Development News from Afghanistan

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Afghanistan’s Health Outreach Grows

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August 3, 2007

Press Release: US Information Service

By Lea Terhune / USINFO Staff Writer

Afghanistan’s health outreach grows – rural areas, more women, children given access to care

Life expectancy is short in Afghanistan, on average about 47 years. Maternal mortality rates are one in 50 births and one of every five children dies before the age of 5, according to the World Health Organization (WHO).

Changing this bleak picture is “one of the most exciting stories” Gary Cook has seen in 33 years with the U.S. Agency for International Development (USAID), he told USINFO. Cook, a senior health adviser who has helped implement USAID-funded Afghan health programs since 2002, says progress is being made in Afghanistan’s health sector “against all odds.”

“It’s a story of people working together for something everybody in the country agrees is needed,” he says. USAID works with Afghanistan’s Ministry of Health, which sets standards and oversees programs, and which Cook credits with strong leadership after the Taliban government fell in 2001. Major donors such as USAID, the European Union and the World Bank work closely with the Afghan government and local nongovernmental organizations (NGOs).

Building a clinic involves not only the Afghan government and NGOs, but also the surrounding local community. Often clinics are built in remote areas. Electricity and a safe water supply must be installed to maintain cleanliness and refrigeration for vital vaccines. Staff must be trained.

Cook says the “real story” is about the courage of the Afghans who work for NGOs contracted by USAID to provide health care. He says doctors and health workers, many of whom are trained in USAID-funded programs, “probably know the risks better than anybody, but they still do it. They show up for work, and they’re taking care of people.”

Security is an issue. Afghanistan is one of the few countries for which USAID generates weekly security reports, according to Cook, and the safety of workers and patients is vital.

Afghanistan’s Ministry of the Interior has announced stricter protection measures for aid workers in the wake of increasing attacks on Afghan and foreign aid workers, a number of whom have been killed in recent months. But some NGO officials worry that obvious government security will draw unwanted attention and attract more attacks.

Hashim Mayar, deputy coordinator for the Agency Coordinating Body for Afghan Relief, an umbrella organization for nearly 100 Afghan and international NGOs, told Reuters, “Because NGOs have increasingly taken part in development activities, human rights and democratization activities — all repugnant to Taliban and al-Qaida doctrine — they have been perceived by insurgents as collaborators with the government of Hamid Karzai and his Western supporters.”

But building the Afghan government’s strength through desperately needed health, education and infrastructure projects is the means to give Afghans the better lives they deserve, Cook says, after decades of being “oppressed and put down by war, drugs, every possible thing.”

“We want to get everyone within two hours of basic health services,” he says, adding that from less than 10 percent, “now it’s reported almost 65 percent are within two hours” of access. But two hours is a long time for a pregnant woman about to deliver. Cook wants improvement to maintain current service levels and “close the gap … get everybody covered.”

To do this, he says, continued investment in a network of small, strategic clinics that provide basic services is needed. Just $50,000 refurbished a Zabul province health clinic in 2006, bringing aid to a poverty-stricken rural region.

Training women health practitioners is a priority — and “the major challenge,” Cook says, “because the women have not been trained to read and write … and you need some literacy to be a health worker.” That said, 2,300 midwives have been trained in an 18-month program. About “70 percent of health facilities have at least one woman health professional,” he says.

“It really opens up the door,” Cook says. Without women medical workers, women and many children would not enter the clinic — in Afghan tribal society often a male doctor is not permitted to treat a woman unrelated to him.

When women stop dying in childbirth and healthy children live to grow up, Cook says, “you have some investment in the future. You want to be peaceful, be a good neighbor.”

USAID-funded programs target tuberculosis, malaria and polio. They assist the many people disabled by land mines and warfare. More than 670 health clinics have been built and about 8,350 health workers trained as of summer 2007.

This has meant a decrease in child mortality that Afghan Health Minister Sayed Mohammad Amin Fatimi called “an important sign for the donor community that their investments … are helping to save lives.” But, he said, there is still much work to be done.


(USINFO is produced by the Bureau of International Information Programs, U.S. Department of State. Web site:


Written by afghandevnews

August 3, 2007 at 5:33 am

Posted in Health

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