The health programme moved forward as scheduled, with monitoring visits made to clinics in seven provinces, while training and support for the work of traditional birth assistants continued. Training of volunteers from 115 villages , and refresher courses for 291 trained volunteers took place. Community Based Disaster Preparedness training guidelines have been produced and procurement has begun to establish minimum relief stocks. A leadership workshop was held for eastern region staff and resource development made progress in the central region.
More than 20 years of conflict have ruined Afghanistan's economy and reduced the living conditions of most of its 20 million population to a bare subsistence level. There are few prospects of a resolution of the political and military situation. The Taliban movement which currently controls an estimated 90% of the territory continues to be challenged by the Northern Alliance. The Kabul government is not recognised internationally.
As long as the conflict continues it is unlikely the socio-economic situation will improve, leaving most Afghanis facing years of extreme vulnerability, without the safety net offered by most societies. The government administration and infrastructure, and the health care and social welfare system have almost completely collapsed. Except in a few cities or urban areas, telephones, utilities, roads and other municipal services are almost non-existent.
Only the Movement - the Afghan Red Crescent Society (ARCS), the ICRC and the Federation - has been able to sustain continuous activities. The Afghan Red Crescent Society, arguably the only indigenous, nationwide humanitarian organisation in the country, is struggling to maintain its ability to work with all ethnic groups and to reach women through its services. Operational in 30 of Afghanistan's 32 provinces, and with an extensive network of branches, it continues to reach more than three million beneficiaries a year, with Federation and ICRC support.
January saw a dramatic increase in armed robberies in Kabul for the first time under the Taliban rule. The money market was looted, HF radios taken from vehicles of international organisations, while private apartments, a mosque and, according to some reports, governmental institutions were robbed. This and unrest in Khost province over a land issue, producing a confrontation between the province and the authorities, has contributed to a general climate of insecurity and political tension.
Red Cross/Red Crescent action
On 1 February the Taliban government announced the appointment of the President of the Afghan Red Crescent Society as deputy minister of Promotion of Virtue and Prevention of Vice, and named Mullah Syed Abdullah Agha, former governor of Khost province, as his successor.
During the month, the Health delegates made monitoring visits, together with ARCS counterparts, to Ghazni, Herat, Logar, Paktia, Kandahar, Zabul and Helmand provinces in order to review the quality of service delivery, the rational prescription of medicines and the proper utilisation of resources. Medical stock and equipment were checked during the visits.
The seven clinics in which maternal and child health care will be further enhanced during the next two years have been identified. Renovation and construction are planned in three of these clinics and proposals are being finalised. These works however are not expected to start before the end of the winter. The construction works for two additional rooms in the clinic in Herat are progressing.
Tentative Health Information Data shows a total of 2,053,650 beneficiary contacts during the year 1999 -- an estimated 18% increase of beneficiary contacts compared to 1998. These figures are incomplete, since due to logistical constraints no December 1999 data were received from the clinics located in Kunduz, Badakhshan, Takhar and Parwan.
Traditional Birth Attendants (TBAs) training and activity Training for 19 TBAs was completed in Herat. During December the TBAs in Herat saw 167 women, and assisted in 78 deliveries. 7 foetal death were reported, but no maternal deaths. A total of 14 mothers were referred to the MoPH hospital.
Monitoring of their activities shows that the TBAs are working well and referring appropriately. The 13 TBAs in Mazar have seen 214 women, and assisted in 41 deliveries (1 foetal death). Four mothers were referred to the local MoPH hospital.
Volunteer training activities In Kabul and Ghazni provinces a total of 113 volunteers, covering 115 villages, were trained. Training started in the provinces of Samangan and Takhar on 23 January, with expected completion in February.
Volunteer follow-up activities A total of 291 volunteers participated in follow-up training, representing 86% of the initially trained group. During all these follow-up sessions, first aid bags were refilled with necessary materials and refresher courses were held on topics including ARCS and Red Cross Red Crescent history; fractures and bleeding; STDs/AIDS; and volunteers' responsibilities.
During these follow-up activities, volunteers provide activity reports. The following main activities were reported from Balkh (Mazar) and Samangan, in addition to the standard first aid interventions (more than 320 in these provinces).
- In Dawlatabad, a district of Balkh, volunteers assisted the community in rebuilding a 6 kilometre road and in extinguishing a fire in a wheat stack. In the same district volunteers participated in a well-digging programme.
- In Balkh's Chemtal district, volunteers took the initiative to find and recruit teachers and students for an abandoned school. Three teachers have started lessons in the school and are being paid by the villages.
- Volunteers in Kholm district (Samangan) reported most cases treated concerned bleeding, shock, burns and diarrhoea.
Since schools are closed for the winter, the youth volunteer training programme will not resume before the end of March.
Community Based Disaster Preparedness (CBDP)
The ARCS has finalised the first draft of CBDP Field Guidelines in Dari, based on the recommendation of the 4th ARCS CBDP supervisors meeting, held 27 and 28 December 1999. The guidelines will be used for future CBDP training and activities.
In order to replenish stocks of tents distributed in last year's Maidan Wardak earthquake and as part of plans to establish a minimum disaster preparedness stock, the procurement process for an additional 1,500 tents has been initiated. It will be finalised upon confirmation of the funding situation. Two hundred Emergency First Aid kits have been procured and delivery was expected in February.
Institutional and Resource Development
Following the joint Federation/ICRC review process in 1999 on all ID and co-operation related issues with the ARCS, core structure support was terminated on 31 December. A new framework agreement is being negotiated with the National Society. Some partial payments were made pending the conclusion of the agreement.
The National Society's ID department continued its training and resource development activities. National Leadership Workshop The third 4-day National Leadership Workshop was held, 22 - 25 January in Jalalabad, for 21 senior staff of branches in the Eastern region. It was the first to be completely managed by the ARCS and Federation national staff. It was particularly outspoken in its conclusions and recommendations, confirming the value of the self-assessment and planning process that the Jalalabad Field delegate initiated and facilitated in 1999. A proposal to include the Eastern Region in the Resource Development programme earlier than July 2000 (as originally planned) is being discussed. A full report of the workshop is under preparation and will be made available.
Resource Development (RD)
Further progress has been made in RD activities in the Central Region branches,. The Logar bakery project has received its first, albeit modest, net income. Ghazni, Paktia and Khost have finalised their proposals and they will be initiated soon. Many discussions took place on the parameters for accepting proposals, especially the one of requiring a 1:5 rate for initial investment budget against first annual net income. This rate is commonly accepted in the RC/RC movement as a standard for fund-raising and income generating activities. National staff and counterparts, however, regard this rate as very unrealistic in the context of Afghanistan, given the few business opportunities, the high inflation and the linkage of many prices to the Pakistani rupee. The first year of the RD programme is a test year, to experiment with and identify successful strategies applicable in Afghanistan, but also to set realistic parameters for RD. Examination of the issue will continue.
With the ICRC Afghanistan Logistics Co-ordinator and its Deputy Head Logistics Operations, Geneva, discussions were held on further strengthening future co-operation in warehousing, procurement, fleet management and national and international transportation. It is expected that in the coming months a further analysis will be made of the areas where joining forces will be of mutual benefit. The purchase of diesel through the ICRC continued as before.
Support as outlined in the Federation's Appeal 2000 - 2001 is urgently needed to ensure that there is no interruption of programmes.
See Annex 1 for details.
Asia and Pacific Department
Operations Funding and