| |
Health Crisis in Afghanistan: Women and Children
By
Dr. Zieba Shorish-Shamley
Congressional Briefing
March 6, 2003
I want to thank congresswoman Maloney, her office staff, and other organizer for this opportunity. Congresswoman Maloney has been a great friend of the Afghan women and has been a strong voice for the cause of the Afghan women since 1996. Congresswoman Maloney, thank you for your care, concern and friendship.
I remember well when President George Bush during his January, 2002 state of the union speech, introduced Afghan cabinet minister Dr. Sima Samar and stated "Today, women are free." The Afghan women and girls were promised of full restoration of their rights. The Afghan people were promised of peace, security, and a democratic government that represented all the people of Afghanistan, and many other promises.
The bitter truth is that over one and half year after the demise of the Taliban, the warlords are still in power. In most of Afghanistan women and girls still do not have any rights. Women and girls are still suffering severe abuse, harassment and repression at the hands of some of Afghanistan's post-Taliban leaders. Women are still harassed by the religious police. Even in Kabul a team of 90 women from the Ministry of Religious Affairs abuse women in the streets for "un-Islamic behavior. " And Dr. Sima Samar was forced out of government by extremists’ six months after the president State of Union Speech.
In sum, the United States government as well as the world’s community made many wonderful promises to the Afghan people. The horrible condition of the Afghan women and children’s health is an example of many promises unfulfilled.
At meetings in Washington in December 2002, Ferozudeen Feroz, Afghanistan's deputy public health minister stated that 70 percent of Afghanistan's primary health care clinics could not provide even basic maternal and child services, and that 90 percent of hospitals lacked equipment to perform Caesarian sections. More than 25 percent of children die before their fifth birthday, and 40 percent of children deaths are due to such preventable causes as diarrhea and respiratory infections
(The New York Times January 2003).
The Afghan health care system’s infrastructure is in ruins. It is reported that about two-thirds of the facilities have toilets, but a majority of these are pit latrines which pose health hazards. Only one-fourth of health care facilities has electricity and about half them depend on generators. There is no adequate transport system for the patients. Some health facilities use bicycles as the means of transporting patients. In some remote areas where roads do not exist horses are used to transport patients. (Boston-based Management Sciences for Health survey, 2002).
Afghanistan’s health problems include polio, scurvy, malnutrition, anemia, tuberculosis, whooping cough and a high maternal mortality rate.
A recent report by the United Nations Assistance Mission in Afghanistan describes the country’s maternal mortality as "one of the highest in the world, with two to three women dying every hour." More than half of all Afghan children is suffering from iodine deficiency (BBC, February 2003).
According to Dr Yon Fleerackers of World Health Organization, the rate of infant mortality is extremely high. Of every 100 babies born in Afghanistan, 14 are likely to die before reaching the age of five. Those more fortunate can look forward to a life lasting an average of 46 years (BBC, February 2003).
The lack of female health care workers has brought about the worst health crisis for the Afghan women. The sociocultural restrictions do not allow women to seek care from male health care workers. Almost all of the pregnant women in rural areas and most women in many cities in Afghanistan do not have access to trained female health care professionals for prenatal, childbirth and postnatal care. This combined with war, poverty, and many other factors have led Afghanistan to have the world's highest maternal mortality rate. There are 1,600 deaths per 100,000 births. (Boston-based Management Sciences for Health survey, 2002).
According a joint study by UNICEF and the Atlanta-based Centers for Disease Control and Prevention report (2002) in the remote northeast province of Badakshan, for every 100,000 birth there are 6,500 maternal deaths. The report states that at least 30 percent the deaths were caused by hemorrhaging and 23 percent of deaths were caused by obstructed labor. The deaths are preventable if there is proper medical care to stop bleeding or if the babies are delivered Caesarian section. Three-quarters of the babies born to mothers who die in childbirth die themselves within the first year of life, mostly from malnutrition due to lack of breast milk. (UNICEF & CDC Report 2002).
Another disease that kills in Afghanistan, is tuberculosis. The majority of patients infected by the disease are women, that is, 70 percent of the cases are female patients. The World Health Organization does not have a clear explanation for the phenomenon. However, it believes that some of the social reasons may be relevant to the spread of disease among women. For example, confinement of women to the house, frequent child births, undernourishment, and living in close quarters (WHO Report Cited in IRIN, March 2003)
Mental health care system is almost nonexistent in Afghanistan. Afghanistan's only mental health hospital in Kabul is in ruins and is ill equipped. Some patients are permanently chained to the beds. Violent and schizophrenia patients are confined to darkened cells (WHO Report Cited in IRIN, March 2003
World Health Organization reports that about four million people, that is, about 20 percent of the population, suffer from various forms of mental health problems that include depression. Depression is particularly widespread among women. Moreover, thousands of children demonstrate learning or behavioral problems that is the result of war-related trauma. About 95 percent of the population are affected psychologically by over two decades of war, and yet there is only one mental health hospital for the entire nation. (WHO Report Cited in IRIN, March 2003).
Added to this horrendous picture of the Afghan health crisis, are the victims of landmines who try to cope with out much assistance and the spread of HIV Aids disease because of drug addiction and sharing of dirty needles.
The state of Afghan women and children health is an example of other state of affairs in Afghanistan. It is not only disappointing it is unsettling. How could the people of Afghanistan (or other areas of conflicts in the world) trust the credibility of promises made by the United States and the rest of the international community? The painful question in the Afghan mind is: are we going to be abandoned again?
We urged the Administration and the international community to keep their promises to the Afghan people. We call on the United States Congress to bring the Afghan women, men and children’s miserable condition to attention of the Administration and the international community.
RECOMMENDATIONS BASED ON BRUSSELS SUMMIT (December 2001) AND WAPHA’s ADDITION
|
|
