The health sector crisis is worsening in Afghanistan and an urgent need to increase international aid

Abdul Bari Omar: The foreign aid provided to the health system in Afghanistan during the past two decades did not fundamentally solve its problems.

KABUL - The health sector in Afghanistan is going through a difficult period, and it is having an impact on the lives of millions of Afghans, especially since the majority live under the threat of poverty. Dr. Abdul Bari Omar, Deputy Minister of Health, says that health centers in the capital and the states are facing shortages and challenges, especially with the freezing of Afghan funds abroad.

The health sector situation was the subject of a meeting held on February 8 between WHO Director-General Tedros Adhanom Ghebreyesus and Afghan Health Minister Qalandar Abbad, who visited Switzerland as part of a delegation from the Afghan government invited to Geneva, and the humanitarian aid file was at the top of the delegation’s discussions with other parties. Official, humanitarian and international organizations, including the International Committee of the Red Cross, according to Swiss media, this is the second visit of a delegation from the current Afghan government to Europe in a month.

Tedros stressed - in his tweet - that the health situation in Afghanistan is still difficult, and that the humanitarian crisis puts more lives at risk, noting that he discussed with the Afghan minister the needs of the health system, its strengthening and preparations for emergencies, and the training of medical teams.

80% dependence on foreign aid

And the Afghan Deputy Minister of Health - in statements to Al Jazeera - describes the foreign aid provided to the health system in Afghanistan during the past two decades as not solving its problems in a fundamental way, and the matter worsened when some aid programs for hospitals stopped with the political transition, and added that Afghanistan complains of a lack of Specialized hospitals meet the needs of citizens, calling on the international community not to politicize the aid file for the medical sector as it is linked to the lives of millions, especially children and women.

Abdel Bari Omar added that, "After we came to this ministry, we found that the work that took place during 20 years was not essential. We inherited a health system from the previous government, from which the people previously suffered and still, and the self-resources were not used well The system The health system was 80% dependent on donor aid, so no health system was found on the basis of which the Afghan people would dispense with external support.”

The Deputy Minister of Health said that health centers in the capital and the states are facing shortages and challenges, especially with the freezing of Afghan funds abroad, which made the task of solving problems in the health system within a few months difficult, adding that the ministry's work team seeks to adhere to transparency and combat corruption in departments. health, after it remained rampant, he said.

Abdul Bari Omar identified the biggest challenge facing the Ministry of Health that donors during 20 years made some promises to the Afghan people in the field of health services, and provided some of this aid, but unfortunately stopped some of it after the political change, he said. He added that some donors did not abide by their pledges and promises to the Afghan people, and "this is an injustice against the Afghans," as he put it. He pointed out that the financial challenge makes it difficult to solve all the problems faced by the health sector in all parts of the country with few capabilities.

Limitations of Foreign Aid Programs

It is noteworthy that there are foreign aid programs for some health services, including the health care program, in which $45 million was provided by the United Nations through the World Health Organization and UNICEF during the past three months to 2,149 hospitals and health centers in 31 states, and in the next five months - that is, until End of June 2022 - There is another pledge from the World Bank through the World Health Organization and UNICEF to provide $100 million in 34 states, and 25,000 doctors, nurses and workers in the health sector are expected to benefit from this program.

According to Abdul Bari Omar, "After the next five months, there is no specific commitment regarding this project, and we have 3800 hospitals and clinics in the country, but the health care project is limited to covering 2331 health points and centers, and it is specialized in the level of primary health care only, and there is little interest in it." secondary health care, and there is no support or commitment to advanced health care, despite its importance to our community.”

Luger Hospital

To find out a model for the suffering of Afghan citizens with health services, we went to Logar province in Bule Alam, the capital of the province (south of the capital, Kabul), where the Deputy Aminullah Khan Governmental Hospital is located; We were met by old buildings and a design that could not accommodate large numbers of patients.

There we met a number of doctors, including the hospital director, Muhammad Siddik, who said that he had been working in the hospital for 7 years, and his first observations were that the building was not equipped to be a hospital, and with his acknowledgment that they had received a lot of aid during the past two decades, with the occurrence of political change, international support was cut off, except for a program One of the World Bank described it as spanning only several months and insufficient in terms of hospital capacity and state population.

Overcrowding is evident in the hospital, and according to its director, “it receives between 1,000 and 1,500 patients per day, the rooms are crowded, and the hospital is not enough; the need is greater than its capabilities. Today and night."

The suffering extends to the emergency department and other corridors, where patients crowd, and in the neonatal department, many devices are out of order because they were affected by a previous explosion in front of the hospital itself. Interruption of salaries for workers, including doctors, nursing teams, and others, for periods ranging from 3 to 11 months.

New alternative hospital

And the story of the health sector’s problems in Logar State does not end with that hospital, and to follow up on that, we left “Bulah Alam” and headed to the outskirts of the state on the way to Kabul. In 2008, Pakistan began establishing a hospital and in 2019 it was opened, and it was given the same name as the old and crowded hospital, i.e. Aminullah Logari Hospital, but this is in the Konjak district, and when you arrive at the hospital you feel that it is a large and spacious hospital in a far from overcrowded area.

But upon entering, the visitor begins to hear a list of problems that need to be resolved so that this hospital - which has a capacity of 300 beds - can serve the citizens of 4 states in the southeast. To begin with, in this cold weather, there is no central heating system working, and there is a problem with the electric current, which is what everyone who enters the hospital feels on a snowy day in the Luger Heights.

According to the Director of Health Affairs in the state of Lugar, Qadra Allah Adel, in an interview with Al-Jazeera, the hospital, despite its opening 3 years ago, is not ready to deal with patients with their full needs so far, only 100 beds are ready to receive patients, i.e. a third of its absorptive capacity for which it was established, and between 20 and 30% of the equipment is incomplete, and there are problems with the heating system and water connections, and most of the equipment you donate is stored in various rooms, and even 5% of the equipment can be used by doctors, and they cannot operate the rest.

Qudratullah added that contact was made several times with the Pakistani embassy, ​​asking to activate the rest of the hospital equipment, and training the teams to use them, noting that the situation is getting worse, in recent months, and he said, "We had 140 workers from the medical team and their assistants, half of them are doctors and nurses, now." The number has decreased and we do not have a sufficient number of employees, because of the interruption of salaries, we do not have the ability to pay their salaries, and there is no donor party that provides salaries for employees, and we also have a drug crisis, we need donor countries to provide us with medicines and even food for employees and patients.” And when it was time for lunch We noticed that no food is prepared in the hospital kitchens for patients and medical teams, and everyone is looking for some simple meals from vendors outside.

This statement is confirmed by Nimatullah Hamkar, who was appointed director of the hospital about a year ago, when he told Al Jazeera that those who remained from the medical team and workers had not received their salaries for 5 months, which prompted many to leave work and move to other places, pointing to the hospital's need to hire 30 additional specialized doctors to cover the need and to operate the hospital effectively, and he expressed his hope that the Pakistani authorities - responsible for building and equipping the hospital with its equipment stored in its rooms - will operate the equipment and train the medical team on it to serve the population, or that any other party capable of doing so will carry out the task.

The hospital is under the custody of the Afghan Ministry of Health

Al Jazeera Net contacted the Pakistani embassy in Afghanistan about what officials and doctors talked about in the hospital built by the Pakistani government in Logar state. Afghan officials are supposed to rely on their capabilities to operate the equipment stored in the hospital, and train teams to use them and activate services.

He added that if there is something related to our responsibilities, it is assumed that the Afghan Ministry of Health will formally address the Pakistani embassy in Kabul, and we will communicate about it with officials in Islamabad and we will accomplish what is required at the time.