WHO Rolling Out Emergency Aid in Afghanistan – Stresses Importance of Retaining Women Health Workers
Afghan women health workers are vital to health services response, including reproductive health issues, says WHO.

WHO has affirmed that it is staying in Afghanistan and providing emergency aid to the tens of thousands of recent victims of conflict and displacement – even as staff in some NGOs go into hiding or desperately seek to leave the country for fear of their lives.  

“The World Health Organization (WHO) is committed to staying in Afghanistan and delivering critical health services and calls on all parties to respect and protect civilians, health workers, patients and health facilities. During this difficult time, the well-being of all civilians — as well as the safety and security of our staff — in Afghanistan is paramount,” said Dr Ahmed Al-Mandhari, WHO Regional Director for the Eastern Mediterranean Region, to which Afghanistan belongs, in a statement Wednesday morning. 

“We cannot backslide on two decades of progress,” WHO Director General  Tedros Adhanom Gheybreysus said in a Wednesday press conference in Geneva. “Our staff remain in the country and are committed to delivering health services to the most vulnerable.”

Tedros said that he had spoken personally to the acting health minister of Afghanistan, Wahid Majrooh: “He is in Kabul working to avoid disruptions and keep essential health services moving. I reassured him that WHO and staff will continue to support the country.” 

“I call on the international community and all actors to prioritize their access to all health services and to safeguard their futures.” Tedros added. 

These comments were made in light of the upcoming World Humanitarian Day on 19 August, as Tedros noted that many emergencies were occurring simultaneously, including the earthquake in Haiti.

“The humanitarian system is being pushed to its absolute limit – and beyond – by the climate crisis, natural disasters, conflict, and the COVID-19 pandemic.”

Mass casualty response, trauma care and diarrhoeal disease are priorities 

The violence in Afghanistan has taken a toll on an already fragile health system.

Supplies and support for mass casualty response, trauma care, cholera and diarrhoeal disease prevention and management, are among the top priorities, WHO has said.

Addressing the needs of displaced populations – including malnutrition, high-blood pressure, COVID and reproductive health, are also critical priorities, Al Mandhari stressed in his statement, also emphasizing the need to ensure women access to female health workers. 

“Months of violence have taken a heavy toll on Afghanistan’s fragile health system, which had already been facing shortages in essential supplies amid the COVID-19 pandemic,”  Al-Mandhari said.  

“As a result of the recent conflict, trauma injuries have increased, requiring scaled up emergency medical and surgical services. In July 2021, some 13 897 conflict-related trauma cases were received at 70 WHO-supported health facilities, compared to 4057 cases in July 2020,” he said. 

Displaced populations & women’s health key priorities 

Women’s health in Afghanistan remains a key priority for WHO

WHO also pointed out an “immediate need” for sustained humanitarian access and health services in Afghanistan, placing special emphasis on women’s health and displaced populations.

“In areas where people have fled to seek safety and shelter, including Kabul and other large cities, field reports indicate that there are increasing cases of diarrhoea, malnutrition, high blood pressure, COVID-19-like symptoms and reproductive health complications,” continued Al-Mandhari in his statement. 

“Delays and disruptions to health care will increase the risk of disease outbreaks and prevent some of the most vulnerable groups from seeking life-saving health care. There is an immediate need to ensure continuity of health services across the country, with a focus on ensuring women have access to female health workers.”  

“Furthermore, attacks on health care remain a major challenge. From January to July 2021, 26 health facilities and 31 health care workers were affected; 12 health workers were killed. ”

COVID vaccines anyone? 

Both Tedros and Al-Mandhari, however, avoided addressing questions around the fate of Afghanistan’s COVID-19 vaccine drive  – although a WHO spokesperson in Geneva, Tariq Jaresevic, confirmed on Tuesday that vaccinations, as well, had been interrupted by the violence, and expressed concerns about the future of vaccine efforts. 

It’s unclear if the new Taliban rulers will in fact allow the campaign to proceed – particularly in light of the past responses to polio vaccine campaigns. Those campaigns have met, at times, with resistance in rural areas where militants long had influence and control.  Afghanistan remains one of the few countries of the world still battling with wild polio virus.  

Al-Mandhari referred to vaccines only in passing, saying: “WHO continues to work with partners to respond to COVID-19 with a focus on diagnosis and testing, surveillance, clinical care, infection prevention and control, vaccination, and referrals for recently displaced people in major cities.”  

United Nations & International Rescue Committee also says it’s staying  

Along with WHO, the International Rescue Committee, and UN humanitarian staff say that they’re committed to staying in the country to assist displaced and vulnerable populations – while further operations for other organizations seem more uncertain. 

We’ve worked under multiple regimes, we’ve worked through multiple cycles of crisis, and we’ve always found a way to work with different actors in order to serve the people of Afghanistan,” said Ciaran Donnelly, Senior Vice President for Crisis Response Recovery and Development, IRC, in an interview on CNN on Tuesday. 

“That’s really our mission we’re focused on helping all of the millions of Afghans in need of humanitarian assistance, and we’re hopeful that we’ll have access to do so we’ll be able to work alongside our humanitarian partners, and all of the authorities on the ground, to be able to deliver assistance.”

The ongoing COVID-19 pandemic, in addition to the escalating humanitarian crisis, requires continued assistance, he pointed out. 

“We can’t forget that the COVID pandemic is still affecting Afghanistan; it’s still the public health measures in particular and to keep people safe in times of displacement that are also high on our list.”  

He called on international donors to “redouble their efforts” in supporting humanitarian aid inside Afghanistan. 

“I think the national responsibility to the people of Afghanistan doesn’t end with the international presence, the presence of international forces on the ground. There’s a humanitarian commitment that must be maintained to support the people of Afghanistan.”

UN to ‘stay and deliver’ in Afghanistan

“I urge all countries to receive Afghan refugees, and refrain for any deportations” — UN chief Secretary General Antonio Guterres said at an emergency Security Council meeting on Afghanistan. UN has reaffirmed its commitment to remain in the country.

Meanwhile, Ramiz Alakbarov, Resident and Humanitarian Coordinator of the UN in Kabul said in a statement that the UN staff would “stay and deliver” aid during this time, though some UN personnel have been relocated. 

“The humanitarian community – both the UN and non-governmental organizations – remain committed to helping people in Afghanistan. While the situation is highly complex, humanitarian agencies are committed to supporting vulnerable people in Afghanistan who need us more than ever.” 

UN Geneva spokesperson Rheal LeBlanc has also noted that no UN staff has evacuated Kabul

“It’s clear that the Taliban and other authorities have the responsibility to protect and ensure the safety of UN staff whether they be national or international and to do whatever they can to ensure their safety.”

Countrywide, the UN employs approximately 3,000 national personnel and 720 international staff members in Afghanistan – although more than half were already remotely  outside the country because of the pandemic. Along with relief and development, a UN political mission, called Unama (UN Assistance Mission in Afghanistan), led by the Canadian, Deborah Lyons. Unama was established in 2002 to support the national government established after the initial United States invasion of the country, in response to the 9/11 attacks on the US. As of Sunday, Lyons was said to be in Kabul and working, and UN Secretary-General António Guterres is reported to be seeking an even stronger role for the mission as Afghanistan transitions to a new government, reported PassBlue. Unama’s base in Herat was attacked, however, by the Taliban on July 30, killing a local security official. 

NGOs – negotiating with Taliban

For other agencies and NGOs, staff safety will rely upon the outcomes of sensitive negotiations with Taliban officials. 

Said one aid worker in Kabul, interviewed anonymously in The New Humanitarian, these negotiations haven’t begun. 

“We would just be waiting for [the Taliban’s] NGO representative to reach out to us. We’re not sure who that is at present,” the aid worker was quoted as saying.

In other parts of the country, Taliban officials have reportedly reached out to NGOs, with indeterminate outcomes so far, NHM reported. 

While some Taliban officials have asked aid workers to continue their operations, in areas where the fighting is more violent, Taliban has taken charge of NGO offices, leaving the overall situation very unclear. 

“They approached us. They went to our office, and asked us what kind of organisation we are,” a senior official at another NGO, which has suspended its programmes in northern Afghanistan, pending more clarity on whether their operations could be authorized to continue.

Image Credits: WHO Eastern Mediterranean Regional Office , British Red Cross/Twitter, Paul Hudson/Flickr, The UN Times/Twitter.

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