Archive for the ‘Health’ Category
KABUL, 3 November 2008 (IRIN) – Tens of thousands of children – mostly in rural parts of the southern provinces of Helmand, Kandahar and Uruzgan – have missed out on polio immunisation due to insecurity and threats to health workers, the Public Health Ministry (MoPH) has said.
“We could not immunise about 120,000 children due to insecurity and attacks on health workers,” Abdullah Fahim, spokesman of the MoPH, told IRIN in Kabul.
Several polio cases have been reported in the southern provinces since 2008, and at least 22 cases of polio have been confirmed in the south, central and east of Afghanistan over the past 10 months, according to the MoPH.
More than seven million children under five were immunised against poliovirus and over six million given supplementary vitamin A capsules during a three-day nationwide immunisation campaign which started on 18 October.
The massive polio and vitamin A drive was conducted by 52,357 health workers in all 34 provinces of the country and was supported by the UN Children’s Fund and the World Health Organization (WHO).
MoPH had raised hopes that a successful implementation of the immunisation exercise would rid the nation of the crippling disease.
The poliovirus has been eradicated all over the world except in Afghanistan, Pakistan, India and Nigeria, according to the WHO.
The inability of vaccinators to access and immunise children in insecure areas could spread the poliovirus among under-five children, health officials warned.
“We will not eradicate polio if we continue to miss children,” said Mohammad Qasim, a health official in Helmand Province.
Taliban insurgents had previously given assurances they would not disrupt the immunisation campaign and would ensure safe passage for health workers in areas under their influence.
But gunmen believed to be associated with the insurgents reportedly attacked and then pillaged an immunisation campaign convoy in Uruzgan Province in October.
Health care providers were also threatened in Helmand and Kandahar provinces.
No Taliban spokesperson was immediately available to comment on the alleged attacks and threats to health workers.
The relatively calm northern parts of the country have been considered polio-free: the virus has not been reported there in the past three years.
By Rose Hoban
Voice of America
Durham, North Carolina
04 November 2008
Countries experiencing conflict often are increasingly susceptible to the spread of infectious disease as their health systems become disrupted or even collapse. A prime example of this phenomenon is in Afghanistan – a country at war for the past seven years and experiencing frequent conflict over the past few decades. But as Rose Hoban reports, many nongovernmental organizations are working to curb the spread of infectious disease within Afghanistan and across its borders into Pakistan, Iran and Tajikistan.
Fred Hartman works with one group, Management Sciences for Health, focusing on controlling six communicable diseases – HIV, tuberculosis, cholera, malaria, polio and avian influenza. He says, for example, avian influenza hit Afghanistan in 2006.
“We know that came in from the northwest areas of Pakistan,” Hartman says. “In 2007,Pakistan reported human deaths with human-to-human transmission, which heightens the concern in Afghanistan.”
One project Hartman worked on was with the Ministry of Health in Kabul. He helped them convene a regional conference to draft basic principles to curb the spread of disease. That included agreeing on border controls – and in the wake of flu outbreaks, Kabul and Islamabad implemented new procedures.
“For example, in 2006 when avian influenza broke out in Pakistan, the poultry farmers would quickly ship all of their chickens to Afghanistan, and of course it was bred in Afghanistan,” he says. “Both governments have worked together to seal the borders, knowing it’s not in anybody’s best interests to start shipping sick chickens around the region.”
The impetus behind the regional conference wasn’t limited to strictly medical matters. Delegates realized that containing disease and developing their economies were intertwined. So along with tighter border control, they also agreed on better disease surveillance.
Hartman says this kind of cooperation has led to fewer cases of avian influenza moving between Afghanistan and Pakistan. Another positive result has been the reduction of the number of people with malaria on the Afghan-Tajik border.
However, Hartman says there is still much work to be done, especially when it comes to controlling the spread of polio. Despite a worldwide effort by UNICEF and the World Health Organization, the disease is still appearing in remote places in Afghanistan.
“We have to conclude that despite serious cross-border efforts of notification of any cases of acute polio, immunization at the border for all children under five who are passing back and forth, that we have been unable to control transmission of the disease in that area,” Hartman says.
He notes that the continuing violence in Afghanistan hampers efforts at controlling disease. In one tragic case, three Ministry of Health doctors who were vaccinating children in Kandahar province were assassinated earlier this year.
But Hartman says there’s also reason for hope. He reports that local authorities – even those in Taliban-controlled areas – recognize the need to control the spread of infectious disease.
Hartman presented a paper on his experiences and his findings in October at the annual meeting of the American Public Health Association in San Diego, California.
Source: International Organization for Migration (IOM)
November 4, 2008
IOM, together with the Afghan government, has launched a nationwide water and sanitation initiative designed to support communities hosting returnees from Pakistan and Iran.
The launch follows the signing of a tripartite agreement between IOM, the Ministry of Rural Rehabilitation and Development (MRRD) and the Ministry of Finance (MoF) last week to provide water and sanitation facilities in areas with high numbers of returnees.
IOM with financial support from Japan will help local authorities provide a total of 114 water points and 342 latrines, benefiting some 20,000 people in Herat, Farah, Nimroz, Kunduz, Bamyan, Kabul and Nangarhar provinces.
“The large scale return of Afghans has stretched to breaking point the capacity of local authorities to deliver basic services, especially clean water,” said IOM Afghanistan Chief of Mission Robbie Thomson. “More than 560,000 Afghans have either voluntarily returned or been deported this year alone. The communities they are returning to need help to absorb them,” Thomson added.
The agreement was signed as part of IOM’s Socio-Economic Reintegration of Afghans Returning from Iran and Pakistan (RARIP) programme. Funded by the Japanese government, the programme aims to promote population stabilization through community-based activities.
For further information, please contact Monica Sandri at IOM Kabul, Tel + 93 (0) 796 568729, Email: firstname.lastname@example.org or Katsui Kaya, Tel +93 (0) 700 185961, Email: email@example.com
Daily Times (Pakistan)
November 2, 2008
Questioning culture is a politically incorrect approach. But we must refuse to bow before the altar of tolerance when it comes to what is truly unacceptable, wherever it occurs, and this is what the world is witnessing passively in Afghanistan
Today in Badakhshan, Afghanistan, for every 100,000 births, 6,500 young mothers die. This is a world record, unrivalled anywhere. In other parts of Afghanistan, too, the rates of maternal mortality continue to be among the highest in the world.
Roughly 75 percent of Afghan newborns that die do so because of lack of food, warmth, and care. Unloved little girls fare the worst. In Afghanistan as a whole, a woman dies of pregnancy-related causes every 27 minutes — and perhaps even more frequently, because many such deaths go unrecorded. Many, perhaps most, are under sixteen years of age.
The Taliban — blamed nowadays for just about all of Afghanistan’s ills — have officially been gone for nearly seven years, so why are conditions still so abysmal?
In Kabul and Herat, mobile phones abound, a tooth-eroding concoction called “Afghan Cola” is sold, the Internet works (sometimes), there are ATM machines, sophisticated heroin laboratories, four-wheel drive vehicles, five-star hotels, ads for private banks — all the trappings of globalised modernity. Yet so many women die like flies, in pools of blood and deep-rooted indifference.
While billions of dollars in aid have led to improvements in urban areas, where health facilities have been built and midwives trained, the overall maternal death figures have hardly changed. As one doctor told me: “A competent midwife or nurse would rather be out of work in Kabul than stuck in a remote village.” But most Afghans live in remote villages — those in Badakhshan can be reached only after a day’s bumpy ride on a donkey.
This miserable situation has been attributed to various causes, mainly lack of infrastructure and local economic conditions. But cultural questions must also be addressed, because gender discrimination is the most important cause of maternal mortality.
In Afghan society, discrimination begins at birth. One obvious reason is that a boy is destined to support his parents and much of his family all his life, and therefore represents a long-term investment, whereas a girl will be given over to her husband’s family as soon as possible. Feeding a girl is seen as effectively looking after someone else’s property.
Once, I heard a dreadful story of a breech birth which a traditional midwife did not know how to handle. In the end, she wrenched the baby’s body out, severing it from its head, which remained inside the mother’s womb. It took six days to get the woman to a hospital in Jalalabad though it was not very far from where she lived. She somehow survived, with major health complications, including permanent fistula, which will condemn her to a life of exclusion from her family and unrelieved misery.
That tragedy can be read on many levels, each more heart-rending than the next. But note that it occurred near a health facility. As soon as the midwife saw that the baby was coming out feet forward, she must have known that there was little she could do to save either mother or baby. Even before that, she would have noticed that the child had not turned properly, and that major problems were on the way.
This means that someone — a husband or mother-in-law — had taken the decision not to send the young woman to the hospital, instead keeping her in inhuman suffering for nearly a week.
The solution is not just to build more hospitals, but also to change deep-rooted disdain for women. And, sadly, things have become worse in the past 30 years, as Afghanistan’s particular brand of Islam, combined with its legacy of dire poverty and war, compounds an already misogynist pre-Islamic tradition.
Maternal mortality is a sinister consequence of this complex situation. The legal system, schools, and the media could bring change, but no official entity takes the problem seriously enough to initiate effective action. The central reason is despairingly simple: women’s lives are not valued, and even women themselves perceive their suffering as being unavoidable.
What Afghanistan needs is an inquest after each death and laws making it a criminal offence to forbid access to medical aid, when available, to women and children (or, more correctly, to children and their children, given that girls are often married by age 14). Prisons, I fear, would be full of abusive husbands and, I regret to say, vengeful mothers-in-law. Health education through public media, reaching distant areas of the country, is an urgent priority, but has been utterly ignored in favour of commercial priorities.
Questioning culture is, of course, a politically incorrect approach. But we must refuse to bow before the altar of tolerance when it comes to what is truly unacceptable, wherever it occurs, and this is what the world is witnessing passively in Afghanistan.
Does diversity authorise such brutal deaths and senseless violence against women simply because some supposedly traditional practice allows them to be married before their bodies are ready and denies them health care when they give birth?
The fight against maternal mortality in Afghanistan must become a global priority. Ultimately, a society that allows women to be brutalised will remain a breeding ground of generalised violence. —DTPS
Carol Mann is Director of FemAid and teaches at the Sorbonne in Paris
By Bob Weber
The Canadian Press
November 2, 2008
KANDAHAR, Afghanistan – Life in Afghanistan can be dangerous enough, but Afghan women face a special hazard all their own – pregnancy.
Now, a Canadian-funded project is trying to reduce one of the worst rates of maternal mortality in the world. The “maternal waiting home” at Kandahar’s Mirwais Hospital may be modest in size, but those behind the project hope it will be widely copied throughout Afghanistan and help change attitudes toward maternal health in the country’s deeply conservative rural districts.
“It’s risky for women to get pregnant here,” said Viola Cassis of the Canadian International Development Agency, which is spending $350,000 to build and equip the facility.
Afghanistan is one of the few countries in the world where men have a longer average lifespan than women, and maternal deaths are one of the main reasons.
Afghan women have a one-in-eight lifetime chance of dying in childbirth. And Kandahar province has the second-worst maternal death rate in the country – 1,600 for every 100,000 live births.
The comparable Canadian figure, depending on how you count, is between four and six.
Very few Afghan women have access to any kind of trained medical care before or after birth. Only 14 per cent of them see any kind of skilled birth attendant, said Roselyn Joseph of UNICEF, which is managing the project.
Rural health care is scarce to non-existent. Taliban insurgents have even been known to assassinate government-trained midwives.
The new 17-bed waiting home, which will become Afghanistan’s first when it opens in a few weeks, will provide women with a place to stay for a few days before and after giving birth. Potential complications can be monitored, and the new mothers can receive some education.
Breastfeeding, for example, isn’t common in Afghanistan, said Joseph. Mothers often feed newborns sweet syrups and food they’ve softened in their own mouths.
As well, the concept of special nutrition for pregnant women or new mothers is largely unknown.
Attending a health-care facility in advance of absolute need is a new idea for Afghanistan, where most women simply deliver at home or show up at the hospital as the baby is arriving.
“Some of them come in a tuktuk (a rickety, three-wheeled open taxi) as they’re delivering,” said Joseph.
And Dr. Sharifa Seddiqi, head of the Mirwais Hospital, acknowledges that its services will be a tough sell in a culture which severely restricts the movement of women.
“Culture is a big problem in our country for women,” she said. “Some families don’t like to come to a hospital for their wives and daughters.”
That’s why the home – bright and cheery, with a small central garden – offers beds for trusted family members to accompany the expectant mother. Although hospital food will be available, a kitchen will also allow guests to prepare some of their own foods.
Anything to draw women in from the rural regions, said Joseph. The hope is that they’ll spread the word about the facility as well as what they’ve learned, such as the advantages of breastfeeding, to other women.
“What we’re really trying to do is tap into those outlying districts,” she said. “That will take some time.”
“We’re working against cultural norms here.”
Kandahar’s dicey security situation is also likely to discourage women from travelling.
The maternal waiting home is small and won’t come close to being able to accommodate every woman who can use its services.
But it’s only the first of several other similar facilities planned across the country.
And it will save lives, said Siddiqi – both those who come here and those who benefit second-hand.
“Maybe the women who come to this centre will talk to their families about it. And what they learned here.”
KABUL, 2 November 2008 (IRIN) – Afghanistan’s high maternal and infant mortality rates could increase and deadly diseases such as malaria could resurface if insurgents continue attacking health workers and impede access to vulnerable communities, the Ministry of Public Health (MoPH) has warned.
Minister of Health Mohammad Amin Fatemi on 1 November spoke of a “possible resurgence of deadly diseases” and warned of the adverse impact of insecurity on overall healthcare.
Health officials are particularly concerned about the spread of pneumonia and respiratory diseases in winter months if people do not have access to medical care.
Cold weather-related illnesses killed hundreds of people, mostly the elderly and children, throughout the country last winter, according to the Afghan government.
The MoPH and aid agencies have repeatedly called on Taliban insurgents to ensure access to areas under their influence for humanitarian aid and health services. The insurgents have, however, turned a deaf ear to such calls, aid agencies say.
Millions of Afghans have been affected by high food prices, drought, crop failure, armed conflict and other disasters, aid workers say. Lack of food and/or poor nutrition has caused deteriorating health in women and children, making access to healthcare all the more important, Abdullah Fahim, spokesman for the MoPH, told IRIN.
“Food insecurity has made already vulnerable people even more vulnerable,” Fahim said.
The MoPH said it has delivered supplies of medicines to health facilities across the country for use over the coming six months. But without security, patients will not benefit from these medicines.
“We need a secure environment to diagnose diseases and treat patients,” Fahim said.
Health achievements under threat
Over the past several years, the MoPH, backed by donors and NGOs, has managed to expand basic public health services to almost 80 percent of the country, thus reducing the under-five mortality rate from 165 per 1,000 live births in 2002 to 125 in 2008.
The MoPH said it has also reduced malaria cases by over 50 percent.
However, armed attacks on health workers and facilities have forced shut dozens of health centres in the volatile south and southeast of the country. At least 51 health centres were torched and/or damaged in deliberate armed attacks from January 2007 to June 2008, according to the MoPH .
In the southern province of Kandahar – often described as the stronghold of the insurgency – there is no health facility at all in five out of its 13 districts, the provincial health department said on 2 November.
KABUL, Oct. 30 (Xinhua) — India has agreed to establish telemedicine facility in Afghanistan under a Memorandum of Understanding (MOU) inked in Afghan capital Kabul on Thursday, said a statement released by Afghan Public Health Ministry.
Afghan Minister for Public Health Syed Mohammad Amin Fatimi and Indian Ambassador to Afghanistan Jayant Prasad signed the MOU on behalf of their respective governments.
“The main purpose of this project is to provide complex technical know-how and expertise to the health care providers of Afghanistan from a distance by the Indian health professionals,” the statement said.
An Indian enterprise, Telecommunications Consultants India Limited (TCIL), would be the sole executing agency for the implementation of the project, it said.
“We believe that the establishment of telemedicine facility by Indian government and transfer of knowledge, consultation and expertise from India to Afghanistan will not only enhance the capacity for health care service delivery but also bring a new technology and facility to Afghanistan,” the statement quoted Afghan Health Minister as saying.
India has contributed more than 750 million U.S. dollars to Afghanistan since 2002 and major parts of the contribution has been invested in the fields of health, education and road building.
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