Afghan health system “on the verge of collapse due to Taliban sanctions” | Global development

Large parts of the Afghan health system are on the verge of collapse due to Western sanctions against the Taliban, international experts have warned, as the country faces epidemics and a growing malnutrition crisis.

As the country has experienced a worsening humanitarian crisis since the Taliban took power in August amid growing famine and economic collapse, many medical staff have gone unpaid for months and Healthcare facilities lack even the most basic items for treating patients.

Dr Paul Spiegel, director of the Center for Humanitarian Health at Johns Hopkins University, said on a recent five-week trip to the country he saw public hospitals – which take in the most vulnerable – running out of fuel , medicines, hygiene products and even basic items such as colostomy bags.

He said the response from Covid-19 had almost stopped and called for a more nuanced response to Western sanctions to avoid a deeper public health catastrophe.

“This is really serious and it will get worse,” Spiegel, former head of public health at the United Nations High Commissioner for Refugees, among other top humanitarian missions, told The Guardian.

“There are six simultaneous epidemics: cholera, a massive measles epidemic, polio, malaria and dengue, and this is on top of the coronavirus pandemic. “

Parts of the primary health care system were funded through a two-decade-old program, Spiegel said, but large parts have gone largely without support, even though health officials, international organizations and NGOs were forced to restart pending programs after the Taliban returned. control of the country in August.

A man walks past oxygen tanks at a hospital in Kabul. Photography: Anadolu Agency / Getty Images

“I’ve been everywhere in my career. What is shocking is that we are not used to stopping everything abruptly. United Nations organizations and NGOs supporting health care in Afghanistan not only deal with acute emergencies, they must respond to make the bases work.

“For example, there are supposed to be 39 hospitals dealing with Covid-19 cases of which 7.7% are fully functioning. And it’s not just hospitals. It’s everything that connects public health systems: surveillance systems, testing and there is very little oxygen to treat those who have Covid. “

He described Kabul’s main infectious disease referral hospital as “on its knees”.

“No staff member has received a salary for months, although most are still arriving. There are hardly any drugs and they cut the trees in the yard to heat the rooms as there is no gas. They also sent their ventilators to the Afghan hospital in Japan to treat the Covid cases, but that is also struggling. “

His comments reflected growing concern over the collapse of health care in Afghanistan, a country of 23 million people. The problem is exacerbated by the fact that Afghanistan’s economic woes, with the IMF’s warning of a contraction of some 30%, have pushed more and more people into poverty, which has had a knock-on effect. training on those who need health care but cannot afford it.

Outside of Kabul and other major cities, Spiegel said the situation was even worse.

Patients are treated outside a hospital in Kabul.
Patients are treated outside a hospital in Kabul. Photography: Anadolu Agency / Getty Images

“There is a provincial hospital in Sarobi outside of Kabul that I visited. There was not enough soap and water for the hygiene protocols, ”he said.

“There was a little child who was born in the hospital with an anal fistula. She was so sick that they had put in a colostomy but they had no bags so they would use whatever material they found – like toilet paper – to collect the colostomy.

Dave Michalski, program manager of Doctors Without Borders in Afghanistan, warned last week in an interview with NPR that there would likely be Afghans in need of health care who could not even access the reduced levels available.

“How many people are stuck [from seeking healthcare], “He asked.” How many people do not take the bus to the neighboring province to find health care that works because their own provincial health system is closed or because there is no of drugs on the shelves.

“And if you don’t have the money to travel to find a private health facility … and many private health facilities are struggling with supply lines as well.”

The United Nations children’s organization, Unicef, has warned that the growing crisis in the country’s health system is exacerbating growing problems of malnutrition in Afghanistan.

“The current humanitarian situation in Afghanistan is dire, especially for children. Winter has already set in and without additional funding, Unicef ​​and its partners will be unable to reach the children and families who need us most ”, said Alice Akunga, representative of the Unicef ​​in Afghanistan.

“As families struggle to put nutritious food on the table and health systems are further strained, millions of Afghan children risk starvation and death. Others struggle to access water and sanitation, are cut off from their schools and are at increased risk of violence.

Spiegel said the West needs to find a different approach to imposing sanctions on the Taliban: “There has to be a much more nuanced way of implementing sanctions than using such a brutal instrument. [as they are currently configured],” he said.

“While understanding the concerns about the Taliban… the reality is that many people will die because of them.”

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