More than 1.6 million children under the age of five and thousands of women could die in 2009 as a result of the lack of food and medical care, particularly in terms of proper services for women and children, according to the Afghan Ministry of Health.
These are troubling statistics not only because of the human suffering involved, but because they indicate that the millions of dollars poured into the country to date have not reached its most vulnerable citizens.
Food shortages and inclement weather could leave eight million Afghans—30 percent of the population—on the brink of starvation, unless more effective aid is provided soon. Lack of food is an actual threat not just in the remote regions of Afghanistan but also in its urban areas.
Recent price increases in basic foods, particularly wheat, have adversely affected millions of Afghans, primarily in rural areas where domestic production cannot satisfy people’s needs.
For example, in 2005 an average household was spending 56 percent of their income on food. Now that figure has risen to 85 percent, according to Susannah Nicol, a spokeswoman for the WFP.
The security situation in Afghanistan continues to deteriorate, affecting the population’s access to food and health aid. Attacks on food convoys in Afghanistan and Pakistan are making it more difficult to bring supplies to the people. It is estimated that 141 of 328 districts are high or extreme safety risk areas.
At the same time, the government, its partners and aid organizations have failed to meet the needs of millions of people returning from Iran and Pakistan, according to a new report by the Afghanistan Independent Human Rights Commission (AIHRC).
Children are particularly vulnerable. They are not only affected by lack of food. Diarrhea, acute respiratory infections, and vaccine-preventable diseases are important threats to children’s health.
Diarrhea and acute respiratory infections account for approximately 41 percent of all child deaths in this desperately poor nation of 26 million people, while vaccine-preventable diseases—such as measles, polio, and diphtheria—account for another 21percent, according to UNICEF.
The tragedy is that 80 to 85 percent of these diseases can be avoided by implementing preventive measures and appropriate and timely health care.
Afghanistan rates low in practically all health indicators. As a result, it has one of the world’s highest infant and maternal mortality rates. Hospitals in most of the country are in deplorable conditions, and lack enough trained doctors or medical equipment for even the most basic surgeries. Life expectancy is 42 years, according to figures from the World Health Organization (WHO).
A survey of 800 Afghan households led by Dr. Barbara Lopes Cardozo of the U.S. Centers for Disease Control (CDC) shows that a majority of Afghans, including children, suffer from depression and anxiety, and almost half from post-traumatic stress disorder.
The researchers also found that although violence and war were important factors in the Afghans’ deteriorating mental health situation, so were the daily stresses of dealing with shortages of food, water, shelter, and lack of medical care.
In spite of this evidence, mental health remains one of the most neglected public health areas in the country, and so do statistics on mental health problems. WHO’s Project ATLAS showed that in 2001 there were only eight psychiatrists for the entire country for a population of 25 million.
The number of disabilities caused by failing medical conditions must also include those injuries caused by millions of landmines and unexploded ordnance that contaminate the country, among the highest rates in the world. During continuing hostilities, several previously de-mined areas have been re-mined thus risking the possibility of getting rid of this menace.
Although health care has been one of the main focal points for much of the humanitarian aid in Afghanistan, the country’s health situation remains serious. Women and children, particularly, have seen a dramatic deterioration of their psychological, social, and family life for the past two decades.
Improving the Afghans’ health situation remains one of the most serious and unresolved issues confronting aid agencies. Addressing health needs of children and women remains a priority. And so is the need to rebuild infrastructure, de-mining the country, and creating law and order while simultaneously respecting Afghans customs and traditions.
This is a tall order for a country ravaged by violence and lawlessness but a situation the new U.S. administration can do much to remedy.
Dr. César Chelala is an international public health consultant. He is the foreign correspondent for the Middle East Times International (Australia).
