Institute for War and Peace Reporting | Giving Voice, Driving Change

Private Clinics On The Rise

Helmand residents resort to paying for healthcare as state hospitals cannot cope.
By IWPR
According to the law, every Afghan citizen is entitled to free healthcare. But public hospitals are poorly equipped to provide that care, and many people are forced to go to private clinics. Doctors benefit from the system, and may even be encouraging the trend.



Matiullah Meenapal reports:



We’re at a private clinic in Lashkar Gah. A patient named Wahidullah is getting his blood pressure taken, but he’s also doing some bargaining.



For many of the patients at this clinic, paying for care is the only way to get treated. In most districts of Helmand, the public hospitals are poorly equipped and often turn patients away.



Here in this clinic, I meet Amanullah, a poor man dressed in old clothes. He says he went to the government hospital for three days, and every time the doctors would say they couldn’t do anything that day. Finally, on the third day, a doctor asked him to come to his own private clinic.



“I had a stomach ache so I went to the public hospital. The first day they said there was no time for me. The second day they were having a meeting. The third day, they said I could go to their private clinic. When I went there, he was asking for 15,000 afghanis,” he said.



It’s not just Amanullah. Another man, Atiqullah, is hooked up to an intravenous drip when I meet him. He too began by going to the public hospital. But he couldn’t get treated there, so he came here.



“The public hospital has no medicine. No one asks about you. That’s why I came here,” he said. “I came here to get checked out and get good medicine. At the public hospital they even told me, ‘go away, we can’t give you any medicine here.”



Doctor Nisar Ahmad Barak, deputy head of the Helmand provincial health department, says no one is turned away from public hospitals, and only people who can afford it go to the private clinics.



“We support the private sector. That’s Afghan policy. Those who can resort to the private sector are free to do so,” he says. “But we are helping the ordinary patients. We are working with them in our public hospital.”



Despite this, doctors and nurses tell me that hospital staff do sometimes pressure patients to go to private clinics. Doctor Mohammad Khan Hamidi works at the public hospital in the mornings and at his private clinic in the afternoons.



“Yes, there are some doctors who push patients to go to their private clinics. But I’m not doing that,” he says.



Here in the public hospital, it’s hard to know why anyone would come here unless they had to. The electricity is rarely on and the place is crowded.



Doctors run past with someone on a stretcher. Outside, people are sleeping on the ground in the hot sun. Many have been waiting for days. If they can find any money, they’ll go to the private clinic. If they can’t, they’ll just have to wait.



Matiullah Meenapal for IWPR in Helmand.