Afghanistan - 2017 Humanitarian Response Plan Mid-Year Review of Financing, Achievements and Response Challenges (January - June 2017)
In keeping with previous years, humanitarian response has continued to be defined by conflict in the first half of 2017 with equally unacceptably high numbers of civilian casualties (‐1 percent) and a steady rise in armed clashes (+4 percent) if compared to the same period last year, despite an overall reduction in displacement (‐15 percent).
Between January and June 2017, some 5,243 civilian casualties (1,662 deaths and 3,581 injuries) were recorded by UNAMA Human Rights with Improvised Explosive Devices (IEDs) by Non‐State Armed Groups (NSAGs) the leading cause (40 percent), followed by ground engagements between ANSF and NSAG forces. Notwithstanding the minimal overall reduction in civilian casualties, both child and women casualties rose during the first half of 2017 with a 23 percent increase in women casualties (636) and a nine percent increase in child deaths (436), mainly due to unexploded ordnance, the use of pressure‐plate IEDs and aerial operations in civilian‐populated areas – the latter up by an unprecedented 61 percent in the first six months of the year.
The contest for territorial control has continued unabated within the same period, with armed clashes now taking place in multiple provinces at the same time – three district administrative centres (Taywara, Janikhel and Kohistan) fell in the same week across different parts of the country in late July while another was (Waygal) temporarily under attack. Overall, conflict incidents are rising year-on-year with a 1,000 percent increase in armed clashes registered between 2007 and 2017.
The intensification of the conflict has led to unsustainably high numbers of war wounded on both sides of the conflict. Between January and June, almost 25,000 war wounded patients were reported through First Aid Trauma Points (FATPs) and specialised trauma care centres across the country with high combat areas Kandahar, Kunduz and Uruzgan recording the most incidences. Heightened NSAG casualties, combined with limited opportunities for in-country and external patient transfer, have increased the pressure on district-level hospitals for additional stabilisation and casualty management services to be provided, while simultaneously restricting their ability to deliver safe and quality primary health care to local communities. The first half of the year saw an increasing number of health facilities closed by NSAGs with Laghman, Farah and Badghis provinces the most affected. These closures, which constitute a grave violation of international humanitarian law, have rendered more than half a million people without access to essential healthcare, 250,000 of them in Laghman province alone, and may be indicative of a growing trend in which basic services are used as a bargaining chip, primarily by NSAG forces, to extract improved healthcare delivery for their combatants.
Overall, access to life-saving and basic health services across Afghanistan remains inadequate as a consequence of a defunct and underfunded public health system and a conflict which is both intensifying in nature and expanding in geographic scope. In some 51 districts the Basic Package of Health Services (BPHS) is not available. Health indicators in these areas are particularly bad: women are twice as likely to die giving birth in Uruzgan and Hilmand compared to the national average – already the third highest in the world – and 50 percent less likely to give birth in the presence of a skilled birthing attendant.
Growing insecurity in 2017 has also been punctuated by a doubling in attacks attributable to the Islamic State of Khorasan (from 128 to 237), with the number of provinces and districts affected increasing from 1 to 7 and 8 to 24 respectively compared to the same period in 2016. The rise of ISK activity, which up until 2016 had mostly been confined to Nangarhar province in the Eastern region, has since intensified as fighting has broken out between three entities – ISK, NSAG and government forces – and threatened to expand into neigbouring provinces Kunar and Nuristan. The presence of multiple competing actors across the region, and attendant rise in conflict activity, is one of the main reasons behind the increase in civilian displacement experienced in the East so far this year.
In this regard, the conflict continues to exact a terrible toll on the people of Afghanistan and fuel the need for largescale humanitarian assistance to be provided. Over 160,600 individuals (24,240 families) were displaced during the first six months of 2017, roughly 30,000 less than in the same period in 2016. With the insurgency now controlling or exerting influence over areas comprising around a third of the Afghan population, it is likely that the humanitarian community’s ability to identify or assess those impacted by conflict has declined. Some 45 districts are now fully or partially under the control of NSAGs according to the Special Inspector General for Afghanistan Reconstruction (SIGAR), while a further 118 are contested. As general insecurity has spread, populations have been faced with increasingly difficult choices: move to areas which are no safer than those where they currently reside or remain where they are and effectively become isolated and without access to essential supplies. Indeed, with the official IDP petition system largely or completely out of reach for those living in non-government held areas, in addition to the limited coverage of disease and food insecurity early warning systems, the capacity of humanitarian partners to detect or respond to the most acute needs may have been considerably weakened over the past six months, resulting in less IDPs being reported despite intensified conflict.
Insecurity is only likely to increase and further expand over the remainder of the year following the recent announcement of next years’ parliamentary elections. In this context, the eroding military stalemate looks set to continue with no seasonal lull in fighting anticipated as winter arrives later and is expected to be more mild. The recent decision by Trump to surge additional troops to Afghanistan may also result in a more volatile landscape over the coming months, contributing to higher outflows of IDPs. With this in mind, it is likely that the number of new IDPs generated by conflict will reach the 450,000 projected caseload.
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