Afghans Dying for Lack of Healthcare

In the mountains of Bamyan province in central Afghanistan, two men slowly lead a donkey along a narrow road. The dead body of a pregnant woman lies across the animal’s back.

“We were taking her to the clinic, but it was too far and she died on the way,” said the woman’s husband. “Now we are taking her back home.”

Afghan women live in fear of death even as they wait for a new life to be born. On average, 1,600 women will die out of every 100,000 pregnancies. For every 1,000 children born, 165 will die within the first year of life, according to official statistics. Dr Hidayatullah Stanakzai, head of the planning department in the ministry of health, calls this rate "shocking” and “a silent disaster”.

But the high rates of death among pregnant women and infants are just two of the many health problems faced by Afghans, the majority of whom live far away from clinics, doctors and medicine.

The life expectancy for Afghans was only 46 years, according to figures provided by the Population Research Bureau in 2000.

An IWPR nationwide survey of 3,000 people in 21 provinces - conducted in mid-August by 100 journalists, as part of a workshop organised by IWPR on civic journalism and the presidential election - found that many people were concerned about the state of healthcare in the country.

People in rural areas especially complained that they had no access to doctors or clinics and that they needed to travel long distances to get medical treatment. They said that many patients often died before they could get healthcare.

They also expressed disappointment with the lack of trained, professional doctors. Women felt there were insufficient female medics.

Related problems cited by those interviewed for the survey were the shortage of clean water, poverty and lack of roads.

"The health problem in our country is multi-dimensional, and the other ministries should help us in this," Stanakzai said.

Residents of Kunar province have to travel to Jalalabad for treatment, said Haji Azamuddin, 60, of Noorgal district. "After a journey of one day we reach Jalalabad, [but] when we reach there either our patient dies or his sickness gets worse,” he said.

Kunar is one of the mountainous provinces in eastern Afghanistan and, like many others, it has few roads for vehicles.

Paghman district is only 20 kilometres from Kabul, but the major roads are so rutted that "it takes one and a half hours to reach the main road to Kabul and the patients who are in serious condition die", said a 50-year-old woman from the district.

The lack of safe drinking water has also led to the spread of many diseases, such as diarrhea, typhoid and other intestinal diseases. Young children have been especially hard hit by these illnesses.

In Chamtal district of Balkh province, a woman said her children have all been struck down with by these ailments. "Our children are suffering from diarrhea and we do not have any way to boil water," she said.

Even where healthcare facilities are available, the demand is often too great.

Muhammad Sadiq said he traveled from his village in Ali Abad district to Kunduz city and then waited for five hours for treatment at the new clinic there. But before he could see a doctor, the facility had closed for the day.

"If we had a clinic in our village, we would not have to come to Kunduz [city]," he said.

Under the constitution, the government is required to provide free healthcare but there are not nearly enough public facilities available to meet the need. To fill the gap, some private clinics have opened, but they are largely unregulated.

All across the country, individuals have donated 300 plots of land to the government for the construction of hospitals and clinics. But Stanakzai said the authorities don’t have enough money to build health facilities.

“I contributed my land for the clinic and the ministry of health had approved the [project],” said a 42-year-old man in the Daman district of Kandahar province. "They brought some construction materials. But they left a few months ago, and it is still unfinished."

Belqis Omaryar is a trainer for IWPR in Kabul.