Closing system

Afghanistan: A health system in intensive care – Afghanistan

After the Islamic Emirate of Afghanistan (IEA) took control of the country in August 2021, funding from development agencies and international financial institutions was halted, halting many critical infrastructure projects, including in the health sector. It resulted in the immediate suspension of projects and the payment of salaries and operating costs.

To avoid the collapse of the secondary health care system, the International Committee of the Red Cross (ICRC) launched the Hospital Resilience Project (HRP), supporting 33 hospitals with a total capacity of 7,057 beds and affecting approximately 26 million people. The support includes paying the salaries of nearly 10,500 health workers (about a third of whom are women) and purchasing medical supplies to limit the disruption of treatment for patients. It also includes cash assistance to buy fuel to run the ambulances, ensure continuity of supply, provide food to patients and carry out necessary maintenance work.

“If the ICRC had not started supporting our hospital, it would have already closed and a large number of people would have been denied access to health care,” says Dr Hafiza Omarkhail, medical director of the Malalai Maternity Hospital. , one of the busiest maternity wards. in Kabul. “We had faced many challenges because we had no money to buy the necessary medicines or pay the salaries. Some doctors even decided to leave the hospital due to the lack of salaries, putting even more already overstretched staff. Fortunately, in December 2021, the ICRC began to pay the hospital’s salaries and running costs. Today, we are once again able to provide quality service to mothers and children,” adds Dr. Omarkhail.

Sharifa, a midwife at another maternity ward in Kabul, recalls how things were in October 2021. “There are not even housekeepers. The doctor and midwives were cleaning patients, beds and the chairs. We did everything, we were the receptionists, the doctors, the midwives, the specialists and also the guards,” she says.

Due to lack of personnel, medicines and equipment, not all patients could be admitted. “This inability has caused further tension, with the families of the patients wanting to beat us for refusing care,” adds Sharifa.

The situation is also grim for patients. Noorulhaq, who was hospitalized in October 2021, said: “I was cycling when a car hit me and broke my leg. The doctors treated me very well, but the hospital pharmacy did not have the prescribed drugs. I had to borrow money and buy medicine from outside. Even my blood work and other lab tests couldn’t be done in the hospital, so I had to go to external labs, which was expensive and difficult.

HRP: Preventing the Collapse of Healthcare

Access to health care remains a major concern for communities across Afghanistan. To access specialized care, patients often travel several hours, sometimes on dangerous roads in areas still heavily contaminated by landmines and explosive remnants of war. Ensuring the availability of quality, specialist healthcare services in Afghanistan is essential and the HRP is a vital project that has enabled a vital medical response.

“It’s heartbreaking to see a patient in extreme pain and having to wait for their carers to buy the necessary painkillers outside the hospital because we don’t have any,” says Dr Amanullah, physician to the emergency room of one of Kabul’s largest hospitals where most patients with blast-related injuries are referred.

Gulaghai, 45, from Jaghouri district in Ghazni province, is one of the patients who directly benefited from the medical capacities restored thanks to ICRC support. “I had complications during the delivery, so the doctors decided to do a caesarean section. Unfortunately, this led to more complications due to medical malpractice and the doctors had to perform two more surgeries. Eventually, my husband took me to Malalai Maternity Hospital in Kabul, seven hours drive from our district.The hospital provided me with medicine, did my lab tests and also operated on me for free.I am now fully recovered and ready to go home,” she said.

“Providing health care is a humanitarian duty”

Dr Malalai Rahim Faizi, director of the Malalai Maternity Hospital, explains that despite being one of the major hospitals in the country, they were seeing OPD patients in a prefabricated corrugated iron shelter with very limited equipment. “With the support of the ICRC, we were able to move this section to a separate building with a real OPD department, a gynecological department, an ultrasound room and a minor surgery room. Our operating theater also has the equipment and equipment needed now and we are able to perform 40 to 50 cesarean surgeries every day,” she says.

Dr Faizi says ICRC support has helped them provide nutritious food and medical care to patients who couldn’t even afford a cup of soup. “We are living through a crisis in Afghanistan. International assistance is vital to deal with such a critical situation. Our request to the international community is that the health sector not be politicized. Patients need to be cared for. duty,” she said.

The ICRC launched the Hospital Resilience Project (HRP) in November 2021 in Afghanistan. The project supports 33 regional, provincial and university hospitals across the country and will ensure the continuity of services provided by these hospitals. This support makes it possible to pay the salaries of nearly 10,500 health workers, to cover the operating costs of the structures and to buy medicines and medical equipment. It also ensures that approximately 26 million people living in these areas have access to health care. The ICRC will continue to support hospitals for as long as necessary.