Afghanistan’s Fragile Health System in Shatters as Taliban Assume Power – WHO Calls for ‘Humanitarian Airbridge’ Emergency Response 22/08/2021 • Shadi Khan Saif Share this:Click to share on Twitter (Opens in new window)Click to share on LinkedIn (Opens in new window)Click to share on Facebook (Opens in new window)Click to print (Opens in new window) Some 300,000-400,000 Afghans have been forced from their homes in the past two months alone, says WHO and UNICEF. KABUL – As the Taliban blitzed through towns and villages of Afghanistan finally capturing Kabul August 15, the war-ravaged country’s fragile health system was also crumbling, leaving the sick and vulnerable in despair. Over the past week, the health ministry’s previously daily updates of coronavirus infections, vaccinations and other key updates on public health have ceased to exist. As per the last official figures, Afghanistan was grappling with mounting rates of COVID-19 infections, driven by the Delta variant, amid shortages of vaccines and oxygen. Health experts believe the situation has taken a sharp turn for the worse in the week since the Taliban took charge of the capita. Continuing health services a priority for the new regime Within days of entering Kabul, the Taliban leaders went to the Health Ministry to highlight the importance in their eyes of this key sector, and particularly the continued engagement of female doctors and health workers. A Health Ministry official who asked not to be named told Health Policy Watch that the Taliban representatives, along with the acting Health Minister, Dr. Wahid Majrooh, were collaborating closely together in order to steer the public health sector out of uncertainty. “They are working hard and no drastic changes have emerged in the Ministry. It is hoped soon things will return to normalcy”, said the official. In a series of tweets, Majrooh also expressed his commitment to working with WHO and other global health partners, returning basic health services to the country – stressing the importance of continued engagement with female health professionals. Basic Health services for those displaced to Kabul from different provinces as the result of recent conflicts, proud our health personal especially the females 🙏 @WHOAfghanistan @UNICEFAfg @UNDP pic.twitter.com/5ZQwCSAENX — Dr. Wahid Majrooh (@WahidMajrooh) August 19, 2021 Other sources within the government, however, say that many doctors and health workers, and particularly female nurses, doctors and members of COVID vaccination teams, remain too anxious to return to their duties – out of fear of the new government. WHO & UNICEF call for “humanitarian airbridge In statements Wednesday, WHO Director General Dr Tedros Adhanom Ghebreyesus and Dr Ahmed Al-Mandhari, Regional Director for WHO’s Eastern Mediterranean Region, also affirmed that WHO is committed to remaining in Afghanistan and working constructively with the new regime. Just spoke with the Acting Health Minister of #Afghanistan, Dr. Majrooh @WahidMajrooh, who is in #Kabul trying to ensure maintenance of essential health services & avoid disruption. I thanked him for his strong commitment to serving people in need. @WHO will continue supporting. pic.twitter.com/rWZcIi5Xow — Tedros Adhanom Ghebreyesus (@DrTedros) August 17, 2021 But they also warned of large, looming health risks as a dire humanitarian situation continues to unfold in Afghanistan. This includes increasing cases of diarrhea, malnutrition, and COVID-19-like symptoms, as well as reproductive health complications being seen nationwide – and particularly among displaced populations who have fled to larger cities like Kabul, to escape conflict zones. On Sunday, amid the continuing airport chaos, WHO and UNICEF called jointly “for the immediate establishment of a humanitarian airbridge for the sustained and unimpeded delivery” of much-needed medicines and supplies to “millions of people in need of aid, including 300,000 people displaced in the last two months alone.” Said the statement: “While the main focus over the past days has been major air operations for the evacuation of internationals and vulnerable Afghans, the massive humanitarian needs facing the majority of the population should not – and cannot – be neglected. “With no commercial aircraft currently permitted to land in Kabul, we have no way to get supplies into the country and to those in need. Other humanitarian agencies are similarly constrained,” said the statement. Even prior to the events of the past weeks, Afghanistan represented the world’s third largest humanitarian operation, with over 18 million people requiring assistance.\ Displaced populations adds to challenges in Kabul and elsewhere Afghan families fleeing conflict in Kunduz and other southern Afghan provinces have now crowded into Kabul In its statement last week, WHO noted the urgent need for reproductive, maternal, newborn and child health (RMNCH) services to be provided to newly displaced people in Kabul and other cities, calling on “all parties to swiftly address disruptions to medical supplies and equipment being shipped into and across the country so as to plug gaps in needs at health facilities.” The Kabul capital’s iconic Shahr-e-Nau commercial district, which was once a population destination for leisure, outings and shopping for the newly-emerging middle class of Afghanistan, is now flooded with war-affected displaced men, women and children from the north and south of the country. With no proper accommodation, hygiene and food mechanism in place, the vulnerable women and children in particular can be seen in despair in the nearby park here under scorching summer heat. Begging for food, one mother of three minor children, who identified herself as Hajira said all of her children are ill, hungry and restless. “Where can I go? What can I do for these children? Nothing is in my control? I am hopeless!” she sighed, clearing her tears with her dusty and torn veil. Some two million Afghan children are malnourished, The World Food Program said this week. “The combined effects of drought and the coronavirus pandemic, on top of years of conflict, look set to worsen the food security situation,” the organization said. For the second time in three years, the country saw a second devastating drought, destroying crops and livestock. A harsh winter could make things even worse said Mary Ellen McGroarty, WFP Afghan country director. Over 260,000 Afghanis were displaced by drought in the country’s western provinces in 2018 – and drought has now struck again in 2021. Questions loom over future of COVID vaccine drive Behind the scenes, health experts also are worried about whether the new regime will move forward aggressively in the COVID vaccination drive that had been gaining steam recently. They point to the long struggle the country has undergone to root out polio virus, with vaccinations – which met with chronic opposition in some parts of the country. Prior to the latest turmoil, Afghan officials told Health Policy Watch that the administration of vaccines had gained momentum – following the sudden rise of infections and corresponding deaths since April. Up to 40,000 people were getting the jabs on a daily basis across the country with the government aiming to take it up to 100,000 per day, health officials say. Now, however, due to the disruptions in health services, the pace of COVID vaccines has slowed dramatically or even halted, officials say, as well as delaying other routine childhood immunizations, which could lead to secondary health emergencies. As per the UN estimates, vaccination rates remain extremely low in Afghanistan, with less than 4-5% of the population vaccinated overall. The virus continues to deeply affect the lives of the most vulnerable children and families across the country as they face the compounded impacts of the pandemic, conflict and longstanding drought. Southern Afghanistan Worst Affected Region A mother and her child in the Haji camp for internally displaced people in Kandahar, southern Afghanistan. Dr. Kabeer Ahmad, a former health ministry official, said the country’s restive south, particularly Helmand province, as well as the Kunduz province in the far north, are currently the worst affected overall by the acute shortages of medicine supplies and public health services. “These two provinces in particular have been literally the frontlines throughout the 20 years of war, and it got worse there (Kunduz, Helmand) in the past couple of months when the foreigners (US and NATO) left, and fighting intensified”, he told Health Policy Watch. That has included various attacks on health care facilities and personnel, which humanitarian groups say continue to strain an already fragile health system. Provinces of Afganistan – regions in the far northern province of Kunduz, and Helmand province in the south, are among the hardest hit by conflict – and displacement. “All parties must respect neutrality of health interventions and ensure safety of health workers, patients and health facilities”, said the WHO in its recent statements, adding unimpeded and sustained access to humanitarian assistance, including essential health services and medical supplies, is a critical lifeline for millions of Afghans, and must not be interrupted. The WHO has called for additional funding of US$ 6.6 million for the urgent health response following the escalation of conflict. Image Credits: Hesamuddin Hesam, © UNHCR/Edris Lutfi, Photo: Enayatullah Azad/NRC, © UNICEF Afghanistan. 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