collapse and a severe humanitarian crisis, NGOs play an essential role in saving lives and bringing aid to the population. Banning women from working will only have a dramatic and devastating impact on the lives of millions of vulnerable women, men and children in the country. By prohibiting women from working in NGOs, a red line has been crossed. Médecins du Monde (MdM) is taking the difficult decision to suspend its activities because an effective humanitarian response in line with humanitarian principles cannot be achieved without women. A choice also made by several NGOs in the country since the announcement on December 24. MdM calls for the lifting of the ban on women aid workers to resume its activities in the country. This decision made by the authorities comes just a few days after restrictions on Afghan girls' access to education were increased. Afghanistan is a historical mission of Médecins du Monde. After being present in the country for 30 years, from 1982 to 2012, MdM has decided to come back at the end of 2021. Currently, MdM is supporting a district hospital in Kabul through the physical rehabilitation of the structure and support in mother and child health. 150,000 people benefit from the medical services offered by this hospital.”

 

UNFPA, Taliban banning women from higher education and from working with humanitarian organizations, 27 December 2022

“Statement by Dr. Natalia Kanem, Executive Director of the United Nations Population Fund, UNFPA I strongly condemn the recent decrees by the Taliban de facto authorities banning women from higher education and from working with national and international humanitarian organizations. These decisions violate international human rights law and deny women and girls in Afghanistan the freedom and ability to make their own choices and decisions, depriving them of their autonomy and the rights to which they are entitled as human beings. […] Women are also key to an effective humanitarian response. Each month, 24,000 women give birth in hard-to-reach areas of Afghanistan, and these women need health services to deliver safely. UNFPA, the United Nations sexual and reproductive health agency, counts on female humanitarian workers to deliver life-saving health and protection services to women and girls in Afghanistan. Over the past year, they and other partners helped UNFPA reach 4.3 million Afghans with essential reproductive, maternal, newborn and child health services, and nearly 1 million people with psychosocial support services, life-skills training and information. UNFPA stands in solidarity with the people of Afghanistan, as we have done for the past 46 years. We call on the de facto authorities to allow women and girls to return to school and to allow women working for non-governmental organizations to continue their life-saving work for the millions of Afghan people in dire need.”

 

ICRC, Afghanistan: ICRC deeply concerned for millions of women and girls, 25 December 2022

“Kabul (ICRC) – The International Committee of the Red Cross (ICRC) is concerned by the recent announcement of the Islamic Emirate of Afghanistan (IEA) suspending with immediate effect the women's rights to study higher education curriculums and to work with national and international non-governmental organizations across the country. The exclusion of women and girls from the education system at all levels and potentially from their essential humanitarian roles can and will lead to catastrophic humanitarian consequences in the short to long term. The ICRC in Afghanistan employs hundreds of women. Humanitarian work in Afghanistan and around the world is only possible thanks to the efforts of all staff, including women. Questioning the full inclusion and participation of women in operations would jeopardize the whole humanitarian action. The ICRC is particularly concerned about the future of the Afghan healthcare system and its female patients. Since November 2021, the ICRC has been supporting 45 health structures including hospitals and medical schools, with a total capacity of 7057 beds serving an estimated population of 26 million people. This support includes the payment of the running costs, medical consumables and the salaries of 10,483 health workers (around one third - 33% - of which are women). This support is ongoing and discussions are currently taking place with relevant authorities regarding the impact the recent decision might have

on it. It is clear that if women are no longer able to complete their health studies, in different specialties, it will have an even more severe impact on the delivery of healthcare services across Afghanistan, putting millions of lives at risk. At a time at which more than half the population (over 24 million people) is in need of humanitarian assistance, we urge the IEA authorities to consider the impact of the recent announcement on the population and to find a solution that will enable all humanitarian actors, to continue delivering life-saving assistance to millions of Afghans.”

 

WHO, Afghanistan Health Cluster Bulletin, November 2022, 23 December 2022

“HIGHLIGHTS

• As of 30 November, a total of 206,704 confirmed cases, and 7,838 deaths of COVID-19 were reported. The recovery rate was 89.5% with a 3.8% case fatality rate.

• The leading causes of morbidity among all age groups were Acute Respiratory Infection (ARI) and Acute Diarrheal Disease (ADD) across the country.

• WHO provided 811 metric tons of medical kits and non-medical supplies to more than 236 health facilities across 34 provinces. It will benefit more than 3.8 million people in the coming three months.

• IOM continues to support the operation of the Cholera Treatment Center (CTC) for mild and moderate cases in PD 12 Kandahar city

• UNICEF prepositioned health supplies with the mobile health and nutrition teams so that they can access remote under-served ice-clad terrain during the winters and maintain the lifeline of health and nutrition services to the extent possible.

• UNFPA supplied 70 RH kits to support emergency reproductive health services for 13,515 childbearing aged women.

• Agha Khan Health Services (AKHS) trained 190 healthcare workers including 69 female and 121 males in

Ataturk Children hospital to provide free lifesaving services to the vulnerable children.”

 

WHO, Afghanistan vaccinates 5.36 million children against measles and 6.1 million children against polio in a nationwide campaign, 22 December 2022

“22 December 2022, Kabul — Afghanistan has vaccinated 5.36 million Afghan children 9–59 months against measles while 6.1 million children 0-59 months received oral polio vaccine in a nationwide vaccination campaign held from 26 November to 12 December 2022. Based on the data from Afghanistan's Ministry of Public Health Expanded Programme on Immunization, the campaign covered 329 districts in all the 34 provinces of Afghanistan. There were 4341 vaccination teams comprising 4 team members on each team. “It warms my heart that we were able to protect Afghan children from measles and polio as we enter the harsh winter season in the country,” says Dr Luo Dapeng, WHO Representative in Afghanistan. “This is the first nationwide integrated measles and polio campaign in Afghanistan since the transition in August 2021 and I thank all the health workers, partners and donors who made this possible.” In 2022, many measles outbreaks were reported in Afghanistan. As of November 2022, Afghanistan has confirmed 5484 measles cases with approximately 300 deaths attributed to measles infection. Most of the measles cases are among children under-5 years old. Prior to the nationwide campaign, a series of subnational measles immunization campaigns were conducted in 141 districts covering approximately 3 million children. Measles is a dangerous disease, with complications that can include severe diarrhoea and dehydration, pneumonia, ear and eye complications, encephalitis or swelling of the brain, permanent disability and death. There is no specific treatment for measles. The only reliable protection from measles is vaccination. “While measles is highly contagious, it is also a preventable disease. We must not lose the decades of progress we have achieved in immunizing and protecting Afghan children. The measles vaccine is safe and has been in use for more than 50 years. The benefits of vaccination are clear, as evidence shows measles vaccination saved over 23 million

lives worldwide over the past 20 year period,” added Dr Dapeng. The measles campaign in Afghanistan was supported by WHO and UNICEF in terms of vaccine procurement and delivery, development of immunization guidelines and communication materials, and building the capacity of health workers to manage and implement the campaign and ensure that all eligible children are protected through safe and effective vaccines for measles and polio. Financial support for the campaign was provided by Gavi - the Vaccine Alliance.”

Afghan Red Crescent, 23 Children Suffering From Cardiovascular Septal Defect Were Referred To Global Hospital By ARCS For Therapy & Surgery Treatment In Capital Kabul!, 22 December 2022

“In Current month, ARCS has introduced 86 children suffering from cardiovascular septal defect to different hospital in capital Kabul. In last one year, ARCS has referred 465 children suffering from cardiovascular septal defect for therapy and surgery treatment to hospitals, of whom 9 patient were sent abroad. The above-mentioned each patient costs between 75000 AFN to 210000 AFN, which is paid by ARCS.”

 

Afghan Red Crescent, Farah (22 December 2022) [EN/PS], 22 December 2022

“The employees of mobile health team of ARCS is providing health services, to those vulnerable and needy

families, who do not have access to health clinics, nearby Chakab village of Balabolak district of Farah province.”

 

WHO, Italy commits €6 million to improve equitable access to health care facilities in Afghanistan, 21 December 2022

“21 December 2022, Kabul, Afghanistan – The Government of Italy, via the Italian Agency for Development Cooperation (Pakistan and Afghanistan offices), has allocated €6 million to the World Health Organization (WHO) in Afghanistan to improve people’s access to health services in primary and secondary health care facilities in 5 provinces: Hilmand, Kandahar, Nimroz, Zabul and Uruzgan. While health care facilities across Afghanistan are closing or facing significant resource shortages, health needs are increasing rapidly. WHO and its partners continue to deliver health services to ensure that primary and secondary health care services are available to people from under-served communities who are at high risk for infectious diseases like acute watery diarrhoea, measles, respiratory infections and polio. The complexity and severity of the ongoing humanitarian crisis in Afghanistan has increased the number of people in need of health assistance by 16%, from 24.3 million in 2022 to a projected 28.3 million in 2023. Through the funding received from the Italian Government, WHO will conduct life-saving health interventions at the primary and secondary levels in the southern region of the country to reduce avoidable deaths from disease. “Italy’s contribution to Afghanistan is crucial for WHO to further strengthen primary and secondary health care services in vulnerable communities,” says Dr Luo Dapeng, WHO Representative in Afghanistan. “This strategic support will also reinforce the preparedness and response capacities of public hospitals for future

outbreaks and health emergencies.” Her Excellency Ms Natalia Quintavalle, Ambassador of Italy to Afghanistan, added, “We are strongly committed to further enhancing health care service delivery in under-served areas for the people of Afghanistan.” She added that, “Italy is committed to working with WHO to enhance health care services and build a healthier future for all Afghans”. "WHO and the Italian Agency for Development Cooperation – AICS – have longstanding experience of promoting joint projects, with Italian excellence, focusing on providing primary health care services to the people of Afghanistan," added Mrs Emanuela Benini, Director of the AICS office based in Islamabad. With the funding from Italy, WHO will support 31 health facilities targeting more than 221 889 beneficiaries from the under-served population. These facilities are spread out across 25 districts and 31 main villages. Moreover, WHO will ensure mainstreaming of gender equity and human rights dimensions across all activities. The focus will be on adopting an equitable approach that leaves no one behind to address multiple vulnerabilities based on gender, age, ethnicity and other social stratifications.”

 

WHO, Afghanistan: Infectious Disease Outbreaks - Epidemiological week # 50, 2022 (11 to 17 Dec 2022) Situation Report #71, 21 December 2022

“Acute Watery Diarrhea (AWD) with Dehydration Outbreak (01 May to 17 Dec 2022) Current Week

3,795 new cases (57.4% under 5)

1 new death

0 new districts reported new alerts 5 samples collected

Cumulative Figures

237,258 cases (<5 years, 55.3%)

86 deaths (77.9% < 5 years), CFR=0.04%

175 districts in all 34 provinces

2,633 samples collected

• During week 50-2022, a total of 3,795 new AWD cases with dehydration and 1 new death were reported which indicates stabilization in the number of cases, compared to the previous week (Figure 2).

• The highest number of new AWD cases were reported from Kabul (962, 25.3%), followed by Helmand (551, 14.5%),

  Baghlan (532, 14.0%) and Balkh (317, 8.4%) provinces.

• The newly reported death, was a female under 5 years old from Jawzjan province.

• Cumulatively, Kabul (54,120, 22.8%), Helmand (40,749,

  17.2%), Baghlan (17,1196, 7.2%), Nangarhar (12,758, 5.4%),

  Kandahar (12,535, 5.3%), Jawzjan (9,187, 3.9%) and Paktya (8,528, 3.6%) are the most affected provinces (Figure

  1).

• Out of the total 237,258 cases, 131,257 (55.3%) were children below 5 years and 118,497 (50.0%) were

  females (Figure 3).

• The first few cases of AWD were reported to the National Disease Surveillance and Response System (NDSR), MoPH and WHO on 04 May 2022 from Kandahar city of Kandahar province and spread to 175 districts in 34 provinces.”

   

  Afghan Red Crescent, Farah (20 December 2022) [EN/Dari/PS], 20 December 2022

  “Access to health is one of the basic human rights! For this purpose, the employees of contractual health team of ARCS, are providing health services to the public in nearby Asad village, the remote area of Gulistan district of Farah province.”

   

• Afghan Red Crescent, Inauguration Of A New Sub-Clinic By ARCS In Lariz Area, The Center Of Daikundi Province! [EN/PS], 20 December 2022

  “The inauguration ceremony of sub-clinic was attended by Mawlavi Meer Ahmad "Hashimi" the in-charge of ARCS branch in Daikundi province, Mawlavi Ameen Ullah the governer of Daikundi province, Rahmat Ullah "Mamak" provincial director of public health, Sami Ullah "Sabit" provincial director of labour and social affairs, Mawlavi Khalil "Hanif" provincial director of Justice and other high-ranking authorities of some other departments. The doctors of ARCS will provide services in afore-mentioned sub-clinic in the field of surgery, Obstetrical and Gynecological, malnutrition and internal diseases. And dressing medical sections, which provide health services, to vulnerable people.”

   

  UNAMA, Briefing to the United Nations Security Council by the Secretary-General's Special Representative for Afghanistan, Roza Otunbayeva New York, 20 December 2022

  “These somewhat positive economic developments might not be sustainable if the real concerns of Afghans are not addressed. Between 11 October and 8 November UNAMA carried out stakeholder meetings in 12 provinces which were selected to ensure a representation of all Afghan communities and sectors. We engaged with 519 participants, including 189 women and 83 representatives of the de facto authorities. The concerns expressed by the population had to do with […] lack of health facilities, mental health problems of the population, poverty and economic insecurity and discrimination of ethnic minorities. The Taliban have not addressed these issues and in many cases their decisions have made them worse.”

   

  GPEI, Polio surveillance review yields results in Afghanistan, 19 December 2022

  “Recommendations from the international review of Afghanistan’s poliovirus surveillance system are yielding important results for the country’s eradication programme. The review team, comprising of experts including virologists and epidemiologists, visited Afghanistan in June, conducting a comprehensive nationwide assessment of the country’s polio surveillance system. Among their recommendations was the need to address gaps in environmental surveillance and expand the number of environmental surveillance sites in areas deemed high risk

  for polio, including the country’s east, southeast, south and west regions, to ensure any presence of the virus is quickly detected. Afghanistan’s AFP surveillance system – monitoring for signs of Acute Flaccid Paralysis in children under 15 years of age – is complemented by environmental surveillance – the collection of sewage samples at designated sites to check for the presence of the virus in the community. Together, they enable the programme to detect where the virus may be circulating and, importantly, mount a timely response. Following the review’s recommendations, three new environmental surveillance sites have now come online, bringing the total number of sites in Afghanistan to 32. One of those sites, at Pezand Pana Dafter in Nangarhar province has produced three positive environmental samples since coming online in September. The programme quickly mounted a response targeting 1.4 million children under 5 years of age in all four eastern provinces – Nangarhar, Kunar, Laghman and Nuristan. “Surveillance is the eyes and ears of the polio programme, and environmental surveillance plays an important part in eradicating polio because it enables the programme to detect the presence of the virus,” says Dr. Khushhal Khan Zaman, who oversees polio surveillance for WHO Afghanistan. “Environmental surveillance tells us very plainly where transmission is likely happening.” WHO guidelines stipulate that an environmental site be located in areas with substantial populations, and with flowing sewage water. In Afghanistan, sites are established in major cities and larger population centres with existing wastewater and drainage systems. Communities with mobile populations are also a focus. Samples are regularly taken and sent to a WHO-accredited polio laboratory for testing. Afghanistan has made significant progress in interrupting transmission of the virus. From 56 children paralysed by WPV1 in 2020, so far this year there have been two cases, in Paktika and Kunar provinces. Seventeen positive environmental samples have been detected in 2022, all in the country’s east region. Further environmental surveillance sites are planned as WHO Afghanistan continues to implement recommendations from the surveillance review.”

   

  UNFPA, Japan's contribution to strengthening maternal health care in Helmand, 18 December 2022

  “Kabul, Afghanistan – The Government of Japan is contributing an additional USD 1.3 million to UNFPA’s response to the escalating crisis in Afghanistan to boost life-saving reproductive health interventions for women, girls and youth. The new funding will support the continuation of services at 29 Family Health Houses in Helmand, strengthen the referral system for emergency maternal and newborn care, and support young people’s access to reproductive health and psychosocial support services and information. Japan’s assistance will also support the provision of Mama and Baby Kits and medical equipment and supplies for mothers who have just delivered their babies. The new interventions aim to reach about half a million Afghans over a period of one year. The new funding brings to USD

  2.2 million Japan’s total contribution to the 2022 UNFPA Afghanistan Humanitarian Response, which requires USD 251 million to reach 9.28 million of the most vulnerable population in the country with humanitarian assistance. Japan’s support has reached more than 20,000 Afghans this year, mostly women and girls, with reproductive and maternal health services, psychosocial support, and distribution of Dignity Kits. Japan has also contributed to the procurement of medical equipment and supplies for reproductive health, adequate to cover at least 102,000 people in need of reproductive health services in the country. The funding has supported women-centered services in Herat, Nimroz and Kandahar.”

   

  Afghan Red Crescent, Kapisa (18 December 2022) [EN/Dari/PS], 18 December 2022

  “The mobile health team of ARCS is providing health services to those vulnerable people, who don't have access, to health centers in Tagab district of Kapisa province.”

   

  Première Urgence Internationale, Première Urgence Internationale receives medicine and medical supplies serving more than 476,800 people in Afghanistan, 18 December 2022

  “Kabul, 18.12.2022. An airplane carrying 200 pallets of essential medicine, medical consumables and equipment with a volume of 100 tones arrived in Kabul on Sunday. This is the largest shipment that Première Urgence Internationale has received since the organization started it first intervention in 1979. It is the first fully loaded charter flight that will meet urgent needs for medicines and medical supplies at Première Urgence Internationale's health facilities and those supported by the organization. This aid is urgently needed as freezing winter conditions worsen, leaving millions of families in desperate circumstances as they struggle to keep their homes warm and provide for their

  families. Almost 23 million people - more than half of the country's population - are facing acute food insecurity. One million children are at risk of the most severe form of malnutrition. The medicines Première Urgence Internationale received today will allow medical staff to supplement treatment for malnourished children, increasing the chances of rapidly improving their nutritional status and reducing the risk of further complications. As the frequency and severity of respiratory infections has already increased, and with the onset of winter in Afghanistan it is likely that these will increase further, our facilities will now have an adequate supply of medicines to rationally treat such and other diseases. "In light of the rapidly deteriorating humanitarian situation and shortage of medical supplies, I am pleased to see this large quantity of medicines and medical supplies being delivered directly to Afghanistan, alleviating access constraints to remote and rural populations in urgent need of medical care. Especially with the poverty situation and another harsh winter just ahead, our biggest concern was to provide the vulnerable communities with the health care they need, as we have seen an increase in cases of malnourished children and respiratory infections in our facilities.” said Justyna Bajer, Première Urgence Internationale’s Head of Mission for Afghanistan. The medicine and equipment will be distrusted to Première Urgence Internationale’s fixed and mobile health facilities. In total 69 health facilities (including Therapeutic Feeding Units, First Aid Trauma Posts, Maternal, Newborn and Child Health departments) and four ambulances will receive enough medicine and equipment to meet the majority of the health needs of more than 476,800 people across four provinces in the eastern, two provinces in the southeastern region. For the next six months, Première Urgence Internationale’s medical staff will be able to provide quality health care services to mothers and children, trauma and other patients. At a time when more than to 18 million people in Afghanistan are in need of health assistance, 3.19 million are children under five years, the constant availability of medical supplies is of upmost importance. Since the authorities of the Islamic Emirate of Afghanistan (IEA) took control of the country in August 2021, the majority of funding was stopped, financial assets remain frozen causing interruptions in vital services within the health sector. Première Urgence Internationale’s health facilities are mostly located in remote and underserved areas such as villages or smaller towns, where its staff provides primary health care, nutrition counseling, trauma care, maternal and child health, and psychosocial support. Access to quality health care remains a major concern for rural and remote communities across Afghanistan. Afghanistan is on the brink of an economic collapse with close to 70 per cent of the population living below the poverty line. Most families can’t even afford the costs for transportation to the nearest health facilities. To access health services, people often have to travel for several hours, sometimes in unsafe conditions that put them at additional health risk. Ensuring the availability of quality primary health care for rural and remote communities in Afghanistan is Première Urgence Internationale’s primary concern. Première Urgence International is a non-governmental, non-profit, non-political and non-religious international aid organization. Première Urgence International’s teams are committed to support vulnerable communities and populations, those marginalized, hit by conflict, natural disaster or economic downturns. In Afghanistan, Première Urgence International, known as Première Urgence - Aide Médicale Internationale (PU-AMI), launched is first medial intervention in 1979. Première Urgence International delivers an integrated health care package, combined with nutrition, psychosocial support, water, sanitation and hygiene (WaSH), as well as trauma services. The organization implements projects mainly in eastern parts of the country, and increasingly in the southeast and central Regions. Since the COVID-19 outbreak in 2020, PUI has also positioned itself as one of the main actors in preparedness and response to the pandemic, implementing health and WaSH-centered activities at health facilities and community level in Kabul and beyond.”

   

  UNICEF, UNICEF Afghanistan Humanitarian Situation Report No.12 for 30 November 2022, 16 December 2022 “UNICEF’s winter response is ongoing with the continued prepositioning of lifesaving supplies for health facilities including 34,000 newborn baby kits and heating materials. […] The UNICEF supported mobile health and nutrition teams were able to reach over 180,000 people in remote areas in November including over 75,000 under-five children.”

   

  WHO, Afghanistan: Infectious Disease Outbreaks - Epidemiological week # 49, 2022 (04 to 10 Dec 2022) Situation Report #70, 16 December 2022

  “Acute Watery Diarrhea (AWD) with Dehydration Outbreak (01 May to 26 Nov 2022) Current Week

  3,686 new cases (56.0.0% under 5)

  0 new deaths

  2 new districts (Ghazni and Ghor) reported new alerts 9 samples collected

  Cumulative Figures

  233,449 cases (<5 years, 55.3%)

  85 deaths (77.6% < 5 years), CFR=0.04%

  175 districts in all 34 provinces

  2,628 samples collected

• During week 49-2022, a total of 3,686 new AWD cases with dehydration were reported which indicates 7.5% decrease in the number of cases, compared to the previous week (Figure 2).

• No new deaths were reported in the last week.

• The highest number of new AWD cases were reported from Kabul (1,143, 31.0%), followed by Helmand (633, 17.2%), Baghlan (491, 13.3%) and Zabul (216, 5.9%) provinces.

• Cumulatively, Kabul (53,158, 22.8%), Helmand (40,198,17.2%), Baghlan (16,664, 7.1%), Nangarhar

  (12,673, 5.4%), Kandahar (12,414, 5.3%), Jawzjan (9,112, 3.9%) and Paktya (8,403, 3.6%) are the most affected provinces (Figure 1).

• Out of the total 233,449 cases, 129,070 (55.3%) were children below 5 years and 116,649 (50.0%) were

  females (Figure 3).

• The first few cases of AWD were reported to the National Disease Surveillance and Response System (NDSR), MoPH and WHO on 04 May 2022 from Kandahar city of Kandahar province and spread to 175 districts in 34 provinces.”

 

Afghan Red Crescent, Badghis (14 December 2022), 14 December 2022

“In continuation of arranging dissemination session by ARCS, on 12th December, ARCS has arranged a dissemination session for 20 teachers and youth in Haji Abdul Samad village of Badghis province. In this session, the dissemination officer of ARCS has briefed the participants regarding the history, fundamental principles, emblems and services of movement & ARCS. Moreover, the first aid trainers of ARCS has established health committee for 15 elders in Jar Sarak district of the very province. In above-mentioned committee, the participants were briefed regarding first aid.”

 

Afghan Red Crescent, Maidan Wardag (12 December 2022), 12 December 2022

“The first aid trainers of ARCS has arranged a workshop on first aid to 60 males in Chak district of Maidan Wardag province. In afore-mentioned workshop, the participants were provided information regarding healthcare, prevention and prophylaxis of infectious and contagious diseases & diarrheas & preparing ORS (Oral Rehydration Solution) at home.”

 

Afghan Red Crescent, Ghazni (9 December 2022) [EN/PS], 9 December 2022

“On 8th December, the first aid trainers of ARCS has finalized a three-days workshop on first aid to a group of 20 volunteers in the center of Ghazni Province. In this workshop, the volunteers were trained practically and theoretically. Meantime, the female trainers of ARCS has arranged one-day awareness workshop on advantages and preparing of Oral rehydration solution (ORS) to 50 mothers and women in Khak-e-Ghariba area of Ghazni province.”

 

MSF, People with tuberculosis face multiple barriers accessing treatment in Afghanistan, 8 December 2022 “Jawahira struggled to find proper medical care after she was infected with tuberculosis (TB). “I used to visit private clinics, but instead of giving me TB medication, they usually just prescribed me painkillers,” she says. She was eventually referred to the Médecins Sans Frontières’ (MSF) tuberculosis hospital in Kandahar earlier this year from a clinic in Daikundi, central Afghanistan. The cost of seeking out treatment also took its toll. “My home is far away in Uruzgan, so when we went to see a doctor, I had to spend 6,000 Afghani (US$67) for the car fare and then 13,000 (US$146) for the drugs they gave me.” The sum spent by Jawahira on each visit to the doctor is about one-third of

the average monthly income in Afghanistan. According to the World Bank, an estimated 60 per cent of people in the country are out of work and receive no income at all. At the same time, the effects of sanctions, combined with additional financial measures against the government of the Islamic Emirate of Afghanistan (IEA), are being felt nationwide. People often struggle to afford even basic food items, let alone travel expenses and medical fees for hospital visits. Meanwhile, the public healthcare system is under-resourced, under-staffed and under-funded. MSF’s 24-bed TB hospital in Kandahar is the only medical facility providing advanced TB care in southern Afghanistan. Many of our patients come from the nearby provinces of Helmand, Uruzgan, Nimroz and Zabul, but others travel from up to 350 kilometres away, from Farah, Dikondi, Badghis, Ghazni and Paktika provinces. “Many travel from afar, and we support them by paying for transport costs, housing expenses and food to alleviate some of the economic burden,” says MSF medical advisor Allieu Tommy. Without such incentives, most patients could not afford to come for treatment. Lack of awareness about TB Difficulties reaching and affording medical care are not the only barriers to TB treatment faced by people in Afghanistan. Another is the widespread lack of knowledge about the disease. MSF teams carry out regular health promotion activities in local communities in Kandahar to improve people’s understanding of TB. We also provide information about TB to patients and caretakers at the hospital in Kandahar. “When a person arrives for the first time and learns that they have TB, we talk to them about what TB is, how it’s transmitted, how to be careful around their family members, and how long the treatment will take,” says MSF nurse Taiba Azizi. MSF also tests patients’ family members for TB, as the disease is highly transmissible, particularly when people live close together. Home treatment Some patients have a form of the disease that is resistant to conventional TB drugs and require treatment that lasts from nine to 12 months. This can be especially difficult to cope with whilst in a hospital and far from friends and relatives. As a result, many patients fail to see their treatment through to the end. But in 2023, following research results, a six-month short course regimen will be introduced that should make it easier for people to finish their treatment. MSF has already set up a DR-TB programme that combines specialist inpatient care with supervised home-based treatment to help patients better cope with the regimens. “What we offer is a system whereby a person spends the first 30 days in our facility under careful observation and, if they do not experience major adverse side effects from the drugs taken, they are discharged for home care,” says Azizi. “Our staff then do weekly follow-ups with them over the phone, meaning that patients only need to come back to the hospital once a month to renew their medications and have an in-person consultation.” TB in Afghanistan 70

% patients in MSF’s Kandahar TB hospital are women and children 13,000 people in Afghanistan die from tuberculosis every year 13,000 consultations provided for patients with TB by MSF in 2022 Women and children are most vulnerable to TB Over 70 per cent of patients in MSF’s Kandahar TB hospital are women and children. “Women and children stay at home in dusty, poorly ventilated rooms for longer periods of time than men,” says Tommy. “If a woman gets infected, the children are likely to catch the disease as well,” he says. An additional challenge for female patients is that they are generally required to be accompanied by a male family member to the hospital, and this coupled with the economic barriers can significantly reduce their access to healthcare. It is estimated that tuberculosis and its resistant forms kill more than 13,000 people in Afghanistan every year. Access to proper care remains a major challenge for patients in the southern part of the country, mainly due to insufficient medical infrastructure, length of treatment and financial obstacles. While MSF’s TB hospital in Kandahar provides quality and free treatment for many, it cannot be seen as a long-term solution. The people of Afghanistan need a health system that meets their needs. MSF’s Kandahar TB hospital aims to provide patients with quality, free and effective treatment. Our teams have provided more than 13,000 consultations for patients with drug-sensitive and drug- resistant TB so far this year and admitted more than 70 patients for inpatient treatment. We also provide patients with mental health support, carry out health promotion activities within the hospital and in the surrounding area, and deliver technical and financial support to provincial laboratories who offer TB testing.”

 

WHO, Afghanistan Emergency Situation Report Issue 23 (Reporting Period: November 2022), 7 December 2022

“Key Figures (For November 2022) 531,511 People reached with emergency health services 13,293 People received trauma care services 811 MT Medical and Non-Medical supplies provided 725 Health workers trained 121 Surveillance support team deployed to outbreak areas Summary of Outbreaks (Cumulative Cases) 205,66 Total COVID -19 confirmed cases 225,756 Total Acute Watery Diarrhoea cases 74,010 Total Measles cases 1,056 Total Dengue Fever cases 384 Total CCHF cases 836 Total Pertusis cases Overview From January to October 2022, the

World Health Organization (WHO) and its Health Cluster partners have reached 10.7 million people with access to health care consultations and treatment, which is 73% of the 14.7 million people targeted for 2022. For 2023, the people in need of health assistance is expected to be 17.6 million people. In preparation for the winter season that is expected to worsen the vulnerability of the people, especially in high-altitude locations and hard-to-reach areas, WHO and Health Cluster partners have prepositioned medicines and medical supplies in 91 priority districts. This is in line with the inter-cluster coordination team (ICCT) winterization plan and based on the collective analysis of seasonal scenarios and risk assessments. WHO has established 189 primary healthcare (PHC) facilities in those underserved areas in 27 provinces to improve healthcare access.4 Currently, WHO is working with the implementing partners on winterization at those facilities with the provision of operational support and logistics, including fuel, heating materials, blankets and food for patients. Winter has contributed to an increased incidence and severity of respiratory infections. In November, a significant surge of pertussis cases was observed, with 64 suspected cases. A total of 2,396 newly suspected measles cases, including seven associated deaths, were reported, which has increased by 15.3% compared to the previous month. The majority of the cases were children under five years of age. To prepare for and respond to the surge of infectious diseases in winter season, WHO has supported the national disease surveillance response (NDSR) system, as well as provided supplies and supported capacity building to ensure proper case management at health facilities. In November, WHO trained 120 community health supervisors and medical officers on event-based surveillance (EBS) which helps capture alerts and signals of infectious diseases and other public health events from various information sources, including communities. In addition, WHO distributed 811 metric tons (MT) for a volume of 3,196 cubic meters (CBM) of medical and non-medical supplies to 235 health facilities across the country. This includes 3,021 Interagency Emergency Health Kits (IEHK), 50 pneumonia kits and 85 cholera kits. The capacity building activities at the public health laboratories have been enhanced – 116 laboratory technicians from 33 provinces were trained on sample collection and handling techniques while 14 laboratory technicians received training on diagnosis of COVID-19 by real-time PCR (RT-PCR). In addition, WHO is supporting the nationwide measles and oral polio vaccination (OPV) campaign being conducted from 26 November until 5 December 2022. The measles vaccination targets 5.4 million children from 9 to 59 months in 329 districts across the 34 provinces, and the campaign has been undertaken by 4,341 vaccination teams consisting of four members in each team and 2,153 supervisors.”

 

Afghan Red Crescent, Uruzgan (6 December 2022), 6 December 2022

“On 6th December, the mobile health team of ARCS has initiated a campaign to prevent measles in Chora district of

Uruzgan province, where so far thousands of children have been vaccinated & this series is still continued.”

 

Afghan Red Crescent, Maidan Wardag (6 December 2022), 6 December 2022

“Providing health services is a part ARCS humanitarian services, therefore the permanent clinic of ARCS provides health services to vulnerable citizens in Sayd Abad district of Maidan Wardag province. The above-mentioned clinic has provided these health services; has examined and treated 1810 people, bandaged 171, vaccinated 365, provided obstetric services to 3 woman and it is always at the service of public.”

 

Afghan Red Crescent, How To Provide First Aid During Conflict To A Wounded Person?, 4 December 2022

“For this purpose, the doctors of ARCS has trained practically and theoretically its 25 volunteers in a three-days workshop in center of Maidan Wardag province, Qala-e-Bashi area. In this workshop, they were taught, what are the vital signs of life? How to breathe an injured person? How to help the heart during a serious injury? How to close a wound, how to close a broken bone? How to stop the blood of an injured? How to shift the injured to a hospital or a safe area? How to provide first aid to a person bitten by a rabid dog and how to provide first aid to person, who is bitten by a snake?”

 

UNICEF, A new 24-hour clinic in Afghanistan is a prescription for good health, 2 December 2022

“With support from UNICEF, nurses work a new night shift to provide relief and reassurance for underserved mothers and infants Hasinullah Qayoumi MAZAR PROVINCE, AFGHANISTAN – 110 km away from Mazar, in the north of Afghanistan, Kaldar health facility has been largely isolated for decades due to conflict and insecurity. But since last

August, most of the country has opened up and UNICEF teams have, at last, been able to start new programmes to help children live healthier and happier lives. This district clinic, supported by the Afghanistan Reconstruction Trust Fund, and the World Bank, is a lifeline for the community. It provides vital health services including nutrition, basic health, maternity care, vaccines, and medicine. Given the widespread poverty across the country, patients are no longer able to afford private health clinics and so Kaldar health clinic is busier than ever. While nightshifts in health clinics may be a common phenomenon in many countries, they are not in Afghanistan. And there can be no doubt that these brave and committed nurses are challenging social norms. Not only do they live a long way from home but, once in Kaldar, they stay for one week to staff the clinic throughout the night. UNICEF-supported nurses can now provide healthcare to patients during the night, from 4pm to 8am. The local community is happy with the extended hours – especially for pregnant women and new mothers and infants, who need specialized care. In discussions with patients, I heard that, in the past, women had lost babies, and even lost their own lives, giving birth with no skilled birth attendant. There was a palpable sense of relief that these night nurses would be on call, trained, and ready to support newborn babies and mothers. “We sleep and rest more easily now knowing that there is help at hand if we need it during the night,” one woman told me. “We want this to be an end to mothers dying in childbirth and losing their much-loved infants.” Arezo, only 6 weeks old, is one of the babies who benefitted from the 24-hour care. She was born, safely, around 07:00 on the day I visited the clinic. I watched her receive life-saving vaccines to shield her against preventable childhood diseases. Karima, 30, is Arezo’s mother. As well as Arezo, she has two daughters and a son. She is very happy with the newly expanded health services because she knows, firsthand, how traumatic birth can be. She says, “Previously, we didn’t have such services and we faced many challenges giving birth. Many mothers were scared. I know some who have died bringing life to the world.” Previously, in the case of emergencies, villagers would travel to Hairatan hospital, 27km away. But with crushing poverty nationwide, that has become a luxury few can afford. Karima knows this all too well. Her husband, a farmer, has been hit hard by the drought. He barely has enough income to feed his children. To ensure that 2,300 health facilities continue to function well, and more than 27,000 healthcare workers are paid salaries and come to work, UNICEF works through Non- Governmental Organization partners, in all 34 provinces, as part of the World Bank’s Health Emergency Response (HER) project. Thanks to the Afghanistan Reconstruction Trust Fund and the World Bank for the funding that has enabled UNICEF and partners to start this bold and path-breaking initiative. It’s more than 24-hour care; it’s a prescription for hope, health, and happiness in one of northern Afghanistan’s most under-served communities.”

 

UNICEF, How clean hands and healthy tummies lead to full attendance in class, 2 December 2022

“Restoring the rights and dignity of students and teachers through new sanitation and water systems in Afghanistan Betty Chella Nalungwe MAZAR-I-SHARIF, Afghanistan – Imagine, for a moment, going to school or a workplace that had no functioning toilets or running water. Imagine how frustrating that would be. How inconvenient. How painful. How undignified. During a visit to Mazar-i-Sharif, in the north of Afghanistan, in December 2021, UNICEF was alerted to the fact that the school, with a population of 9,000 students (3,500 girls and 5,500 boys), led by 190 teachers, in two morning and afternoon shifts, had neither functioning toilets nor running water. In the last years, we lost our toilet facilities one by one until they were all shut down. Then our only source of water broke down. It was hard to come to school, especially for us girls. I feel relaxed about coming to school now because I can manage myself with dignity. - Bahara, a student in Mazar-i-Sharif For adolescent girls who have to manage menstruation every month, the lack of water and sanitation facilities meant embarrassment, a worrying lack of hygiene and, as has been reported in many countries, a reason many girls don’t come to school or drop out altogether. UNICEF Afghanistan’s regional field office in Mazar-i-Sharif responded to the official request from the Education Department for support. UNICEF rehabilitated the school's sanitation facilities with European Union Civil Protection and Humanitarian Aid (ECHO) funding. Since May 2022, the high school has had a water source thanks to a brand-new borehole connected to a 20,000-litre overhead storage tank powered by a solar system. As a result, there are functioning toilets for girls and boys, including a 12-faucet handwashing point on the school grounds. Before the borehole was drilled, the school community experienced a lot of waterborne diseases because we used to get unclean water from surrounding areas. Our clean water source has brought back health and dignity to our school. The girls and boys, including their teachers, are now guaranteed safe drinking water and fully functioning ablution facilities. - School principal UNICEF knows that getting access to the right resources, like water, can make a positive difference in the lives of children

and their families. Through our School WASH programme, we have contributed to restoring the rights and dignity of learners by providing safe drinking water for 11 high schools in the Mazar region (10 in Balkh and one in Faryab) using solar-powered water systems benefiting 21,520 learners. To keep these efforts sustainable, UNICEF has delivered hygiene awareness sessions for students and teachers. In response, the school set up a committee among the teachers to promote personal and community hygiene among the students on periodical bases. Teachers and guards have been trained to operate and maintain the refurbished facilities. Here’s to clean hands, healthy tummies, and full attendance in class.”

 

UNHCR, UNHCR Regional Bureau for Asia and Pacific (RBAP): External Update: Afghanistan Situation #21, As of 01 November 2022, 2 December 2022

“UNHCR released the Mid-year Report on the Afghanistan Situation Regional Refugee Response Plan (RRP). Conditions for refugees and Afghans of other statuses in host countries have deteriorated since the launch of the RRP earlier this year, compounded by rising living costs and lack of livelihoods opportunities across the region. To support host governments and to reduce the impact on vulnerable populations, partners continue to adopt a community- and areabased approach by working through government systems – wherever possible – in the spirit of burden sharing. Of note, nearly 350,000 Afghans have been supported to access secondary and tertiary healthcare services, over 165,000 children (including Afghan refugees, Afghans of other status and members of the host community) supported to access primary and secondary education and some 12,500 received unconditional multi-purpose cash assistance.”

 

WHO, Afghanistan: Infectious Disease Outbreaks - Epidemiological week # 47, 2022 (20 to 26 Nov 2022) Situation Report #68, 2 December 2022

“Acute Watery Diarrhea (AWD) with Dehydration Outbreak (01 May to 26 Nov 2022) Current Week 3,419 new cases (54.5% under 5) 3 new deaths 0 new district reported new alert 22 samples collected Cumulative Figures 225,756 cases (<5 years, 55.2%) 83 deaths (77.1% < 5 years), CFR=0.04% 173 districts in all 34 provinces 2,600 samples collected During week 47-2022, a total of 3,419 new AWD cases with dehydration and 3 new death were reported which indicates 8.4% decrease and 200% increase in the number of cases and deaths, respectively, compared to the previous week (Figure 2). The highest number of new AWD cases were reported from Kabul (1,181, 34.5%), followed by Baghlan (446, 13.0%), Helmand (208, 6.1%) and Parwan (178, 5.2%) provinces. The newly reported deaths were all females, children below 5 and from Nimroz (2) and Kabul (1) provinces.

Cumulatively, Kabul (50,803, 22.5%), Helmand (38,859, 17.2%), Baghlan (15,672, 6.9%), Nangarhar (12,481, 5.5%),

Kandahar (12,088, 5.3%), Jawzjan (8,887, 3.9%) and Paktya (8,142, 3.6%) are the most affected provinces (Figure

1). Out of the total 225,756 cases, 124,678 (55.2%) were children below 5 years and 112,886 (50.0%) were females (Figure 3). The first few cases of AWD were reported to the National Disease Surveillance and Response System (NDSR), MoPH and WHO on 04 May 2022 from Kandahar city of Kandahar province and spread to 173 districts in

34 provinces.”

 

UNICEF, Afghanistan Appeal Humanitarian Action for Children, December 2022

“While the health system has narrowly avoided collapse, 13.3 million people have no access to health care, largely due to the lack of infrastructure, coupled with high costs.”

 

International Federation of Red Cross And Red Crescent Societies, Afghanistan 2023 IFRC network country plan (MAAAF001), 29 November 2022

“Afghan Red Crescent volunteers play a critical role at all stages of National Society programming, with a nationwide network of at least 30,000 volunteers operating through 34 provincial branches. They are responsible for the assessment, identification and registration of target communities, including internally displaced people. In addition, volunteers carry out hygiene promotion and community mobilization. The National Society in Afghanistan provides healthcare services through facilities in all 34 provinces. It has 46 fixed clinics, 22 sub-health centres, 70 mobile health teams, one district hospital, and one comprehensive health centre. The National Society in Afghanistan is also the main organization in Afghanistan providing or facilitating treatment for congenital heart defects.”

ICRC, Humanitarian needs to deepen in dozens of conflict zones as world’s attention wanes, 29 November 2022 “The economic situation in Afghanistan is worsening. At 33 ICRC-supported hospitals across the country, child malnutrition cases are already 90% higher in 2022 compared to all of 2021, rising from 33,000 cases to over 63,000 so far this year. Meanwhile, at an ICRC-supported children’s hospital in Kabul, the number of children under 5 being treated for pneumonia has risen 55% in 2022 versus the same period last year.”

 

International Committee of the Red Cross (ICRC), Humanitarian needs to deepen in dozens of conflict zones as

world’s attention wanes, 29 November 2022

“The economic situation in Afghanistan is worsening. At 33 ICRC-supported hospitals across the country, child malnutrition cases are already 90% higher in 2022 compared to all of 2021, rising from 33,000 cases to over 63,000 so far this year. Meanwhile, at an ICRC-supported children’s hospital in Kabul, the number of children under 5 being treated for pneumonia has risen 55% in 2022 versus the same period last year.”

 

International Committee of the Red Cross (ICRC), Afghanistan: Child pneumonia, malnutrition spikes as families face impossible choice: eat or heat, 24 November 2022

“The poverty level in Afghanistan has increased compared to past years. Most people cannot buy material to keep their homes and children warm. They also cannot afford to feed their children properly so pneumonia cases are rising, and the number of malnutrition cases linked to pneumonia will rise, too,” said Dr. Abdul Qayum Azeemi, an ICRC doctor who coordinates ICRC’s programme in Kabul’s Indira Ghandhi hospital.”

Save the Children, CHILD MALNUTRITION CASES RISE NEARLY 50% IN AFGHANISTAN AS HUNGER HITS RECORD LEVELS, 31 October 2022

“KABUL, 31 Oct 2022 – The number of dangerously malnourished children admitted to Save the Children’s mobile health clinics in Afghanistan has increased by 47% since January this year, with some babies dying before managing to receive any treatment, the children's charity said today.”

“The climate crisis poses a serious risk to all Afghan children whose families or communities survive on farming – nearly 13.2 million children[i] —, with current drought and unseasonal summer floods wiping out crops, killing livestock, drastically reducing vital food supplies and diminishing water sources.”

“Child labour is also on the rise[v], with desperate parents taking their children out of school and sending them to work on the streets, in other people’s homes, factories and mines to make up for the income they have lost due to the drought or floods.”

 

UNICEF, Afghanistan Humanitarian Situation Report No. 11, 31 October 2022

“Despite an increasingly challenging operational environment, through UNICEF support, more than 4.7 million people received essential health and nutrition services in 2,310 health facilities across all 34 provinces of Afghanistan. Mobile health and nutrition teams (MHNT) continued to provide services in remote, hard-to-reach and previously inaccessible areas, reaching over 170,000 people, including 73,000 under-five children. However, due to issues relating to Memorandums of Understanding (MoU) between NGO partners and the authorities, 95 of the 171 UNICEF-supported MHNTs (covering 13 NGO partners) were forced to slow or cease operations altogether in 21 provinces. Further challenges hindering the provision of emergency health care include negotiations with the Ministry of Public Health on the service […] provider selection process for Basic Package of Health Services (BPHS) and Essential Package of Hospital Services (EPHS) contracts, as well as rapid dispatch of supplies due to delays in issuing quality certification of pharmaceuticals from the Afghanistan Drug Authority. UNICEF is staggering the procurement of medicines to ensure a robust supply chain lest a crisis arise.”

United Nations Office for the Coordination of Humanitarian Affairs (UNOCHA), Afghanistan: Earthquake Response Situation Report No. 4, 31 October 2022

“More than 20 health partners are active in all the earthquake-affected areas and have reached 203,000 people

through mobile and fixed health teams. The Health Cluster is working with partners to ensure necessary supplies, enhance surveillance, pre-position medical and non-medical items for AWD treatment, setting-up Oral Rehydration Therapy (ORT) corners and isolation beds at the hospitals and Cholera Treatment Centers (CHCs), and strengthening

of Risk Communication & Community Engagement (RCCE) activities in affected areas. Due to poor health infrastructure & limited access during upcoming winter, continuity of current health services will be a challenge. […]

“Needs: • Of the 184 villages assessed, 26 (14 per cent) reported damaged clinics; the most impacted district is Barmal, where 45 per cent of villages reported damaged clinics. • Of the damaged health facilities, 88 per cent have lost access to in-patient departments (IPDs), 73 per cent have lost access to out-patient departments (OPD); further, 58 per cent have lost access to first aid rooms and 42 per cent to delivery services. • The JATs identified some 11,500 cases of diarrhea, vomiting, and dehydration, 250 cases of respiratory infections, and over 700 cases of trauma- related injuries across the earthquake-affected areas.”

 

International Organisation for Migration IOM, IOM Afghanistan Migration Health Situation Report, 30 October 2022

“IOM’s health activities aim to improve access to primary and secondary health services with over 400 staff across 16 provinces in Afghanistan focusing on healthcare service provision for returnees, migrants, internally displaced persons (IDPs), and underserved host communities, alongside other vulnerable populations in Afghanistan. IOM’s overarching goal for Migration Health programming in Afghanistan is to reduce avoidable mortality, morbidity and disability, through ensuring the delivery of essential preventive and curative healthcare services in line with IOM’s Migration Crisis Operational Framework (MCOF). IOM employs a direct implementation modality of quality healthcare services through its own operations which ensures greater responsiveness, tailored to community needs.”

Care, Toxic cocktail of cholera and hunger threatens lives from Haiti to the Horn of Africa, 17 October 20222 “The resurgence of cholera in some of the world’s hunger hotspots, including Haiti, Syria, Pakistan, South Sudan and Afghanistan, is threatening the lives of millions of already vulnerable people.”

 

Tolo News, Women’s Access to Health Facilities Decreased Over Last Year: GWHI, 22 September 2022

“The doctors said that many people are obliged to bring their patients to Kabul due to the lack of health services in the provinces. “Many patients come from Paktia and Helmand. They say there is no female doctor,” said a doctor at the Najmulsama Shafajo hospital. However, the residents of Kabul voiced concerns over the shortage of female doctors in the country, saying that women are facing severe challenges in access to health facilities.”

[…] “We came

from Maidan Wardak. There was war in the past 20 years in our village. There is no female doctor, we call on the

Minister of Public Health to hire female doctors,” said a resident of Kabul.”

 

1United Nations Children’s Fund UNICEF, Delivering for the children of Afghanistan, 11 October 2022 “Over a year since the Taliban seized power and UNICEF pledged to ‘stay and deliver,’ life in Afghanistan – already weakened by decades of insecurity and natural disasters, and now distanced from the global community – has further deteriorated. The country is in crisis, and it’s a child rights crisis.

Millions of children continue to need essential services, including primary healthcare, lifesaving vaccines against polio and measles, nutrition, education, protection, shelter, water and sanitation. UNICEF has been on the ground in Afghanistan for over 70 years with 13 offices nationwide and a range of partners that support us in delivering assistance to the most vulnerable, especially children. But as winter approaches, urgent funding is needed to secure children’s futures, to guarantee their rights, and to ensure that vital support is given equitably to all of Afghanistan’s children. More than half the country – 24.4 million people, including 13 million children – are in urgent need of humanitarian assistance. […] “UNICEF will continue to advocate to get all children back in school – for as long as it takes – because demand for education nationwide is at an all-time high, particularly in areas where there are no schools and children have been deprived of education for years. UNICEF is responding to the commitment from communities to keep schools open for high school age girls by providing, amongst other things, textbooks in schools, training for female teachers, and expanding Community-Based Education classes. UNICEF is also exploring alternative pathways to education, including financial support to small-scale education initiatives, and lessons on

tablets and via radio or TV. UNICEF is supporting water, hygiene and sanitation (WASH) services, including delivering safe water through water trucking, construction and repair of hand pumps, as well as providing supplies and hygiene promotion.

UNICEF is supporting primary healthcare facilities providing basic health services, including out-patient consultations. In addition, over 170 UNICEF-supported mobile health and nutrition teams are operating across the country, including in the most remote and hard-to-reach mountains that were previously inaccessible. Following the 22 June 2022 earthquake, UNICEF delivered tents and medical supplies to earthquake-affected areas including first aid kits, oral and injectable antibiotics and IV fluids. Too many of Afghanistan’s children have witnessed scenes that no child should ever see. Children and adolescents are struggling with anxieties and fears, with many in desperate need of mental health support. UNICEF has, therefore, scaled up its child protection response by providing immediate and life-saving services to children affected by conflict and displacement, including providing child- friendly spaces and psychosocial support to children and their caregivers or parents. In 2022, Afghanistan has experienced worsening disease outbreaks, economic decline, acute food insecurity, and devastating natural disasters. During the first half of the year, UNICEF scaled up its humanitarian response in the face of increasing needs. In the first six months of 2022, UNICEF and partners:

 

• Treated more than 300,000 children aged 6 to 59 months for severe acute malnutrition.

• Provided humanitarian cash transfers to around 100,000 unique households.

• Reached more than 3.5 million people with safe water for drinking, cooking and personal hygiene.

• Provided 17.3 million people with out-patient health care.

• Reached 1.7 million children and their caregivers with a range of urgent child protection services including mental health and psychosocial support services.”

 

EUAA, Afghanistan – Targeting of Individuals, 16 September 2022

"In July 2022, WSJ reported that ‘[m]idwives say dozens of staff have fled the country, and more plan to leave because of the Taliban’s ban on girls’ education and curbs on women’s freedom."

 

Gandhara, Gandhara Briefing: The Taliban's War With IS-K; A Pakistani Women-Only Park Closes; Afghans Deported From Tajikistan, 26 August 2022

“Passports And Taliban Bribes Radio Azadi reports on the complaints by Afghans of the hurdles they face in getting a passport from the Taliban government. Issuing identity documents is a significant revenue stream for the militants. "We don't have any money and do not know any Taliban officials," said Shakila, who has been trying to get a passport for her family members since the Taliban takeover a year ago. "We have been knocking on the

doors of the passport office every day." A Kabul resident says he has been trying to get a passport for a sick relative so he can travel outside the country for treatment. But he has been waiting for more than one month. "Only people who have $1,000 or $1,500 [to pay in bribes] can get passports," he said. "The rest of us just queue up with no luck."”

 

MSF (Medecins Sans Frontieres), MSF’s emergency project in Paktika province comes to a close, 25 August 2022 “During the night of 21 and 22 June, a 5.9 magnitude earthquake shook Khost and Paktika provinces in the east of Afghanistan. Spera District (Khost province), Gayan (Paktika province) and Bermal (Paktika province) were the most affected. […] “On our arrival we saw that the situation was precarious. Families and communities had lost almost everything, and they were living under the open sky. We realised that the closest healthcare facilities were almost 150 kilometres away,” says Dr Taufeeq, who was a member of the earthquake intervention team. […] Trucks of medical, logistic, and water and sanitation materials also arrived from Kabul. After the first few days, the number of people coming to the clinic with acute watery diarrhoea started to increase and so isolation tents were also set up nearby. “Within the first 72 hours we were able to provide basic healthcare and trauma care to the affected population,” says Gaetan Drossart, Afghanistan Country Representative. “And the decision to close our activities after a few weeks was taken given the emergency nature of our response and the fact that other organisations were

increasing their activities in Bermal.” “But, access to healthcare in the area needs to be improved in a longer-term,

sustainable way,” he says.” “

 

Khaama Press, Afghanistan Has Highest Maternal Mortality Rate in Asia-Pacific: UNFPA, 17 August 2022

“The United Nations Population Fund (UNFPA) has voiced concern over the rise in maternal mortality during childbirth in Afghanistan, noting that Afghanistan has the highest maternal mortality rate in the Asia-Pacific region. According to the UNFPA report released on Wednesday, August 17, without immediate and long-term efforts for maternal health, there will be 51,000 more maternal deaths by 2025. […] According to statistics, 396 pregnant women in Afghanistan died in 2018 out of 100,000 live births, a considerable decline from previous years, which is almost half of the figures this year. Access to health care is also impeded by the Taliban’s restrictions on the mobility of women. This comes as Afghanistan is experiencing the world’s “worst” humanitarian crisis and Afghanistan is at the pinnacle of hunger, poverty, and unemployment.”

 

Ariana News, Afghanistan makes progress toward polio eradication, 16 August 2022

“Wild poliovirus transmission in Afghanistan is currently at its lowest level in history. Fifty six children were paralysed by wild poliovirus in 2020. In 2021, the number fell to four. This year to date, only one child has been paralysed by the virus, giving the country an extraordinary opportunity to end polio, the World Health Organization (WHO) reported.”

 

WHO, Afghanistan makes progress toward polio eradication but challenges remain, 15 August 2022

“One year on from Afghanistan’s transition of power in August 2021, the polio eradication programme in Afghanistan has made critical gains – but the job is far from finished. Wild poliovirus transmission in Afghanistan is currently at its lowest level in history. [...] This year to date, only one child has been paralysed by the virus, giving the country an extraordinary opportunity to end polio.

The resumption of nationwide polio vaccination campaigns targeting 9.9 million children has been a critical step. Since 2018, local-level bans on polio vaccination activities in some districts controlled by the Taliban had significantly reduced the programme’s ability to vaccinate every child across the country. With access to the entire country following the August transition, seven nationwide vaccination campaigns took place between November 2021 and June 2022, and a sub national campaign targeting 6.7 million children in 28 provinces took place in July. Of the 3.6 million children who had been inaccessible to the programme since 2018, 2.6 million were reached during the November, December and January campaigns. With improving reach to previously inaccessible children during subsequent campaigns, the number of missed children has been reduced to 0.7 million.

[...]

Although the number of children paralysed by polio has reduced significantly in Afghanistan, the threat of a resurgence remains and the programme faces significant challenges. While access has improved across the country, reaching every child remains a challenge in some of the highest risk areas leaving immunity gaps and, with them, children vulnerable to polio.

On 24 February, eight polio workers were killed in targeted attacks in the country’s north, not the first time polio workers had come under attack in the course of their life saving work. Four of those killed were women. Female polio workers play a critical role in the programme, building community trust and reaching all children.”

 

Gandhara, UN Agencies Assail Taliban For Year of Deteriorating Rights in ‘all aspects’ of girls’, women’s lives, 15 August 2022

“Women are still excluded from public life and many jobs, and girls are routinely forbidden to attend schools, in addition to strict controls on movement and attire.

"It has been a year since the Taliban takeover in #Afghanistan," the UN said in a tweet introducing the report. "During this time, women and girls have seen increasing disrespect for their #HumanRights including access to health care and education."

In May, the UN Security Council issued a statement of “deep concern” about the erosion of the rights of women and girls in Afghanistan and called on the Taliban to “swiftly reverse” their policies and “to adhere to their

commitments to reopen schools for all female students without further delay.”

Human Rights Watch (HRW)'s Afghanistan researcher warned recently that the Afghan people were "living a human rights nightmare, victims of both Taliban cruelty and international apathy."”

 

Khaama Press (Afghan News Agency), Three Children in Southern Afghanistan Succumb to Cholera Disease, 14 August 2022

“According to Abdul Hakim Hakimi, the Taliban’s director of the public health department for Zabul province…, three children passed away from cholera in the Akazi region of Zabul province. According to him, this tragedy occurred on Saturday night in areas of Zabul province that were remote from the province’s capital since medical teams were not sent… This occurs while a number of disease outbreaks, including Acute Watery Diarrhea (AWD), measles, Congo fever, cholera, dengue fever, and Covid-19, have been reported in Afghanistan recently by the World Health Organization (WHO). These outbreaks, especially cholera has contributed to the fatalities spiking the cholera-related death toll in Afghanistan.”

 

Deutsche Welle, Afghanistan is starving and the West is partly to blame, 14 August 2022

“More than a million children are severely malnourished and half of Afghanistan's population is going hungry. The humanitarian catastrophe is being made worse by ongoing sanctions against the Taliban… According to the WFP, about 20 million people — half the population — require urgent food aid. But there is not enough money, according to the WFP country director for Afghanistan, Mary-Ellen McGroarty. At an online press conference in July, she explained that decisions on who to feed are made based on the individual's current nutritional situation or their particular vulnerability. McGroarty spoke of an "extremely difficult and often heartbreaking" decision-

making process.” “The health sector is collapsing, too. Samira Sayed Rahman, who works for the aid organization International Rescue Committee (IRC), told DW what she saw when she visited a hospital in the eastern province of Paktia: There were not enough doctors, not enough nurses. "The doctors we spoke with have not been paid for the past six months," she said. "The wards were full of women cradling malnourished children. In the neonatal unit,

three babies had to share an incubator.”” “Humanitarian groups must therefore adopt unconventional methods. In an interview with DW, Elke Gottschalk, regional director for Asia for the German aid organization Welthungerhilfe, described how money transfers must be processed through alternative channels, called hawala networks. It works like this: Welthungerhilfe transfers money to the account of a hawala dealer, known as a hawaladar, in a third country. "This agent then makes sure that money arrives in Kabul — in cash. We count it, then it can be used.”…However, this is "not a reliable and sustainable method."

 

ICRC, Afghanistan: A health care system on life support, 13 August 2022

“Access to health care remains a major concern for communities across Afghanistan. To access specialized care, patients often travel several hours, sometimes along dangerous roads in areas that are still heavily contaminated by landmines and explosive remnants of war.”

 

IOM, No woman left behind: exceptional efforts increase health care access for Afghan women, 12 August 2022

“Since August 2021, accessing basic health care has been carrying more risks for women in Afghanistan. Many suffer in silence from various diseases while being prevented from seeking the necessary medical support. Women are disproportionately impacted by barriers to accessing health services due to restricted decision-making and mobility, as well as gender norms that prohibit them from interacting with anyone outside of their family members. As a result, most of the services are received by men, and women are not part of decision-making processes.”

 

UNFPA, New midwife’s first call of duty: Emergency response to earthquake ‘Women were in shock, many of them were pregnant’, 10 August 2022

“More than a thousand people died during the earthquake, which affected about 362,000 people and damaged or destroyed some 4,500 homes. UNFPA estimates that the affected population include almost 87,000 women of childbearing age (15-49), with more than 8,000 who are pregnant.”

International Rescue Committee (IRC), One year on: How the IRC expanded our impact in Afghanistan, 8 August 2022

“In 2021, the IRC supported health facilities around the country by providing personal protective equipment (PPE)

 

to clinics to prepare them against COVID-19. We also trained health care workers on infection prevention measures

and community volunteers to identify symptoms and refer people to clinics for treatment. Now, the IRC is supporting 62 health clinics in 11 provinces, and programming includes the delivery of malnutrition services, responding to deadly cholera outbreaks, and maternal and reproductive health.

We also have a network of 31 mobile health teams, who can travel to remote communities to deliver lifesaving medical assistance. After a June earthquake hit a remote area in the southeast, IRC staff formed an all-female mobile health team that was able to quickly deploy to people who had been injured and provide first aid support.

“The proudest point in my job is serving my people—the people of Afghanistan,” said Amna Gul, an IRC health manager who helped create the all-female team. “Especially the women who are not able to go to health care facilities because of transportation, financial conditions and Mahram [needing a male chaperone to receive care from a male health care worker].”

 

Swedish Committee for Afghanistan, The Swedish Committee for Afghanistan Established a Midwifery Training Center in 4 provinces of Afghanistan, 3 August 2022

“SCA established a midwifery training center in Parwan, Nuristan, Samangan and Panjshir Provinces where the entrance examination for the Community Midwifery Education (CME) was conducted by the technical and management team of SCA in Parwan and Panjshir provinces.”

“[…] SCA recorded 1.77 million patient visits in 2021 with 973 000 of these were women, trained 25 midwives and 24 nurses and built two child and maternity health centers. SCA has taken over responsibility for all healthcare services in Nuristan province, one of Afghanistan’s poorest and most vulnerable provinces in terms of healthcare.”

 

United Nations Children’s Fund (UNICEF), UNICEF Afghanistan Twitter, 3 August 2022

“After the recent earthquake there is an increased risk of an outbreak of diseases like Cholera in Spera District in Khost”.

 

NRC, Unprecedented flash floods batter rural Afghanistan, 3 August 2022

“This year’s unseasonal flooding is catastrophic for impacted communities in Afghanistan. The scale of destruction is unparalleled. Flash floods have swept away entire sections of roads and other critical infrastructure - bridges, wheat mills, hospitals and schools. People have lost their businesses, and the entire families have seen their homes and acres of farmland destroyed.

“We estimate that more than 18,000 people have been affected, many of whom were already struggling to

survive. Over 40 people have lost their lives to date. The disaster has hit nine of Afghanistan’s provinces, including

Khost and Paktika, areas which only just witnessed a devastating earthquake in June.”

 

The Khaama Press News Agency, One-Kilometer-Long Surface Fault Occurs in Central Afghanistan, 30 July 2022

“According to a USAID report, merely 42% of Afghans have access to clean drinking water, and only 27% of those

living in rural areas have access to sanitation facilities.”

“As a result, the diarrheal disease kills an estimated 85,000 Afghan children under the age of five each year.”

 

Khaama Press, Over 13 Million Afghan Children Need Humanitarian Assistance: Save the Children Report, 27 July 2022

“According to a study from the Save the Children organization released today, Wednesday, July 27, 18.9 million people, including 9.2 million children in Afghanistan, are anticipated to experience an emergency or critical food insecurity between June and November 2022.

Save the Children’s report cited the United Nations Development Program stating that 97% of the Afghan

population faces the prospect of living in poverty and falling below the poverty line.

Acute malnutrition affects 1.1 million Afghan children under the age of five, according to the report.

Covid-19, measles, acute watery diarrhea (AWD), and dengue fever are among the numerous disease emergencies Afghanistan is currently dealing with.

A significant contraction of the economy, rising poverty, and financial instability, as well as high unemployment and high food and agricultural input prices, have been caused by the rapid drop in international grant support, loss of access to offshore assets, and disruption of financial links.

In addition, the Ukraine crisis has had a significant impact on how much food costs rise and become out of reach for many Afghans.

With the rebels-turned-politicians behind the wheel, Afghanistan’s unstable economy is impacted by the Taliban’s

political isolation and economic sanctions, which exacerbated the country’s already-impoverished citizens’ poverty, unemployment, and hunger.”

 

Khaama Press, Over 7,000 People Contract Cholera with 12 Cholera-Related Deaths in Northern Afghanistan, 21 July 2022

“According to Jawzjan health officials quoted by Bakhtar News Agency on Thursday, cholera disease has spread in

the Jangal Arigh village in the Mardyan district of this province.

7,000 cases of cholera have reportedly been confirmed in Jawzjan up to this point, according to the provincial public health officials of which only 2644 people are reportedly being attended to at the moment.

In addition, as the weather warms and floods rise, the cholera disease has spread throughout the southern regions of Afghanistan. In the three southern provinces of Afghanistan, approximately 5,000 people have contracted cholera, according to official statistics, prompting the health officials to seek aiding organizations’ assistance. (…)”

 

AVA, 40% of pregnant women in Afghanistan do not have access to obstetric services, 20 July 2022

“CARE International Institute has published a report saying that about 40% of pregnant women in Afghanistan do not have proper access to prenatal health care. This institution added that it is estimated that 638 women die every year in every 100,000 births. According to this health organization, about 40 percent of pregnant women do not have prenatal care and there are few health workers who have training skills in this field.”

 

Tolo News, Cases of Seasonal Diseases Surge in Kabul, Doctors Say, 17 July 2022

“Other seasonal diseases include cold, malaria and measles, said Mohammad Naeem Akbari, a physician at Infectious Diseases Hospital in Kabul. “In this season of the year, diarrhea cases have spiked. Around 1,000 to 1,500 people are brought to the (infectious diseases) hospital in Kabul and every doctor visits around 50 to 60 patients a day,” said Abdulrahman Jawad, a doctor.Warm weather and inattention to personal hygiene are the main reasons for the spike in cases of seasonal diseases, doctors said.”

 

ToloNews, Committee Formed to Address Shortage of Medicine, 14 July 2022

“The institution acknowledged the shortage of drugs in the cancer treatment sector and said that efforts to provide these drugs are ongoing…Meanwhile, some Kabul residents complained about the increase medicine's prices, saying they cannot easily find medicine with reasonable prices in the country. “I went to three to four pharmacies to buy medicine in the Da Afghanan area of Kabul, it was too pricey and finally I bought the medicine costing 4400 Afs,” said Ziaullah, a resident of Kabul. Afghanistan’s Food and Drug Administration called on businesspeople to import drugs of sufficient quality to the country.”

 

Khaama, Cholera-Related Death Toll Surges in Central and Southern Afghanistan, 14 July 2022

“[Daikundi] cited locals who claimed that 11 people had died from the disease, although he added that this number had not been officially confirmed. Furthermore, 590 people have been diagnosed with the disease in the province of Helmand’s Baghran district, according to local Taliban officials.”

 

AVA, Shortage of Medicine in Afghanistan, 14 July 2022

"[…] Kabul residents complained about the increase medicine's prices, saying they cannot easily find medicine with reasonable prices in the country.”

ToloNews, Cases of Severe Diarrhea Spike in Afghanistan: Doctors, 13 July 2022

“Every day around 100 patients who are infected with severe diarrhea come to the hospital, there are men and women among the patients, we are trying to treat them all, but the number is increasing day by day,” said Faridullah Omari, physicians at Kabul’s Antani Hospital…“Over 100 cases of the disease have been recorded in the provinces of Helmand and Kandahar,” said Sharafat Zaman, a spokesman of the Ministry of Public Health. This comes as the Ministry of Public Health said that more than 15 people have died as a result of severe cholera in Helmand province alone.”

 

AVA, Cholera disease spreads in Zabul, 13 July 2022

"[…] other parts of Zabul witnessed the outbreak of cholera, an event in which hundreds of people were infected and some died."

"[…] health officials in Helmand reported that 20 died of the cholera disease in that province and more than 120 people were hospitalized."

AVA, The difficult situation of the displaced people of Balkhab, 13 July 2022

"As a result of the conflict between Mawlavi Mehdi and the Islamic Emirate in Balkhab district, many families have been displaced from their homes and have settled in a bad situation near the "Band Pitab" mountains. It has been said that most of these people are residents of "Glorz" region."

 

Khaama Press (Afghan News Agency), 4 Cholera-Related Deaths Reported in Southern Afghanistan, 13 July 2022 "In Shahwali Kot district of Kandahar province, in southern Afghanistan, 60 people have reportedly contracted cholera, according to health officials.

Four people died among those who were ill, according to Mohammad Haqbin, head of a health facility in the Shahwali Kot district, who also told that the disease is caused by drinking contaminated water.

According to the Taliban officials, the disease has also spread in Helmand province, also in southern Afghanistan. There are already 590 persons affected with this disease in Helmand province’s Baghran district, with almost 18 deaths associated with the disease outbreak.

Officials from the Ministry of Public Health stated that the cholera outbreak has been recorded in the districts of Baghran and Shahwali Kot and has been associated with the consumption of contaminated food and unclean water.

There have also been fatalities related to the cholera outbreak in the Zabul province’s Sewri and Day Chopan districts.

The situation in Helmand and Kandahar provinces appear critical as local sources say hospitals are overwhelmed with patients."

 

AVA, Severe Diarrhea Spike in Afghanistan, 13 July 2022

"Physicians at Kabul’s Antani Hospital said that as the weather is getting warmer the number of patients infected with severe diarrhea has surged in some provinces […] more than 100 patients come to the hospital every day […] lack of access to clean water and healthy food are among the reasons that this disease surged." “Every day around 100 patients who are infected with severe diarrhea come to the hospital, there are men and women among the patients, we are trying to treat them all, but the number is increasing day by day,” said Faridullah Omari, physicians at Kabul’s Antani Hospital. “One day before Eid, we had 21 cases, on the first day of Eid 28 cases of severe diarrhea were recorded, on the second day of Eid 35 cases were recorded and on the third day of Eid 37 cases were recorded in the hospital,” said Farida Qadri, a physician at Kabul’s Antani Hospital. Meanwhile, a number of patients who came to the hospital for treatment said that the rise in the disease is due to economic problems.

"One day before Eid, I drank a glass of sugarcane juice. The next morning, I had diarrhea. Later, I took medicine, but

it did not help,” said Abdul Basir, the patient.

“Over 100 cases of the disease have been recorded in the provinces of Helmand and Kandahar,” said Sharafat Zaman, a spokesman of the Ministry of Public Health. "This comes as the Ministry of Public Health said that more than 15 people have died as a result of severe cholera in Helmand province alone."

 

Pajhwok Afghan News (Afghan News Agency), Cholera kills 20, infects dozens on Daikundi-Helmand border, 12 July 2022

"About 20 people have died of cholera which is spreading fast in Nawa Ghari village on the border between Helmand and Daikundi provinces"

 

Pajhwok Afghan News (Afghan News Agency), 20 children died from cholera in Helman's Baghran district, 11 July 2022

"Twenty children have died from cholera disease in the Baghran district of southern Helmand province, an official said on Monday.

Information Department Assistant Director Mawlavi Mohammad Qasim Riyaz told Pajhwok Afghan News over 120 children infected by the cholera virus in the past two days out of which 20 died."

 

United Nations Office for the Coordination of Humanitarian Affairs (UNOCHA) (Afghanistan) Humanitarian

 

Response (Afghanistan), Afghanistan: Emergency Earthquake Response Plan (Jul - Sep 2022), 30 June 2022

“• "Staffing of female humanitarians is particularly difficult given pre-existing limited numbers of women

staff and restrictions on women’s movements without a Mahram."

• "Staff are further stretched with pre-existing emergency response priorities in the east, central and south eastern regions, including due to AWD outbreak, measles outbreak, and pervasive acute food insecurity."

• "In Paktika, one health facility was fully damaged, and two are partially damaged. In Khost, one health facility is partially damaged. People’s access to functioning health facilities is also compromised due to roads and transportation challenges."

• "The Health facilities and Emergency Room Departments are overwhelmed with patients while operating with limited capacity."

• "There are limited stocks for medicines and a healthy supply of medicines, medical supplies and equipment is required."

• "… disruptions to health services as well as disrupted access to markets and lack of food or separation from parents, will have a detrimental impact particularly on children under 5, if not rapidly addressed. Furthermore, psychosocial risks and risks of unsolicited distribution of Breastmilk Substitute (BMS) may affect appropriate infant and young child feeding (IYCF) practices, i.e., breastfeeding, and complementary feeding."

• "Past admission data shows that the nutrition situation in the earthquake affected areas was already concerning."

• "Sudden onset disasters affect women, girls and other vulnerable groups in terms of vulnerabilities and exposure to violence including physical injury and through compromised dignity. Decreased access to lifesaving protection and GBV services for women and girls is also expected. Exacerbated/ increased risk of GBV, and exacerbated risk of negative coping strategies are also high amidst such shocks."

 

ToloNews, Residents Complain of Increased Trash Across Kabul City, 10 July 2022

Residents said that some people throw the trash of the animals sacrificed in the feast in social areas instead of in the trash.

“The people are responsible for this. Instead of throwing it in trash cans, they throw it on the side of the street,” said

Meer Alam, a resident of Kabul.

[…]

"Meanwhile, health officials said that the increase of trash in social areas in hot weather causes severe health issues. “Unfortunately, as part of the feast sacrifice, throwing out the remains of animals harms the environment, it causes pneumonia and skin diseases,” said Ahmad Shikib Zaheer, a doctor. “

IRC, IRC provides emergency health services to families affected by Afghanistan earthquake amid ongoing economic collapse, 29 June 2022

“Estimates that between 700 - 800 families are sleeping in the open air in the worst-affected areas, having lost their homes or too fearful of further tremors to go back inside, have led to concerns that many people are vulnerable to risks such as family separation, abuse or violence. Many families are attempting to travel to the nearby Paktia region in an effort to access medical treatment, with local medical services - already under enormous strain from the ongoing economic crisis - unable to cope.”

 

Care, CARE mobile health teams on the ground assisting earthquake survivors in Afghanistan, 23 June 2022

“Dr Anwer notes: “Alongside physical injuries, we are very worried about the immediate and longer-term psychological impacts of the earthquake on survivors and those living in the area who are processing the trauma of the event and loss of loved ones. Providing them with mental health support, alongside other medical assistance, as they deal with this trauma is crucial. Many of these people were already struggling to provide financially for their families due to soaring prices and inflation, and extreme levels of hungry before this latest crisis.” Reports suggest that many of those affected have been women and children. Most are sheltering in makeshift tents or living with neighbors as homes and livelihoods have been completely destroyed. “Also of concern, is the potential spread of cholera across the affected communities as water sources are damaged or polluted and sanitation facilities destroyed. Cholera was already endemic in the Afghanistan and cases have been reported to be on the rise even before the earthquake. It is crucial we act quickly to avert a new major outbreak of waterborne diseases,” adds Dr Anwer.”

 

BBC News, Afghanistan quake: Gyan clinic with five beds for 500 injured patients, 23 June 2022 "Gyan is one of the worst-hit areas. Many people remain trapped under the rubble […]

International development agencies set up the clinic there a couple of years ago. It was meant to deal with minor health conditions and refer people to hospitals in major cities for more significant treatment. It had no accident and emergency department.

Since the hard-line Islamist Taliban took power across the country last August, many international aid agencies have left the country. The medical system has been dealing with severe shortages of supplies and staff.

When the Taliban's acting district governor toured Gyan on Tuesday, people shouted at him, telling him to leave, a volunteer from a neighbouring district told the BBC.

"The Taliban are not capable of dealing with this disaster. There is no system in place," the volunteer, who did not want to be named, said.

"And we cannot be hopeful for international help. The world has forgotten Afghanistan."

Even before the Taliban takeover, the country's emergency services in its larger towns and cities had limited capacity to respond to natural disasters. There were few aircraft and helicopters available.

According to Paktika's medical authorities, there is a severe shortage of painkillers and antibiotics in the region."

 

UNHCR, 2021 Multi sectorial Rapid Assessments Analysis, June 2022

“With the public healthcare system on the verge of collapse, costs related to obtaining medicines and treatment emerge as significant problems. Costs of transport to access health facilities, distance and availability of clinics are additional barriers in accessing to health care. These problems are largely similar between male and female headed households and IDPs and IDP returnees.”

 

Tolo News, Afghan Earthquake: Officials Say Transfer of the Wounded Challenging, 21 June 2022

“The transfer of scores of those wounded in the earthquake in southwestern Afghanistan has turned challenging for the rescue teams due to the high number of the injured, health officials in Paktika said, vowing to manage the situation at their best. The officials said that many of the wounded have been sent to health centers and hospitals in Paktika and Khost provinces. Hekmatullah, the public health director for Paktika, said the casualties and the number of the wounded might increase as almost all villages in Barmal and Gayan districts of Paktika have been

destroyed. “So far, all villages have been destroyed and it is not clear how many of them are wounded and how many of them have been martyred,” he said. “These districts are very remote and their roads are unconstructed. It takes three to six hours for our medical teams to reach the affected areas. We also need a helicopter to ensure

quick transfer of the wounded.” Paktika residents said that the bumpy roads have interrupted the rescue operations for the survivors of the deadly earthquake.”

 

UNCHR, 2021 Multisectorial Rapid Assessments Analysis, 21 June 2022

"A number of considerations arise in relation to accessing healthcare. With the public health system on the verge of collapse, costs related obtaining medicines and treatment emerge as significant problems. Costs of transport to access health facilities, distance and availability of clinics are additional barriers in accessing to healthcare. These problems are largely similar between male and female headed households and IDPs and IDP returnees."

 

AVA, Poverty in Afghanistan / The Red Cross called for 80 million francs in emergency aid, 16 June 2022

“The International Committee of the Red Cross (ICRC) has released a report on Afghanistan today (Thursday, June 16) stating that due to the humanitarian situation, it has extended its emergency request from 36 million francs to 80 million francs by 31 December 2023. The Red Cross has called for help for 2 million people in 34 provinces; the figure, which the organization believes makes up 10 percent of Afghanistan's affected population. The committee went on to say that drought, severe economic and health crises have affected the entire territory of Afghanistan. According to the Red Cross, restrictions on the participation of women and minority groups, and displacement inside and outside the borders have added to this difficult situation. The International Committee of the Red Cross (ICRC) further noted that disruptions in the public service system have weakened investment in Afghanistan. "More than half of children under the age of five are expected to experience acute malnutrition," the Red Cross added. Unemployment, a weak health system, gaps in the health system, education, energy and public services are other factors that put pressure on people. This urgent call for help to the people of Afghanistan was made by the International Committee of the Red Cross at a time when Afghanistan is facing unprecedented unemployment, poverty and hunger following recent developments.”

 

AVA, Lahore University, MoPH sign cooperation agreement, 15 June 2022

“Afghan Minister of Public Health H.E. Dr. Qalandar Ebad and a team from University of Lahore signed a Letter of Understanding for assistance in running M. A. Jinnah Hospital Kabul and upgrade its facilities to make it a teaching hospital,” Ahmad Khan tweeted on Tuesday. He said: “The cost has not been estimated yet because it is an ongoing project, but Lahore University provides monthly assistance with medical equipment, technical equipment and training for the hospital’s doctors.” The IEA’s Ministry of Public Health welcomed the university’s move to increase the hospital’s technical and human resources’ capacity. However, Ebad said they did not sign the MoU with the ambassador of Pakistan to Kabul nor with the Pakistan government. He said the MoU was with the

university. “We didn’t sign this agreement with the ambassador of Pakistan but with the hospital delegation from Lahore. The delegation from Lahore wants to make the hospital professional, technical and capable,” Ebad said. In addition to improving the hospital and its services, the university will also pay the salaries of staff and other expenses. The non-payment of salaries over the past few months has been a serious cause of concern for staff at the hospital. According to them, they have faced serious financial pressure due to not having received salaries, which were paid by the former government. “We are asking the (new) government to pay us our salaries because we are facing countless problems,” said Abdul Ghafoor, a health worker at the hospital. According to the IEA officials, this type of cooperation will be extended to a number of other hospitals that were built and supported by Pakistan in the last few years.

 

Ariana News, EU signs deal with Bavarian Nordic for delivery of monkeypox vaccine, 15 June 2022

“The European Commission on Tuesday said it had signed a deal with Danish biotech firm Bavarian Nordic (BAVA.CO) for the delivery of around 110,000 doses of monkeypox vaccine. The agreement marks the first time that the EU budget is used for the direct purchase of vaccines and would make the shots rapidly available to all EU

member states, Norway and Iceland, the commission said. Around 900 cases of monkeypox have been reported in

19 EU countries, Norway and Iceland since May 18.”

 

AVA, UNAMA’s outgoing head meets with Haqqani, 12 June 2022

“In a series of tweets Saturday night Lyons said that in a meeting with Sirajuddin Haqqani, the acting minister of interior, she emphasized the need to fight terrorism and narcotics and to strengthen cooperation for humanitarian operations. She also said there was a need to work together to fight the recent cholera outbreak in the country.”

 

AREU, Afghanistan Covid-19 Poverty Report, 1 June 2022

"Access to health facilities is widely reported, though treatment costs and transportation disruptions have had an impact on people seeking treatment. Many respondents sought treatment, though most emphasised the effect of the costs of these treatments on their households’ economic security, as well as lost time in employment and day labour. One respondent reported avoiding treatment due to misinformation about the dangers of attending a health facility for Covid-19."

 

UNFPA, UNFPA Afghanistan Humanitarian Updates - First Quarter 2022, 29 May 2022 [click on the hyperlink to see infographic and information on reproductive health services]

 

UNFPA, Afghanistan’s Family Health Houses: Evidence of Life-Saving Impact, 29 May 2022

“Through the Family Heath House programme, UNFPA and its partners have developed a long needed solution for women and their children in rural Afghanistan, where they far too often die in childbirth or suffer lifelong consequences of pregnancy-related complications. The FHHs have proven their efficiency and sustainability. When Afghanistan's health system faced collapse during the post August 2021 crisis, the FHHs were the only facilities that provided health services in the remote areas of the country.”

 

UNICEF, Afghanistan Humanitarian Situation Report Report # 5 1-30 April 2022, 26 May 2022

“Measles cases continue to rise with 41,085 cases and 270 deaths since the start of the year, as do acute watery diarrhoea (AWD) cases with a heightened risk of cholera outbreaks as the weather warms.

• UNICEF continues to increase its AWD/Cholera preparedness and prevention activities reaching 299,431 people with AWD/Cholera messaging and 328,130 people with critical hygiene supplies.

• Over 4.6 million people were reached at UNICEF supported primary health care facilities including 1.52 million

  children under-five and 219,245 persons with disabilities.

• During the reporting period, 40,758 children were treated for Severe Acute Malnutrition (SAM) - a 14% increase since March.

• UNICEF-supported mobile health and nutrition teams reached around 130,000 people in remote and hard to reach areas in April.

• With UNICEF support more than 175,000 children and caregivers received life-saving child protection services including psycho-social support and case-management.”

 

WHO, Director-General's report to Member States at the 75th World Health Assembly – 23 May 2022, 23 May 2022

“Our dream of a polio-free world is tantalisingly close, with four cases of wild poliovirus reported so far this year in

Afghanistan and Pakistan […]”

 

WHO, Director-General's address at the High-Level Welcome at the 75th World Health Assembly – 22 May 2022, 22 May 2022

“Following the Taliban takeover last year, I travelled to Afghanistan, where I met a group of women nurses who

told me they had not been paid in three months, but would continue to serve their patients WHO paid their

salaries so they could continue to deliver the care on which their communities depend […] It’s no coincidence that

the final frontier for eradicating polio is in the most insecure regions of Afghanistan and Pakistan.”

Ariana News, 400 confirmed cases of cholera in Zabul: Health Officials, 24 May 2022

"The lack of access to health facilities, poverty and unemployment are said to be the major causes of the increase in the number of cholera cases. […] The cholera surge comes as Afghanistan is already grappling with the challenges of drought, poverty and an economic crisis. Afghanistan is in the grips of one of the worst humanitarian crises in the world and international organizations have warned of the collapsing healthcare system. The country is also facing multiple outbreaks of disease, including COVID-19, measles, and diarrhea, as well as acute malnutrition."

 

Ariana News, Eshkamish district residents voice concerns about infrastructure, service delivery problems, 17 May 2022

"Residents of Eshkamish district of Takhar province have raised concerns about the lack of facilities in the area stating there is a severe shortage of medicine at clinics, and not enough schools and a poor electricity supply. They have in turn called on the Islamic Emirate of Afghanistan (IEA) to establish the facilities so as to provide basic public services. Local officials have said they are prioritizing the needs of residents and looking for ways to resolve the problems. According to locals, damaged roads, the lack of electricity, lack of medicine at clinics and a shortage of school buildings are the main problems in the district.”

 

Afghan Voice Agency, Health Ministry Pledges to Hire More Midwives, 16 May 2022

"Hela Gharshin, the director general of midwives at the Ministry of Public Health, said that due to the lack of

higher education in the field of midwifery in the country, some midwives do not want to work in the field. “Our midwives in remote areas are working up to three days at a time because there is a shortage of midwives; Midwives are also subject to risk and their education is two years; Higher education in the field of midwifery is very rare,” she said.

Based on available numbers, 6,000 midwives are working within the Ministry of Public Health, and the shortage of professional midwives in remote areas of the country is considered a major challenge."

 

UNICEF, Afghanistan diaries: Supporting health, learning and hope: Paloma Escudero, UNICEF Director for Global Communication and Advocacy, reflects on a recent visit to Afghanistan, 12 May 2022

“16 April 2022 […] UNICEF security specialist in Kabul, along with one of our local security officers, describe the months-long effort. Their 14-person team covered over 2,000 kilometres – from Kandahar, through Urozgan, Helmand and Nimroz, close to the border with Iran. Two thousand kilometres of villages, they tell me, now accessible to UNICEF staff who have stayed in the country to deliver nutrition, education and other essential services for Afghanistan’s children. […] On the outskirts of Kabul, we pass children in the streets. A young girl,

seeking money for her family. A boy working at one of the market stalls that line the road. It’s two weeks into the holy month of Ramadan, and tables pile high with fruits and vegetables. But there are no crowds here. […] The empty stalls are a stark contrast from the place we’re headed. It’s a three-hour drive to Paktya Regional Hospital, in Gardez, where dozens of families fill the waiting room. […] This is one of more than 2,300 health facilities across the country that UNICEF, together with WHO, is supporting. The hospital serves over 75,000 people throughout Paktya Province. As fighting in recent months has let up, more Afghans are able to seek out health care – a blessing for children and their parents. But the jump in demand is straining the health sector. To help prevent the system from collapsing, UNICEF and WHO are providing the supplies, salaries and training needed to keep services running. No sooner than we arrive, I’m guided into a treatment ward for children with severe acute malnutrition. […] This year alone, some 3.2 million children are projected to suffer from severe malnutrition across the country.

As we make our way to another part of the ward, Dr. Niamatullah Zaheer, the hospital director, tells me his staff are overwhelmed. The hospital’s only paediatrician regularly screens more than 100 children a day. Even the neonatal unit is stretched: Too often, the hospital is forced to accommodate more than one infant per bed.”

 

United Nations Population Fund – UNFPA, With community support, Family Health House scores zero maternal death, 10 May 2022

"There are currently 172 Family Health Houses supported by UNFPA across Afghanistan, with 32 in Faryab. The FHHs have become an integral support to the Afghan health system, which suffered considerably with the withdrawal of development assistance after August 2021. This is why scaling up and strengthening existing FHHs is one of the priority areas of support for the Special Trust Fund for Afghanistan (STFA). The scale up plan involves expanding the number of the FHHs from the current 172 to 1,500. Existing FHHs, such as the 32 facilities in Faryab province, are also receiving support from STFA to sustain their operations and continue serving the people in their catchment areas. Under the plan, 10 more FHHs will be built in Faryab."

 

The Guardian, ‘The Taliban know they need us’: the Afghan hospitals run by women, 9 May 2022

"Up to 100 children a day are born at the hospital where Maqsoodi works – the doctors asked for the name of the clinic to be omitted for security reasons – and at least 140 female staff take care of all operations. “I have four children myself and I miss them during the day, but I tell them I have an important job to do. When the Taliban took over, 12 of our hospital’s doctors left the country. “We were all afraid and most of us wanted to leave,” Maqsoodi adds, “but we’re still here saving lives.” It has been difficult. The women say they feel under pressure from the Taliban. After the Islamists’ takeover in August, many of the medics stayed at home for weeks, too scared to go to work. Slowly, most of them returned to their jobs. “We keep pressing on,” Faizli says. “Even the Taliban know that they need us.”"

 

Human Rights Watch, Afghans Dying from Lack of Medicine, 9 May 2022

“Gul Ahmad, who lives in Ghor province and whose 5-year-old son died from diarrhea last week, had a similar story: “The doctors told me that they were out of medicine, and I must take my son to a larger clinic.” He didn’t have the money to take his son to another clinic, and the child died. Afghanistan is in the grips of one of the worst

humanitarian crises in the world. More than 24.4 million people will need humanitarian health aid in 2022, roughly two-thirds of the population. Earlier this year, the World Health Organization (WHO) warned that Afghanistan’s health system was on the brink of collapse. Afghanistan’s banking crisis and loss of funding has meant that most healthcare workers have not been paid for months, and clinics and hospitals are running seriously short of essential medicines and supplies. The country is facing multiple outbreaks of disease, including Covid-19, measles, and diarrhea, as well as acute malnutrition. As many Afghans fall deeper into poverty, the lines outside healthcare facilities are growing. “People come to our clinics, they bring their malnourished children, and we don't have enough medicine,” a healthcare worker in Bamiyan told me. “Every week I witness three or four kids dying of malnutrition, a preventable death.”

 

United Nations Office for the Coordination of Humanitarian Affairs, Afghanistan Collective Feedback Digest - A compilation of community voices - Issue 6, 5 May 2022

"People also cited health services, including on Acute Watery Diarrhea (AWD), as a key need."

 

Tolo News, 10 Children in Balkh Died of Thalassemia in Past Year: Official, 4 May 2022

“At least 10 children lost their lives to thalassemia, an inherited blood disorder, over the past year in the northern province of Balkh, a local health official said. The head of the provincial department of health, Najibulah Tawana, said they are unable to treat the disease. “We lost ten innocent children. The main way to treat the thalassemia patients ... is impossible in Afghanistan,” he said. According to him, previously patients suffering from the disease were taken to Germany and Iran. Thalassemia is an inherited blood disorder that causes the body to have less hemoglobin than normal. Some of the patients struggling from the disease are brought into the provincial hospital of Abu Ali Sina Balkhi. […] The provincial health department said it recorded 230 patients suffering from thalassemia.”

 

United Nations World Health Organisation (Afghanistan), UNICEF and WHO warn of perfect storm of conditions for measles outbreaks, affecting children, 27 April 2022

"An increase in measles cases in January and February 2022 is a worrying sign of a heightened risk for the spread of vaccine-preventable diseases and could trigger larger outbreaks, particularly of measles affecting millions of

children in 2022, warn WHO and UNICEF. Pandemic-related disruptions, increasing inequalities in access to vaccines, and the diversion of resources from routine immunization are leaving too many children without protection against measles and other vaccine-preventable diseases. The risk for large outbreaks has increased as communities relax social distancing practices and other preventive measures for COVID-19 implemented during the height of the pandemic. In addition, with millions of people being displaced due to conflicts and crises including in Ukraine, Ethiopia, Somalia and Afghanistan, disruptions in routine immunization and COVID-19 vaccination services, lack of clean water and sanitation, and overcrowding increase the risk of vaccine-preventable disease outbreaks. 2020, 23 million children missed out on basic childhood vaccines through routine health services, the highest number since 2009 and 3.7 million more than in 2019.

As of April 2022, the agencies report 21 large and disruptive measles outbreaks around the world in the last 12 months. Most of the measles cases were reported in Africa and the East Mediterranean region. The figures are likely higher as the pandemic has disrupted surveillance systems globally, with potential underreporting. Countries with the largest measles outbreaks since the past year include Somalia, Yemen, Nigeria, Afghanistan and Ethiopia. Insufficient measles vaccine coverage is the major reason for outbreaks, wherever they occur. “The COVID-19 pandemic has interrupted immunization services, health systems have been overwhelmed, and we are now seeing a resurgence of deadly diseases including measles. For many other diseases, the impact of these disruptions to immunization services will be felt for decades to come,” said Dr Tedros Adhanom Ghebreyesus, Director-General of the World Health Organization. “Now is the moment to get essential immunization back on track and launch catch-up campaigns so that everybody can have access to these life-saving vaccines.”"

Afghan Voice Agency, Samangan Provincial Hospital: Many Children Infected with Measles to Die, Serious Attention and Health Supports Needed, 25 April 2022

“The residents further have added that due to lack of for measles, they have to travel to neighboring provinces for

treatment.

The authorities at Dr. Ikramuddin Wakilzadeh Hospital in Aybak city told Hasht-e Subh that more than 100 children with have been hospitalized at the Provincial Hospital in the past month.

According to sources, in Samangan Provincial Hospital, the highest number of infant deaths is recorded in the districts of Du Ab, Dara-i-Suf Bala, -i-Suf Paeen, Khuram, and Sarobagh.

Over the last two months, measles has increased in most provinces, killing many children.”

 

UNHCR, UNHCR AFGHANISTAN 2021 MULTI SECTORIAL RAPID ASSESSMENTS ANALYSIS, 21 April 2022

“A number of considerations arise in relation to accessing healthcare. With the public health system on the verge of collapse, costs related obtaining medicines and treatment emerge as significant problems. Costs of transport to access health facilities, distance and availability of clinics are additional barriers in accessing to health care. These problems are largely similar.”

 

US DOS, 2021 Country Reports on Human Rights Practices: Afghanistan, 12 April 2022

“LGBTQI+ persons, already disadvantaged prior to August 15, faced further barriers to accessing reproductive health resources after the Taliban takeover. […] Access to maternal health care services was constrained by the limited number of female health practitioners, including an insufficient number of skilled birth attendants.

Additionally, the conflict environment and other security concerns limited women’s safe access to health services of any kind. Since their takeover, the Taliban permitted women to continue their roles as health practitioners, but many women were afraid to return to work due to safety and security concerns related to the Taliban’s stated

policies restricting women in the workplace. After August 15, the ever-smaller number of qualified female health

practitioners steeply increased the risk of poor health outcomes for women.”

 

Afghan Voice Agency, MSF raises concern over increase in measles cases in three provinces, 6 April 2022

“Médecins Sans Frontières (MSF) in Afghanistan has expressed concern about the rising incidence of measles in the

country, saying that the provinces of Herat, Kunduz and Helmand are the most affected.

Afghan Voice Agency (AVA)_MSF said Wednesday that in the past week alone, 90 children with measles had been admitted to a special ward in Herat province.

Last week, the agency announced the opening of a special ward for patients at the provincial hospital, saying that it has now increased the ward to 60 beds.

Médecins Sans Frontières said in just a few days, all the beds in this ward were full of measles patients and now

there is no room for other sick children.”

 

UNFPA, PRESS RELEASE: UNFPA scaling up support to save and protect the lives of Afghan women and girls, 31 March 2022

“Interim funding at the end of 2021 prevented the total collapse of the health system in the country following the withdrawal of development assistance, but women and girls’ access to lifesaving sexual and reproductive health services has been severely diminished especially in remote parts of the country […]

In spite of the challenging context, UNFPA continues to provide essential and life-saving maternal health and

protection services, with support from local communities […]

UNFPA requires US$251.9 million in 2022 to continue and scale up the delivery of maternal health and protection services to meet the urgent needs of 9.3 million Afghans, including 2.2 million women of childbearing age, 2.3

million adolescents and 289,000 women expected to give birth this year.”

 

UNFPA, Emergency Response: UNFPA Afghanistan supported Mobile Health Teams & Family Health Houses, 31 March 2022

“The Family Health Houses and Mobile Health Teams play critical roles during the emergency response in Afghanistan, they provide health services for the vulnerable and deprived population in the hard to reach areas of the country…”

 

UNHCR, Afghanistan Situation Regional Refugee Response Plan - 2021 Final Report, 31 March 2022

“Limitations on women’s freedom of movement have negatively impacted several aspects of women’s lives, including preventing them from accessing health services.”

 

Care International Afghanistan, CARE provides livesaving health care to vulnerable Afghans, 29 March 2022

“In a mountainous village of 4,000 houses in Kabul province, CARE is the only organization that provides health services including medicines, maternal health and nutrition services to residents, in particular to women and girls, through its weekly mobile health clinics. Unemployment, poverty, lack of schools and mental health issues are the main challenges in the area.

Dr. Shamsur Rahman* a CARE doctor said, “Each time I come here, I see between 100 and 150 patients in a day. Flu, cough, and other winter-related diseases, like lung problems, and diarrhea, are the most common problems in this village. Women and children are the most vulnerable and are in dire need. There are no physical health centers here. CARE is the only organization that provides health services for this community.” We also provide free medicine, whereas in public health centers, medication must be paid for, and often, people simply cannot afford it.”

Over the past 6 months CARE Afghanistan has supported 61,592 people with health services, of which 65% are women and girls in Ghazni, Herat, Balkh, Kabul and Khost provinces. The services include primary health care, maternal health, nutrition support, referrals to specialized facilities for gender-based violence cases, COVID

awareness-raising and psychosocial support services. In addition, CARE has distributed emergency medicines, medical supplies and equipment to health facilities.

Since the change in power in August 2021, medicine and equipment shortages, and unpaid salaries for health workers, have put enormous additional strain on an already weak health system. An estimated six million people have no access, or insufficient access, to health care in Afghanistan, and women and children pay the heaviest price. Ahead of the 31 March Afghanistan donor pledging conference, CARE is urging the international community to step-up their commitment to support the most vulnerable people in Afghanistan to access critical health

services.”

 

WHO, WHO Director-General's Keynote address at the World TB Day Online Talk Show – 24 March 2022, 24 March 2022

“We are especially concerned for the health of people with TB in Afghanistan, Ethiopia, Syria, Ukraine and Yemen, where conflict is jeopardising their access to services – and their very lives.”

 

UNICEF, Afghanistan Humanitarian Situation Report Report #3 1-28 February 2022, 22 March 2022

“There has been a sharp rise of more than 13,400 measles cases this year, bringing the total since Jan 2021 to 43,988 cases (80 per cent among children under five). UNICEF is working with partners on a measles-outbreak campaign as an immediate response.”

 

BBC News, Afghanistan crisis: Children malnourished as hospitals collapse, 23 March 2022

“Foreign funds given to the government of Afghanistan ran the country's healthcare system before the Taliban takeover in August 2021. Without them, public hospitals have collapsed. Malnutrition and diseases like measles and tuberculosis are causing the deaths of children - more than a million are at risk. The BBC's Yogita Limaye visits Musa Qala district hospital in Helmand province, southern Afghanistan.”

 

Radio Free Europe/Radio Liberty’s Gandhara, Taliban Resurrects Gender Segregation In Public Offices, Transport In Afghanistan, 16th March 2022

“The Taliban’s Ministry for the Promotion of Virtue and Prevention of Vice earlier this month sent a letter to the Health Ministry ordering it to segregate male and female employees. “The offices for men and women should be separate,” said the letter, a copy of which was obtained by RFE/RL’s Radio Azadi.” The ministry, which is the enforcer of the Taliban’s radical interpretation of Islamic law, also warned that health care should be denied to female patients who do not observe the Islamic hijab. Several employees of the Health Ministry, who talked to Radio Azadi on condition of anonymity, confirmed the authenticity of the letter. The Taliban did not respond to messages from Radio Azadi seeking comment. The Taliban initially ordered women not to return to work. But it later called female health workers back to clinics and hospitals, although many were too scared to resume their

work. Rights groups say gender segregation has created barriers to women and girls accessing health care. At many facilities, patients are only treated by a health professional of the same sex.”

 

UNFPA, Afghanistan Humanitarian Appeal 2022, 14 March 2022

“Every two hours, a mother dies from preventable childbirth and pregnancy complications and the current crisis could make the situation worse.”

 

The Khaama Press, 1.2 million children to be vaccinated against measles in Afghanistan, 14 March 2022

“World Health Organization in a press release announced that they have launched a nationwide vaccination of measles on March 12 that will last until March 17, 2022, covering 1.2 children across Afghanistan. The week-long campaign that is planned to be implemented in 49 districts of 24 provinces will involve 9,200 workers, volunteers, supervisors, and monitors. Measles has transformed into another headache in Afghanistan as the contiguous viral disease has infected 18,000 children and has claimed the lives of 142 minors since the beginning of 2022.”

 

WHO, Statement of the Thirty-first Polio IHR Emergency Committee, 11 March 2022

and killed in four different locations. These are the first attacks on polio workers since nationwide campaigns

resumed in November last year and underline that major challenges remain in the country including security challenges and the adverse economic situation. [...] The unpredictable situation in Afghanistan, with looming humanitarian crises including food insecurity and risk of financial collapse disrupting eradication activities [...]”

 

IOM (DTM), Afghanistan - Baseline Mobility and Community Based Needs Assessment (November-December 2021), 11 March 2022

“In Kandahar, the closest health centre is on average 21.4 kilometers away from the community.”

 

VOA, Afghanistan Faces Return to Highest Maternal Mortality Rates, 7 March 2022

"Following the events of mid-August 2021, Afghanistan's health sector was close to collapse, with coverage of many lifesaving interventions for women and children falling between 20 and 30% within days," said Joe English, a UNICEF spokesperson. Such setbacks have given rise to one of Afghanistan's long-standing health crises — high maternal mortality.”

 

OHCHR, Interactive dialogue on the High Commissioner's report on Afghanistan, 7 March 2022

“Limitations on freedom of movement negatively impact other aspects of women’s lives, including access to health services.”

 

WHO, Afghanistan Emergency Situation Report No. 13/ Reporting Period 15 - 28 February, 6 March 2022 “During the reporting period, one of the challenges in health service delivery in the southeastern and southern regions concerned female patients who were not allowed to visit the health facilities without Mahram (an adult male companion of a female). This would seriously affect access and utilization of health services.

WHO is in communication with the de facto health authorities at the national and regional levels to find solutions for access of quality healthcare services among female patients.

During the last two-weeks, reduction in the new cases of acute watery diarrhea (AWD), dengue, and malaria continues while new measles cases are being reported every day. Furthermore, one suspected outbreak of rabies was reported from Paktia province which was responded by surveillance team. WHO has deployed 111 rapid response teams (RRT) to support surveillance and response.

Trauma and post-trauma physical rehabilitation services were provided to 8,920 people through the WHOsupported Trauma Care Units (TCUs) and physical rehabilitation centers. Emergency primary healthcare services were extended to 94,893 people living in underserved and remote areas of Afghanistan through mobile health teams (MHTs) and sub health centers (SHCs). The emergency medical supplies and kits deployed by WHO to various areas in the last two weeks reached 191,700 people in various parts of the country.

On February 24, eight polio workers were killed in Kunduz and Takhar provinces during the course of their lifesaving work. The national polio vaccination campaign was suspended in both provinces following the attacks. The UN and WHO have extended its deepest condolences to the families, friends and colleagues of these courageous health workers.”

 

IOM, CBNA R14 — Afghanistan — Community-Based Needs Assessment: Summary Results (November—December 2021), 2 March 2022

“Four in five communities (81%) do not have a health clinic within the confines of the community. When healthcare is available, one in four households do not visit a healthcare provider when they are ill due to poor quality or lack of medicine, services, and staff. COVID-19 symptoms are widely reported throughout the country.”

 

Khaama Press, Health Workers Safety Essential to Eradicate Polio, 27 February 2022

“Still, Polio is endemic in Afghanistan yet the news of attacks on the polio vaccinators are coming in from the war-

“The committee was very disturbed by the news that eight front line workers in Afghanistan had been attacked

 

torn state. Eight polio vaccination workers in four locations in northern Afghanistan were killed on February 24 during a polio vaccination campaign in Afghanistan. One member of the vaccination transit team was killed in the Taloqan district in Takhar province. In another incident, four health care workers were killed in Kunduz city. These four polio workers were running a door-to-door polio campaign. In a separate incident in the Imam Sahib district of Kunduz province, two vaccinators and other polio workers were killed. Very similar coordinated attacks took place last year as well.

The United Nations has condemned the recent attacks on health workers and extended condolences to the families, friends, and colleagues of the skilled health workers. The Taliban will be accountable for the killings of innocent health workers. Soon after retaining power last year, the Taliban promised that they would include female workers and ensure security to the aid workers. The polio drive is a result of high-level negotiation between the Taliban and UN officials.

Nationwide polio campaigns resumed in November last year. During national polio vaccination campaigns last year at least nine polio workers were killed.

[...]

The lack of a massive vaccination drive may lead to an outbreak of polio cases across the state, already suffering from several deadly diseases. The Taliban and other Islamist leaders have misled the citizens about polio immunization. They have been telling that the polio vaccine is a Western conspiracy aimed at sterilizing Muslim children.

The health workers and aid agencies have been facing severe threats from Islamic extremist organizations. Even they claim the vaccinators are the spies or informers of the CIA. This is worth mentioning that the CIA used a vaccination drive in Pakistan in 2011 to confirm the location of Osama bin Laden.”

 

ICRC, Time is running out to save millions of lives in Afghanistan, 25 February 2022

“Healthcare services are among those in most urgent need of support. Perhaps nowhere is this more evident than at the ICRC-supported Mirwais regional hospital in the southern city of Kandahar. Serving a population of up to 9 million in the region and beyond, demand far outstrips capacity, with some 4,000 sick or wounded seeking treatment in the 650-bed facility every day. This is partly because the current crisis caused some smaller healthcare facilities to close down and many practitioners to leave the country. All the wards are overcrowded.

Bed occupancy in the paediatric ward, for example, is at almost 300 per cent, with often two or three children per bed. Many are severely malnourished, and numbers are rising – not only in children but in young adults as well. Some are the victims of improvised explosive devices, like one boy whose hands were blown off when he picked up what he thought was a toy. One ward is full of children suffering from measles, a disease endemic across the country. [...] Kristiina Kumpula, secretary-general of the Finnish Red Cross society. "Afghanistan was already one of the most difficult places in the world to be a mother or an infant. Now it is harder than ever. And the people we are seeing here might be considered the lucky ones – with many health facilities not functioning at all, sick and vulnerable people are forced to travel long distances, which few can afford. Many simply don't reach the care they need." "Access to healthcare is clearly one the most pressing humanitarian concerns in the country," said Anders Ladekarl, secretary-general of the Danish Red Cross society. "Supporting teaching hospitals and nursing schools is one of the most effective and sustainable ways to save an already-debilitated health system from collapse and help secure its future. The urgency of putting the right support in place cannot be overestimated." While there has been welcome progress on some restrictive measures that help facilitate humanitarian response, including a December 2021 UN Security Council resolution allowing some exemptions in the sanctions regime, Robert Mardini is clear that States need to go much further. [...] In March the ICRC will launch a budget extension appeal of close to 50 million Swiss francs (USD 54 million), most of which will be used to help provide assistance to the country's hospitals and medical staff.”

 

Radio Free Europe/Radio Liberty’s Gandhara, Eight Polio Workers Killed In Attacks In Afghanistan, 24 February 2022

“Eight members of polio vaccination teams were killed in separate attacks in Afghanistan, the United Nations said

on February 24.

[...]

The UN said one person was killed in Takhar Province in the far north, and seven in neighboring Kunduz Province -- including four in the provincial capital, Kunduz city.

[...]

Matiullah Rohani, head of the Taliban's Information and Culture Department in Kunduz, said security forces are working to arrest the perpetrators.

"Our security and intelligence agencies have launched an operation in connection with the incidents that took place today in Kunduz Province, and efforts are under way to apprehend the perpetrators,” Rohani told Radio Azadi.

The killings were the first since UNICEF and the World Health Organization launched a nationwide polio vaccine campaign in November aimed at reaching over 3 million children, with the backing of the Taliban.

Polio teams were frequently targeted by insurgent groups in Afghanistan until the Taliban's takeover of the country last year, when the hard-line Islamist group said it wanted to work with the UN to stamp out the disease. Last year, several polio vaccinators were shot by unknown militants in eastern Nangarhar province.

No group has claimed responsibility for the recent attacks.”

 

Afghan Voice Agency, Measles Outbreak in Afghanistan - 80 People Infected in Parwan Recently, 23 February 2022 “ [...] Following the increase in measles disease in Afghanistan, the number of infected in Parwan province has also increased unprecedentedly. Health officials in province expressed concerns about the rapid spread of the measles virus. According to them, in the last two weeks alone, 80 cases of the disease have been registered in Parwan province. Abdul Qasim Sangin, head of the 100-bed hospital in Parwan, said that 80 cases of measles had been registered in the village of Abdibay, in Charikar, and in the Sayed Khel, and Siahgerd districts. He added that two of them have died so far, adding that other patients are receiving medical care at the provincial hospital and their homes. [...] The head of the Provincial Hospital in Parwan said that the reason for the increase in measles was that children did not get measles vaccine due to the spread of the coronavirus in recent years. According to statistics, most of the sufferers of this disease are children. Meanwhile, some doctors say that measles is a highly contagious disease that threatens young children, especially those suffering from acute malnutrition. Speaking to Hasht-e Sobh, Seyed Zabih Saifi, a pediatrician at the 100-bed hospital in Parwan, said there was no cure for the virus, stressing that the only way to prevent it was to vaccinate children. According to him, children get measles and high fever after getting measles. However, a number of patients at the 100-bed hospital in Parwan are urging residents of Parwan province to vaccinate their children to prevent measles.”

 

Ariana News, Pneumonia runs rampant through Afghanistan, 20 February 2022

“In the last 45 days, more than four hundred people have died of pneumonia across the country, officials said adding that most of them were children. The Ministry of Public Health says that during this period, nearly 190,000 people contracted pneumonia across the country. According to health officials, the highest number of cases were in Kabul, Nangarhar and Balkh provinces. According to the ministry:

• In 2020, more than 900,000 people were infected and 1,700 people died

• In 2021 more than 944,000 people were infected and 1,900 died

• In 2022, more than 188,000 people have so far been infected while 436 people have died

  The highest number of infections recorded this year so far have been in Balkh with 23,075 cases, then Kabul with 20,990 and Nangarhar with 14,560. Nangarhar recorded the most deaths from pneumonia with 88 cases, Balkh with 75 cases and Kabul with 45. Extreme cold, a lack of fuel to heat homes, limited access to health care and hospitals is behind the rising case load officials said. A large percentage of fatalities however have been children.”

• The New Humanitarian, Afghanistan’s crises, by the numbers, 15 February 2022

  “Healthcare: COVID-19 is not the only epidemic

  Multiple disease outbreaks are hitting a barely functioning health system simultaneously. These include a worsening measles outbreak, acute watery diarrhoea, dengue fever, and malaria – on top of endemic polio and COVID-19. The food and hunger crisis bleeds into the health emergency. Aid group Save the Children says the

  number of severely malnourished children at its clinics has more than doubled since August. Malnutrition and vitamin A deficiencies make measles more likely to be fatal, health experts say.

  Afghanistan’s healthcare system is on life support, floated for now by emergency aid and money diverted from the World Bank-managed programme that had powered 30 percent of public spending before the Taliban takeover, including health services. COVID-19 cases and deaths continue to rise, but funding and doctor shortages have shut down many treatment facilities. Aid groups say many Afghans who need healthcare don’t have access.”

   

  AVA Press, Health sector faces oxygen shortage amid COVID-19 Surge. 12 February 2022

  “The emergency department of the Afghan-Japan Hospital is once again full of COVID-19 patients these days, which includes youth and children. Our hospital has the capacity of 100 beds, but now we have 85 to 90 patients. Numbers are increasing day by day. The Ministry of Public Health must be prepared because we have not yet reached the peak stage of the disease. Perhaps in the coming weeks the situation will become more critical and the previous -19 private hospitals will be reactivated,” said Heshmatullah Faizi, a doctor at the -Japan Hospital. “Every day we have 120 to 180 patients, and more than 80 percent of the cases are positive,” said Ebadullah Ebad, head of the Afghan-Japan hospital's infectious diseases department. Meanwhile, the doctors at the hospital say that it has been five months since they have received their salaries. According to them, they also face severe shortages of hygienic substances [...] “Right now, we only have oxygen for our patients for just one more day, but after that we will face a lack of oxygen,” said Ebadullah Ebad, head of the Afghan-Japan hospital's infectious diseases department. “The oxygen generating machine has the capacity to produce oxygen for 60 patients and is not enough for us.””

   

  WHO, Measles – Afghanistan, 10 February 2022

  “Measles is endemic in Afghanistan, with almost all provinces reporting suspected cases every year. Following periods of lower transmission in 2019 and 2020, and amid the humanitarian crisis in Afghanistan, weekly notifications of suspected measles cases have been increasing in all provinces since the end of July 2021, with the highest weekly toll observed in the last four weeks in January 2022 (Figure 1). The number of cases and deaths increased by 18% and 40% respectively from week 4, 2022 (week commencing January 24) to week 5, 2022 (week commencing January 31). Figure 1. Weekly number of reported suspected measles cases in Afghanistan. Week 1, 2018 to week 4, 2022. Source: WHO Country Office in Afghanistan, WHO Regional Office for the Eastern Mediterranean.

  [...] From 1 January 2021 to 29 January 2022, 35 319 suspected measles cases were reported in Afghanistan, of which 3221 (9%) were laboratory-confirmed by IgM-ELISA in the seven reference laboratories (one national and six regional). Most of the suspected measles cases (91%) occurred among children less than 5 years of age. During the same period, 156 measles deaths were reported among the confirmed cases (CFR=4.8%), with more than 97% of the fatalities registered among children less than 5 years of age. Although the number of deaths is relatively low, the rapid rise in cases suggests that the trend of reported deaths will continue to increase sharply in the coming weeks. The most affected provinces, with the highest number of reported cases (confirmed and suspected) are Balkh, Ghazni, Helmand, Kandahar, Kabul, Paktika, and Paktya. Figure 2 shows the measles notification rate (confirmed and suspected cases) per million population. The highest rates were observed in Paktya (617 cases per 1 000 000), Balkh (275 cases per 1 000 000), Kunduz (204 cases per 1 000 000) Zabul (168 cases per 1 000 000), Kandahar (145 cases per 1 000 000), Logar (127 cases per 1 000 000).

   

  Public health response

   

  • In December 2021, a measles outbreak response immunization campaign reached 1 510 440 children aged 9 to 59 months in Balk, Ghazni, Ghor, Helmand, Kandahar, and Paktika provinces. The campaign was implemented at fixed sites like mosques, schools and other suitable places easily accessible for parents. The highest administrative immunization coverage was reported in Ghor province (121%) and the lowest was reported in Ghazni province (90%). The next nationwide measles immunization campaign will be conducted in the first quarter of 2022.

    In the provinces where campaigns were conducted, implementing partners are supporting case

     

  •  

    management, risk communication and community engagement in the affected villages and surrounding areas.

  • Vitamin A supplementation was provided to all children aged 6 to 59 months in November 2021 during the nationwide Polio campaign.

  • WHO is providing technical support on surveillance, vaccination, laboratory testing, case management, and risk communication and together with the Health Cluster, WHO is continuing to coordinate and support a multi-pronged health response.

  • Since November 2021, with emergency funding, WHO is delivering essential life-saving maternal and child health services in 17 provinces through 1209 Sehatmandi health facilities.

  • As part of an emergency response to treat more than 1000 hospitalized children suffering from severe acute malnutrition, WHO supports 123 health clinics specialized in the management of severe acute malnutrition and airlifted 34.6 tons of life-saving health supplies to Afghanistan. The supplies include enough medicines to treat 15 000 people in need of medical care for three months.

  • WHO provided technical and financial support for the establishment of the regional reference laboratory in Paktya province and supported 1131 health facilities to provide essential health services from November 2021 to January 2022, including medical referral facilities.

 

WHO risk assessment

 

Measles is a very highly contagious, vaccine-preventable disease caused by a virus that is transmitted by air and through direct contact with infected cases. Unvaccinated young children are at the highest risk of measles and its complications (e.g. pneumonia and encephalitis), including death. Measles outbreaks can result in epidemics with a high case fatality rate, especially among young, malnourished children.

 

Afghanistan is considered a fragile, conflict-affected and vulnerable setting. The country has faced years of compounded crises, under-investment, instability and drought, and has now the highest number of people in emergency food insecurity in the world. According to UNICEF, 14 million people in Afghanistan are facing acute food insecurity, and an estimated 3.2 million children under five years suffer from acute malnutrition.

 

The large and widespread outbreaks and the increasing number of reported measles cases in Afghanistan, is due to a variety of complex factors that on the one hand have resulted in the low immunization coverage of both first dose of measles-containing vaccine (MCV1) and second dose (MCV2), on the other has exacerbated the impact of the outbreak (e.g. high levels of acute malnutrition, winter conditions and crowded domestic situation, previous displacement). The 2020 WHO/UNICEF national immunization coverage estimates were 66% for MCV1 and 43% for MCV2. At the sub-national level, administrative coverage data shows that six provinces achieved less than 50% MCV1 coverage (Kandahar 40%; Paktya 38%; Jozjan 37%; Khost 36%; Helmand 18%; Urozgan 3.1%). The internal displacement of 698 000 people in 2021 was another driver of low MCV coverage. Internally displaced persons (IDPs) frequently live in conditions that increase susceptibility to measles (e.g. through less access to immunization services) and may increase measles exposures (e.g. through over-crowding) as well as experiencing poor health outcomes (e.g. due to factors like increasing risk and rates of malnutrition, poor access to curative services). Cross- border travel due to the recent instability in Afghanistan has increased the risk of international spread, particularly in Pakistan and Iran.

 

Overall risk at the national level is assessed as very high due to:

 

1. Prolonged low measles vaccination coverage that has led to the accumulation of a large susceptible population.

2. High number of internally displaced people.

   High rates of malnutrition and vitamin A deficiency which could result in increased mortality and expected

    

3.  

   to increase especially in remote areas during the winter.

4. Inadequate case management due to a shortage of equipment, supplies, and skilled staff in health facilities, long and difficult access to health facilities during the winter period.

5. Barriers to access to healthcare in the rural population.

 

The regional risk is considered moderate due to the movement of people to Tajikistan, Iran and Pakistan, while at the global level the risk is considered low due to moderately high global MCV coverage estimates. More information is required from neighbouring countries and continued monitoring of displacement trends."

 

International Rescue Committee, David Miliband's Testimony to the Senate Foreign Relations Committee Subcommittee on Afghanistan, 9 February 2022

“Since August, our nearly 3,000 staff have resumed operations, providing lifesaving assistance and expanding our programs to reach ten provinces. Afghans make up more than 99% of IRC staff in the country and women make up half of our staff. Last year, we reached one million Afghans with vital services spanning health, emergency cash, education, water and sanitation, and economic recovery programs. The IRC is responding to the ongoing deterioration by providing emergency winterization assistance and scaling up support for 64 health facilities. We are also launching mobile health teams to travel to treat malnourished children in rural communities with no other access to healthcare. We support those displaced with cash, tents, clean water, sanitation, and other basic

necessities. The IRC has expanded our women’s protection and empowerment activities in recent years and has become a leading actor in the protection field. Our teams also help Afghans gain self-sufficiency, including by helping local communities plan and manage their own development projects and by providing livelihoods support like climate-smart agriculture programming. Generous US government funding has helped support our work, including ongoing programs focused on protection and economic (cash) support for women, protection services for at-risk children, and gender-based violence case management and psychosocial support.”

 

Ariana News, Afghanistan’s health system is on brink of collapse: urgent action needed, 26 January 2022

“The World Health Organization (WHO) has once again appealed to the international community to find a funding mechanism to help prevent Afghanistan’s primary health care initiative from collapsing. The WHO stated this week international donors need to find a funding mechanism for the Sehatmandi program, which is Afghanistan’s crucial primary health care initiative. The Sehatmandi program is the backbone of Afghanistan’s health system, providing care for millions of people through 2,331 health facilities across the country. However, since the Islamic Emirate of Afghanistan (IEA) took control, major funding for the program has been withdrawn. Previously funded by the World Bank, the European Commission, and USAID, there are now serious challenges to continuing these vital primary health care services. Over the last two decades, life expectancy has risen, and maternal, newborn and child deaths in Afghanistan have dramatically decreased, largely due to the success of the Sehatmandi program.

Today, the population’s health is seriously under threat and all the progress in health outcomes may be lost, the organization warned. “The recent funding pause by key donors to the country’s biggest health programme (Sehatmandi) will cause the majority of the public health facilities to close. As a result, more mothers, infants and children will die of reduced access to essential health care. “WHO is determined to work with partners in identifying a sustainable solution with the support of donors to maintain and scale up the lifesaving interventions when needed in the country,” said Dr Luo Dapeng, WHO Representative in Afghanistan this week.”

 

Khaama Press, Afghanistan’s 90% health centers may shut down by the end of 2022: IRC, 8 January 2022

“International Rescue Committee in its latest report warned that up to 90 percent of health centers in Afghanistan might shut down by the end of this year, 2022. The reports review that millions of Afghan people will be left without health services and facilities and millions more may lose lives if the current economic and political situation continues. IRC has also warned of the bleak future of the Afghan people as it estimates up to 97 percent

of the country’s people to face starvation by the end of 2022.”

 

The New Yorker, Afghanistan has become the world’s largest humanitarian crisis, 5 January 2022

“A month after the Biden Administration pulled U.S forces out of Afghanistan, only seventeen per cent of the country’s more than twenty-three hundred health clinics were functional. Doctors in the hospital in Kabul told me that they hadn’t been paid since the Taliban seized power, in August, and that medicine is in short supply. The new government is struggling to feed the country’s thirty-nine million people, and the chance that an Afghan baby will go hungry and die is the highest in twenty years. Half of the country’s population needs humanitarian assistance to survive, double the number from 2020. More than twenty million people are on the brink of famine. The United Nations Development Programme projects that by the middle of this year Afghanistan could face “universal

poverty,” with ninety-seven per cent of Afghans living below the World Bank-designated international poverty line

of $1.90 a day.”

 

Pajhwok, The only Covid-19 hospital in Uruzgan shut down, 29 December 2021

“Officials of the Public Health Department in central Uruzgan province say the only Covid-19 hospital has been shut down to financial problems and lack of cooperation from donors.

“The 20-bed coronavirus hospital was inaugurated in Tirinkot, the provincial capital, in January 2021. Covid-19 patients from all districts, including Tirinkot, were treated here.

“The facility was run by the Ministry of Public Health, with assistance from SHDP and MOVE in terms of equipment

and staff salaries.”

 

ANI, Afghanistan: number of cancer patients rises amid deteriorating healthcare services, 28 December 2021

“Following the deterioration in healthcare services, after the Taliban took control of Afghanistan, the number of

cancer patients is rising in the country.

The Ministry of Public Health (MoPH) said the number of patients diagnosed with cancer, with 60 per cent female patients have been recorded since the beginning of 2021, reported TOLO News.

Findings of the MoPH show that the most frequent cancer among Afghans is breast cancer for women and oesophagus cancer for men.”

 

UNFPA, Emergency health kits ensure maternal and newborn care in Afghanistan, 20 December 2021

“Since Kabul fell to the Taliban in August, more and more women have been seeking maternal health care from the Malalai hospital, many of them internally displaced from the northern provinces of Afghanistan into the capital.

Although the number of patients has gradually returned to normal as the displaced moved elsewhere, the

hospital’s supplies have been left badly depleted.

Ms. Oruzgani fears the situation could get far worse should the health care system fail completely. Preliminary estimates warn that the current humanitarian emergency and suspension of lifesaving reproductive services for women and girls could cause up to 58,000 additional maternal deaths, 5.1 million unintended pregnancies and a near doubling of the unmet need for family planning over the next four years.

In a country where a woman dies every two hours from pregnancy-related complications, Ms. Oruzgani said: “The kits are critical at this time, as hospital resources are running out and the support we were receiving has dwindled. We can’t be sure where our next assistance will come from.”

 

TOLO News, 1000s of Afghan Children With Heart Problems Await Treatment, 19 December 2021

“The treatment of Afghan children with congenital heart defects--either at domestic medical centers or abroad-- has been suspended for the last four months because of a lack of funds, officials at the Afghan Red Crescent Society (ARCS) said on Sunday.

Officials said that more than 1,000 children with congenital heart defects have been registered since the beginning of 2021 and are waiting to be treated inside or outside the country, but the process of treatment has been halted. Red Crescent says that as many as 6,000 Afghan children in total are waiting for treatment.”

Medecin Sans Frontieres (MSF), A hospital of women, for women: Preserving maternity care in Khost, 16 December 2021

“Healthcare workers have done their best to keep providing care to pregnant women despite their facilities being

deprived of much-needed funds.

“In the public system, we’ve heard of people pooling their money to buy medical items to keep their facilities open,” says Cormack. “If a woman needs a caesarean-section they all chip in to buy enough fuel so the generator can run during the procedure. This is despite the fact that healthcare workers and other civil servants haven’t been paid for months,” she says.”

BBC, On the front line as Afghan children battle malnutrition and measles, 15 December 2021

"There's no space inside," shouts a beleaguered hospital worker as he tries to push back a frantic crowd of mothers and babies hoping to receive nutrition packs.

"It's like this every day," he yells out to us over their heads, "it's been like this for the last four or five months... It was bad last year too, but not like this."

The war in Afghanistan is over, but its economy is collapsing and at this hospital, in the remote, central province of Ghor, they're struggling to cope with the fallout.

 

The Guardian, Afghan health system ‘close to collapse due to sanctions on Taliban,’ 13 December 2021

“Large parts of Afghanistan’s health system are on the brink of collapse because of western sanctions against the Taliban, international experts have warned, as the country faces outbreaks of disease and an escalating malnutrition crisis. With the country experiencing a deepening humanitarian crisis since the Taliban’s seizure of power in August amid mounting levels of famine and economic collapse, many medical staff have not been paid for months and health facilities lack even the most basic items to treat patients. [...] There are six simultaneous disease outbreaks: cholera, a massive measles outbreak, polio, malaria and dengue fever, and that is in addition to the coronavirus pandemic. Some parts of the primary healthcare system were being funded through a two- decades-old scheme, Spiegel said, but large parts remained largely unsupported, even as health officials, international organisations and NGOs have been required to restart programmes on hold after the Taliban

regained control of the country in August. [...] UNICEF: “The current humanitarian situation in Afghanistan is dire, especially for children. Winter has already set in and, without additional funding, Unicef and partners will be unable to reach the children and families that need us the most,” said Alice Akunga, Unicef’s Afghanistan

representative.”

 

Politico, A great suffering: starvation and the collapse of Afghan healthcare, 9 December 2021

“Nearly half of Afghanistan’s 39 million people aren’t getting enough food. One million children are at risk of dying from malnutrition as winter sets in, the WHO said last month. Those on the brink of starvation sometimes make it to the hospital, but even there, resources are scarce.

Afghanistan’s predicament could undo years of maternal health gains, said Aleksandar Bodiroza, the United Nations Population Fund’s representative in Afghanistan.

“We are risking in just two years to lose the basically 10-years-long progress in maternal health,” he said, adding that 51,000 mothers could die between 2021 and 2025. “We are looking at 4.8 million unintended pregnancies and near doubling of the unmet need for family planning between now and 2025.””

 

BBC, ‘It’s like hell in here’: The struggle to save Afghanistan's starving babies, 2 December 2021

“Across the country, hospitals treating the starving are on the brink of collapse, with nearly 2,300 health facilities already closed. Doctors in remote areas have reported being unable to provide basic medicines - even something as simple as paracetamol for the gravely ill who have walked 12 hours to seek treatment.

In the capital Kabul, a major children's hospital is seeing some of the country's worst cases of starvation. It's currently running at 150% capacity.

The hospital's director Dr Siddiqi saw a surge in fatalities in September after funding was cut, when up to four children under the age of 10 died every week from malnutrition or related diseases, such as poisoning from poor

food hygiene. He says it's the youngest who bear the brunt of the crisis, with most under the age of five arriving

too late to be saved.”

UNFPA, “Press Release: Prioritize needs of women and girls in Afghanistan”, 1 December 2021

“As the health system teeters on the brink of collapse, UNFPA is also distributing emergency reproductive health kits to health facilities to keep services functioning, including for emergency obstetric care for the estimated 21,500 pregnant women who will likely experience complications or require a Caesarean section in the next three months. Dignity kits that contain items such as sanitary pads and other personal hygiene supplies are being distributed to displaced women and girls to support their psychosocial and physical wellbeing. The kits also free up money for food as hunger knocks at the door of many Afghan households.”

 

UN News, UN News: Mobile health teams , 25 November 2021

“The doctors were part of a mobile health team supported by the UN Population Fund (UNFPA) that provides medical services to those who would otherwise have no or limited access. In the most remote parts of Afghanistan, the nearest health facility can be over two hours’ walk away, with communities in these areas accounting for most of the country's maternal and childhood illnesses and deaths.”

 

International Committee of the Red Cross, Afghanistan: An infuriating, man-made catastrophe points toward massive suffering for Afghan families, 22 November 2021

“Amid a sea of heartache is one small silver lining: The ICRC on Monday began supporting 18 regional and provincial hospitals and the 5,100 staff who work in them to help prevent total collapse of the public health system in Afghanistan. This support, slated to last six months, includes funding for running costs and medical supplies, and will ensure the continuity of nearly half a million medical consultations per month.”

 

The Guardian, On Helmand’s bleak wards, dying children pay the price as western aid to Afghanistan is switched off, 21 November 2021

“The wards need a cleaner in order to remain as safe as possible for new mothers, even in a hospital starved of cash and slowly grinding to a halt, like this one. Last month the operating theatre had to shut down, because there was no money for fuel for the generator – there is no grid power in this rural corner of Helmand near former Camp Bastion – or any gas to sterilise their equipment.”

“It is perhaps hard to picture a healthcare system “in collapse”, but you can see the human cost of the funding cuts at Boost hospital, in the fragile bodies of children racked with disease and malnutrition, or being wheeled to the morgue.”

 

UNFPA, Mobile health teams: On the road saving lives in Afghanistan’s most remote areas, 21 November 2021 While the full ramifications of recent events in Afghanistan will only become clear over time, the UN Office for the Coordination of Humanitarian Affairs reports that humanitarian needs in the country have already risen sharply and that the health care system has been brought to its knees.

Since August this year, UNFPA has increased the number of mobile health teams it supports across Afghanistan to respond to the humanitarian health emergency. The teams have defied formidable odds to deliver essential reproductive, maternal, newborn and child health and psychosocial support services to mothers and children in hard-to-reach areas that are otherwise precariously underserved.

 

The Daily Telegraph, On the frontline of Afghanistan's humanitarian crisis, where malnourished babies share incubators, 20 November 2021

“The listless children in the overcrowded malnutrition ward lie two, or sometimes three, to each bed. Their wasted limbs can be glimpsed beneath layers of blankets and clothes to warm them against the oncoming winter. Before Afghanistan was tipped into near economic collapse following the Taliban takeover, the malnutrition department at Kabul's Indira Gandhi hospital treated on average four or six hungry infants at any one time. It is now home to

20 and there are another 70 registered patients being treated in their own homes, said Raziya, one of the nurses. The hospital is short of beds and staff, who have quit because wages have not been paid for months. “Our patients are very poor people. In the last three months more than 20 malnourished children have lost their lives,” she told the Telegraph. The Taliban's takeover has sent the country into spiralling crises which threaten lives and the modest gains of the past two decades of international aid.”

 

ABC News, Key aid group says Afghanistan's most pressing need is cash, 19 November 2021

“Afghanistan is facing a looming humanitarian crisis as aid organizations struggle with ways to pay doctors, nurses and others on the ground because there is currently no way to transfer salaries to bank accounts there, the head of the International Committee of the Red Cross (ICRC) said. ICRC President Peter Maurer's comments echo those of the U.N.’s special representative for Afghanistan, who warned this week that the country is “on the brink of a humanitarian catastrophe” and that its collapsing economy is heightening the risk of extremism. The country’s economy is estimated to have contracted by 40% since the Taliban took control in August.”

 

MSF, Malnutrition soars in Herat as healthcare reaches breaking point, 10 November 2021

“The Afghan healthcare system has been fragile and plagued by major gaps for years now. The suspension of international aid as a result of the recent political developments has further deteriorated the situation. In Herat, in southwestern Afghanistan, Médecins Sans Frontières (MSF) is witnessing a worrying increase in malnutrition, says Mamman Mustapha, former project coordinator in the province.

The healthcare system is at risk of collapse in the whole country, while the needs are huge. This is also reflected in what we observe in Herat. Access to care was a major issue in Afghanistan well before the Taliban takeover, but today the situation has further degraded, as most of the international aid has been suspended. This includes the World Bank funding of the World Health Organization’s (WHO) basic and essential care programmes covering Herat province.

Health facilities in the area are either closing or have reduced to providing minimum services with whatever residual resources are available. We have no visibility on what is going to happen to these facilities. People are jobless and are poor; they cannot afford private care, while some of the humanitarian organisations previously working in the area are yet to resume their activities in full.

There are probably several reasons for the increase of malnutrition in the area, most likely indicative of the broader situation in Afghanistan: a lack of functioning health facilities in the area; the economic downturn (with up to 30 per cent inflation rate for food items); the lack of liquidity and closing of banks; and a drought that is expected to persist throughout 2021.”

 

UNHCR, Afghanistan Situation Update, 8 November 2021

“Health facilities in parts of Afghanistan have shut down and, in the capital, hospitals are functioning without electricity or water supply. More than 2,000 health facilities have been forced to close since the Taliban takeover, according to the Red Cross, and in those hospitals that are still accepting patients, most staff have not been paid their salaries for months and patients are forced to buy their own medication, a difficult prospect during an economic crisis. That said, according to the Taliban's Acting Public Health Minister, Dr Qalandar Ebad, the new government has agreed to launch a four-day polio vaccination programme. Vaccination teams have been unable to work in parts of the country for much of the past three years, meaning that since 2018, an estimated 3.3 million children have missed out on a polio vaccination. It is estimated that 10 million Afghan children aged under five will be targeted by this programme, which appears to be aimed at showing the de facto authorities can cooperate with international agencies.”

 

Reuters, Dozens killed and wounded as blasts and gunfire hit Kabul hospital, 3 November 2021

At least 25 people were killed and more than 50 wounded when gunmen attacked Afghanistan's biggest military hospital after two heavy explosionsat the site in central Kabul, officials said. [...]

The United Nations' mission in Afghanistan (UNAMA), along with countries including Pakistan, condemned the attack.

"Attacks targeting medical personnel and civilians seeking treatment are violations of human rights and

 

international humanitarian law. Those responsible need to be held to account," UNAMA said in a tweet.

 

Gandhara, Afghanistan’s Health-Care System In ‘Free Fall’ As Punishing Winter Looms, 3 November 2021 The main problem affecting Afghanistan’s health-care sector is the loss of financial aid, according to Patricia Gossman, associate director for Human Rights Watch's Asia Division.

"There is no money to pay health-care workers. There is no money to buy medicines," said Gossman, who added that the system was "already weak" under the previous government. "With former donors blocking aid -- not humanitarian aid, but actual cash to pay salaries -- the health-care situation is in a free fall like the rest of the economy."

Hundreds of health facilities have been shuttered in Afghanistan since the Taliban toppled the internationally recognized government in Kabul.

Abdul Bari Omari, the Taliban's caretaker deputy director of public health, told RFE/RL in October that nearly 90 percent of the sector was dependent on foreign aid, which led to the closure of 2,300 health centers when that aid was cut off.

Urgent appeals for more funds by NGOs and the United Nations have resulted in pledges of more than $1 billion, and outside states and aid groups have delivered much-needed medical supplies. But there is no clear path for the distribution of the funds and supplies, and billions of dollars held by Afghanistan's previous government remain frozen in the United States.

 

Reuters, In Kabul children's hospital, medics struggle with staff shortages, 26 October 2021

“In Kabul's main children's hospital, the crumbling of Afghanistan's health system is reflected in the eyes of

exhausted staff as they eke out fast-diminishing stocks of medicines.

As crowds of mothers and sick children fill waiting rooms in the Indira Gandhi Children's Hospital, medical staff are squeezing three babies into a single incubator and doubling them up in cot-like infant warmer beds.

Nurses who once took care of three or four babies each are now having to look after 20 or more to make up for the absence of staff who fled the country when the Taliban seized power in August. [...]

Although the number of blast victims and war wounded have fallen since the fighting ended, Afghanistan's hospitals are grappling with the fallout of a rapidly spreading economic crisis that has threatened millions with hunger.

U.N. agencies say as much as 95% of the population does not regularly have enough to eat and last month, the head of the World Health Organisation warned the health system was on the brink of collapse as international aid has dried up.

Lack of support for the $600 million Sehatmandi health service project administered by World Bank, has left thousands of facilities unable to buy supplies and pay salaries, threatening health services at all levels from village clinics to hospitals offering caesarian sections.

STAFF NOT PAID IN MONTHS

For the medical team, it is the acute staff shortage that is causing the heaviest strain. They have not been paid in months and often struggle even to pay their car fare to work.”

 

Al Jazeera, Afghanistan: Taliban agrees to door-to-door polio vaccine drive, 19 October 2021

“Health workers in Afghanistan will begin a house-to-house polio vaccination drive next month after the new Taliban government agreed to support the campaign, the World Health Organization and the United Nations Children’s Fund said.”

“The campaign, due to start on November 8, will be the first in more than three years aimed at all children in

Afghanistan, including more than 3 million in remote and previously inaccessible areas.”

 

The Guardian, Critically ill Afghans suffer as Taliban tighten Pakistan border, 13 October 2021

“Shortage of specialised doctors in Afghanistan means patients seek lifesaving care in Pakistan, but conventions have changed [...]

Doctors and family members of patients say conventions at the border have changed since the Taliban takeover, which has made it more difficult for Afghan patients to seek lifesaving care in Pakistan. [...]

Afghanistan’s healthcare system, which already suffered from a shortage of specialised doctors and well-equipped facilities, has been critically wounded. Funding cuts from international donors have led to a dearth of medical supplies and equipment. Some doctors left during the early days of the Taliban rule, and others lost jobs at hospitals that could no longer afford to pay them. The head of the World Health Organization said late last month that Afghanistan’s health system was on the brink of collapse.”

 

Landinfo, Afghanistan: En humanitær krise, 13 October 2021

“The Afghan health service is close to collapse. Hospitals and clinics have no money for food, medicine, oxygen or diesel for power supplies. The crisis in the health care system affects treatment capacity, but also preventive work and vaccination programs. Health workers who still go to work cannot expect to be paid - they have not been paid for several months (Bolle & Røst 2021; Mandavilli 2021).”

 

Original excerpt in Norwegian [translated using Google translate]

”Den afghanske helsevesenet er nær kollaps. Sykehus og klinikker har verken penger til mat, medisiner, oksygen eller diesel til strømaggregater. Krisen i helsevesenet rammer behandlingskapasitet, men også forebyggende arbeid og vaksineringsprogrammer. Helsearbeidere som fortsatt går på jobb, kan ikke forvente å få lønn – de har ikke fått lønn på flere måneder (Bolle & Røst 2021; Mandavilli 2021).”

 

Ariana News, UN agency to pay salaries of Afghan health care workers, 7 October 2021

“The World Bank previously gave hundreds of millions of dollars to Afghanistan to cover workers and other health care needs but cut off its support after the government in Kabul was no longer officially recognized by most countries.

The U.N. agency will be taking over the program from the World Bank this week in order to provide money to health care workers and the health care system in order to avoid a looming humanitarian crisis in the country, The Washington Post reported.

Global Fund, a global health organization, donated $15 million to the program at the beginning of October.”

 

TOLO News, Provincial Health Centres Closed, Kabul Hospitals Crowded, 04 October 2021

“Officials at the state-owned hospitals said the citizens’ access to health care has significantly declined across the country, so people mostly travel to the capital for medical treatment.

According to officials, the number of patients coming to Kabul’s hospitals has increased after healthcare centers

faced challenges in some provinces.

The shortage of medicine and professional staff are major challenges in Kabul city as well.

“As the healthcare centers were closed in the provinces, the number of patients increased in the capital’s hospitals. There will not be sufficient capacity if the situation continues," said Parwiz Noori, head of the Wazir Mohammad Akbar Khan Hospital.

“Kabul’s hospitals are affected as well. We face a lack of medicine and doctors,” said Dr. Mohammad Ishaq Shirani.

[...] Provincial healthcare centers recently closed due to lack of medicine, medical equipment and doctors. [...]

Beds are full [...] and there is no medicine or doctors.”

At the same time, the World Health Organization (WHO) released an assessment and warned that Afghanistan’s

healthcare system is facing a crisis.

The assessment says: “Only 17% of health facilities supported by Sehatmandi remain fully functional. Two thirds

are experiencing stock-out of essential medicines. Without urgent action, they are at risk of closure.”

International organizations have repeatedly announced that Afghanistan’s healthcare system is at risk of collapse.”

 

Swedish Committee for Afghanistan, SCA the only health service provider in Maidan Wardak, 4 October 2021 “"Currently the health service in the provincial hospital is limited; there is no medicine or food for the patients. This is a problem that our poor people cannot bear,” he said. “Despite all these problems, we thank SCA for

providing health services to the people of Afghanistan, as we are aware that health services in other provinces have declined. We call on SCA and other international bodies to help us. If they don’t help, a humanitarian catastrophe could happen in Afghanistan due to the lack of public health services."

About 650 patients daily receive health services in Maidan Shahr Provincial Hospital, including around 300 children and more than 150 female patients. This hospital with a capacity of 110 beds admits 85 to 90 patients every day, including patients who need maternal and surgical care.

Maidan Shahr Provincial Hospital previously provided wider services under Sehatmandi Health Project. Sehatmandi project supported 77 health centers in Wardak under a health contract funded by the World Bank. The contract was for 30 months beginning from January 2019 to June 2021. However, after the political transition in the country, the project ended up vague without signs of extension. This has affected the supply of health services in the province.

“It would be difficult to run such a big hospital and other clinics without having a project, but we are still providing patients with only essential life-saving services using SCA’s funds only. If these insufficient services are stopped, we are afraid of a deadly catastrophe for mothers, children and needy people in the country," explained Dr.

Mohammad Nader Rahmani, director of the Maidan Wardak Provincial Hospital.

The World Health Organization (WHO) has warned in a new report that halting the budget for health projects in Afghanistan will close down more than 2,000 health centers in the country. This is while the Red Cross has also warned that more than seven million people in Afghanistan do not have access to basic health care.”

 

WHO, Dr Maragaret Harris - Emergencies in Lebanon and Afghanistan - Virtual Press conference, 23 September 2021

“WHO Director-General, Dr Tedros Adhanom Ghebreyesus [...]

“Those gains are now at severe risk with the country's health system on the brink of collapse. There has been a surge in cases of measles and diarrhoea. Almost 50% of children are at risk of malnutrition. The resurgence of polio is a major risk and 2.1 million doses of COVID-19 vaccine remain unused.”

 

OCHA, Afghanistan, Weekly Humanitarian Update (13-19 September 2021), 23 September 2021

“Most public health facilities and hospitals are reportedly running low on medicines and other basic supplies due

to a shortage of funding [...]

Health services remain limited in hospitals due to funding shortage. A number of medical units in the Nangarhar

Regional Hospital and districts’ hospitals are reportedly closed.”

 

The Guardian, UN frees funds to prevent Afghan health system collapse, 22 September 2021

“The UN released emergency funds on Wednesday to help prevent Afghanistan’s battered healthcare system from

collapsing, with the WHO chief warning of an imminent catastrophe.”

 

WHO, Statement by Dr Tedros Adhanom Ghebreyesus, Director-General of the World Health Organization, and Dr Ahmed Al-Mandhari, WHO Regional Director for the Eastern Mediterranean on their visit to Kabul, 22 September 2021

“Only 17% of all Sehatmandi health facilities are now fully functional. This breakdown in health services is having a rippling effect on the availability of basic and essential health care, as well as on emergency response, polio eradication, and COVID-19 vaccination efforts.

Nine of 37 COVID-19 hospitals have already closed, and all aspects of the COVID-19 response have dropped, including surveillance, testing, and vaccination. Prior to August this year, 2.2 million people had been vaccinated against COVID-19. In recent weeks, vaccination rates have decreased rapidly while 1.8 million COVID-19 vaccine doses in country remain unused. Swift action is needed to use these doses in the coming weeks and work towards reaching the goal of vaccinating at least 20% of the population by the end of the year based on national targets. Afghanistan is one of two countries in the world where polio remains endemic. With only one case of wild poliovirus reported so far this year, compared to 56 in 2020, there has never been a better time to eradicate polio. However, the polio programme will struggle to respond if the basic immunization infrastructure begins to collapse

around it. Measles outbreaks are also spreading. With access to all communities no longer impeded, WHO and partners are ready to begin a country-wide house-to-house polio vaccination campaign and include measles and COVID vaccination in an integrated campaign”

 

OCHA, Afghanistan, Weekly Humanitarian Update (30 August – 5 September 2021), 13 September 2021

“South: Limited health services in Uruzgan province

Most public health facilities and hospitals are reportedly running short of medication and other basic supplies. The situation in Uruzgan province is reportedly particularly dire with medical staff including doctors who have not been paid for months quitting. Currently, other health facilities supported by NGOs such as the Mirwais hospital in Kandahar province and Bost hospital in Lashkargah city in Hilmand province continue to function but are overstretched and facing an increasing number of patients from rural areas.”

 

The New Humanitarian, Healthcare, aid, and the Taliban: A Q&A with Afghanistan’s health minister, 8 September 2021

“International aid donors must find a way to fund Afghanistan’s crumbling health system, or risk an even greater

humanitarian catastrophe.

This is the warning from the country’s acting health minister, Dr. Wahid Majrooh, who now oversees a sector he

says is on the verge of collapse due to donor funding freezes.”

 

The New Humanitarian, Afghan healthcare under threat from international aid freeze, 6 September 2021 “International aid suspensions could shutter most of Afghanistan’s public health facilities, essentially leaving the country without a working healthcare system, officials and aid groups say.

Some 2,000 donor-funded clinics and other health facilities could shut their doors within days, stripping access to primary or secondary healthcare from millions of people. The closures, amounting to 90 percent of clinics funded by a World Bank-administered donor pot, would also leave only a fraction of Afghanistan’s COVID-19 isolation beds still operating, the World Health Organization said.”