Afghanistan: Civil war and drought compound immense humanitarian needs

<B>International staff:</B> 75<BR> <B>National staff:</B> 705<BR><BR>
Civil war and severe drought have continued to drain the life out of Afghanistan over the last year. By late spring 2001, the number of people taking refuge in neighboring countries had been pushed to 3.5 million, and displaced people inside the country numbered at least 700,000. People living near the front line live the consequences of war, while people living under the Taleban, the group that controls much of the country, are confronted daily with totalitarian methods of maintaining order: curfew in the cities, harsh punishments for petty crimes, restrictions on the movement, education and employment of women, and large-scale persecution endured by many Afghans, especially members of religious minorities. The Taleban has not taken responsibility for ensuring a basic health care system. MSF, working in Afghanistan since 1980, continues to meet pressing medical needs of many of the most vulnerable Afghans, with a special focus on women and children in some programs. The question of whether working in the Taleban-controlled country legitimizes their repressive techniques remains a constant source of reflection for MSF. What is clear is that the humanitarian needs are immense, and that MSF can bring health assistance to people whose needs are being neglected. Drought and displacement After two years of minimal rains, by summer 2000 Afghanistan was gripped by the worst drought in 30 years. Many people were forced to seek food and help in cities or camps, joining others already displaced by war. In addition to setting up nutritional surveillance systems, MSF opened therapeutic and supplementary feeding centers for displaced people and area residents in hard-hit Herat, Badghis and Kandahar provinces in the west and south, with additional programs in Balkh, Faryab and Baghlan provinces in the north. By December 2000, as the effects of the drought deepened, 50% of the international aid pledged during the year had failed to materialize. At the time, MSF called on the international community to fulfill its humanitarian responsibility toward the country. As of May 2001, the situation was far from improving, as the effects of the drought intensified and fighting resumed in the north, causing many more people to flee their homes. Ongoing projects
  • In Kabul, the capital, MSF began working in a 52-bed hospital in late spring 2001 and continues to work in three other clinics. In Ghazni, MSF supports a provincial hospital and a clinic with an 80-bed tuberculosis (TB) treatment center. In the isolated region of Hazarajat, MSF works in three clinics.
  • MSF supports an infectious diseases ward at Mirwais hospital in Kandahar. In Herat province, the focus is on mother-and-child care, health education, nurse training, and mental health programs at the village level, and on pediatric care at Herat hospital. In northern Afghanistan, 18 MSF-supported clinics in several provinces provide 40,000 consultations a month. MSF mobile clinics also provide health care at numerous IDP camps in the area, and water and sanitation activities where needed. In the front-line town of Taloqan, MSF works in the hospital. In the isolated Panjshir Valley, under opposition control, MSF cares for IDPs and residents in two hospitals and several clinics and tent clinics. In the Badakhshan and Takhar regions, also under the opposition, MSF has been working since September 2000 in several IDP camps. MSF works at the hospital in Faizabad and in clinics in nearby Baharak, Eskashen and Zebok. In late December 2000, MSF opened a delivery room in Iskashim for complicated births. Afghan refugees abroad Since 1996, MSF has cared for Afghans seeking refuge in Iran (see opposite page). In September 2000, MSF also began working in two camps for Afghan refugees near Peshawar, Pakistan. In the Jalozai camp, approximately 45,000 people live in deplorable conditions in a camp that is treeless, waterless, overcrowded, and incredibly cold in winter. Until only recently, people living in the camp were not even screened, and thus had no possibility of being granted refugee status. Some were deported. MSF welcomes the onset of the screening at Jalozai but is concerned about the voluntary repatriation encouraged by the process, because the situation in Afghanistan remains unstable and insecure. There is still no screening of refugees in the New Shamshatoo camp, where MSF is also working.