Afghanistan + 1 more

Afghanistan: COVID-19 challenges and responses in a war-affected country

After initiating COVID-19 awareness-raising and sanitation activities in Herat and four other Afghan provinces, Cordaid is now gearing up to support testing of suspected cases. “With more funds, we will be able to do more, including assisting the government with treating infected cases”, says Cordaid Afghanistan Director Jaap van Hierden.

Meanwhile, one would almost forget Afghanistan remains a country at war. There are two rivalling self-declared presidents, peace talks with the Taliban are on hold, while Islamic State-Khorasan (IS-K) is increasing its attacks. “We work in a country fragmented by conflict”, Kabul-based van Hierden says. “As the Netherlands and other European countries are struggling to impose effective nationwide COVID-19 measures, you can imagine the challenges we have here. I can only reiterate what UN Secretary-General Gutterez said recently: ‘the fury of the virus illustrates the folly of war’. I fully endorse his campaign for a global ceasefire. By putting armed conflict on lockdown, we can focus on the true fight.”

No movement means no food

So far, Afghan officials have reported 237 COVID-19 cases. But the crisis is bound to spiral and may put millions at risk. Thousands of destitute returnees come back from heavily infected areas in Iran and cross the border every day. While some are tested at the border, about 90% of them aren’t. Most aren’t well aware of physical distancing and other preventative measures. Or not able to abide by them because of economic constraints. No movement means no work, which means no food in the next weeks. They are spreading the virus among impoverished, underserved and remote communities of the country. A lot of them live in Taliban-controlled areas, with less humanitarian access. Recently, Afghan’s Minister of Public Health warned that half of the 35 million population could get infected and that more than 100,000 could die. On the positive side, the Taliban appear interested in a full ceasefire to help stop the spread of COVID-19 and treat infected cases.

Contingency plans activated

Even before Herat and Kabul went into lockdown, van Hierden activated contingency plans. “We have reviewed our programmes and now prioritize interventions that are most essential in slowing down the spread and the impact of the virus as well as those that are life-saving”, he explains. “We are therefore scaling up our humanitarian and health care interventions to meet this challenge head-on.”

“The best way to not feel hopeless is to get up and do something. Don’t wait for good things to happen to you. If you go out and make some good things happen, you will fill the world with hope.”

Zmarai Noori, Cordaid project officer in Herat

To minimise the likelihood of infection, most Cordaid staff is working from home, with essential staff still going to the office and to the field. “Given the movement restrictions, we first had to negotiate continued humanitarian access. We did this successfully in Herat and prevented disruptions to our life-saving activities accordingly.”

Today, NGOs are exempted from mobility restrictions, as long as they strictly follow prevention instructions, meaning no large gatherings and keeping physical distance. “We have stringent protection measures for our field staff and our partners who continue working throughout the country”, van Hierden continues. “They act as role models when it comes to sanitary and distancing practices. In fact, right after the first cases were reported, medical staff provided online COVID-19 training to all our colleagues and partner organisations, from Kabul to the outer parts of the country.”

Slowing down the spread

Cordaid has allocated a first batch of funding to help slow down the spread of COVID-19 in Kabul, Herat, Kandahar, Nangarhar and Balkh. The past 10 days our focus has been on awareness-raising. “We joined forces with our Afghan implementing partners, with medical staff in our networks and with the Provincial Women’s Network to make people aware of COVID-19 and how to stop the spread. We do this among communities in the border areas and in remote rural parts of half of the country’s provinces. In these conservative areas, religious leaders play a central role. We work with them, we inform them about the scope of the crisis and how to stop it. Through them, we get our prevention messages across. Remember, these are the areas where most people are illiterate, have no access to the internet, are cut off by a maze of checkpoints. And where people need to walk long distances to reach basic healthcare centres. A few of which, by the way, were run and supported by Cordaid and its local partners in the past. They are still fully operational.”

Increasing COVID-19 treatment capacity

As the number of infected cases is rising and expected to spiral, the Afghan Ministry of Public Health has asked Cordaid to strengthen COVID-19 testing and treatment capacity. “We are now gearing up for that. Herat and Kabul have treatment centers, but in no way are they prepared for what is coming. We are assessing how we can assist them with the means we have. By providing testing kits or other medical equipment or services”, van Hierden says.

More than a public health emergency

COVID-19 is far more than a public health emergency. “Conflict and crises have been shaping all aspects of people’s lives here for decades. They live on the brink, physically, economically, emotionally, socially, politically. 80% of the people work in the informal sector and live from hand to mouth. Millions are displaced and have even less. Lockdowns, as we see in Herat and Kabul, could well be the millstone around their necks. They prevent people from earning enough to buy a day’s ration, they push up prices of essential food items, like bread, rice, oil. Or lemons. There’s a rush on them now, as people think vitamin C helps you protect against the virus. Overnight, the price went up fourfold in Kabul. Lockdowns could easily fuel social unrest and have devastating, fatal effects.”

Zmarai Noori, Cordaid project officer in Herat, demonstrates handwashing and other COVID-19 prevention measures in Kohsan district. “The best way to not feel hopeless is to get up and do something. Don’t wait for good things to happen to you. If you go out and make some good things happen, you will fill the world with hope”, Zmarai says. © Cordaid

The virus and mobility restrictions also affect the plagued Afghan peace process. US-Taliban talks had already slowed down, the same is happening to the intra-Afghan peace talks. “People can’t meet, so government and civil society delegations can’t meet either”, van Hierden explains. “But we continue to support the inclusion and empowerment of Afghan women leaders in the peace negotiation process.”

“We not only actively participate in the health cluster that coordinates nationwide responses, but also in the food security and agriculture cluster.”

Jaap van Hierden, Cordaid Afghanistan Director

As a result of the peace talks, the Taliban have reduced hostilities. “But we see that IS-K is actually increasing the number of terror attacks during this COVID-19 crisis”, van Hierden says. “Which is in line with their goal of creating chaos and destruction as much as they can. It confronts all of us, citizens and aid workers alike, with challenges on top of many other challenges.”

Call for global solidarity

To support Afghans in coping with the economic impact of COVID-19 measures, Cordaid does everything to continue its humanitarian cash and income support programmes for displaced families and other vulnerable groups. Van Hierden: “We not only actively participate in the health cluster that coordinates nationwide responses, but also in the food security and agriculture cluster. We are all doing our bit.”

Yet, combined efforts are not sufficient. “We are all critically aware that the international community must step up efforts and funding to support this country, devastated by conflict, in coping with this rapidly evolving pandemic”, Van Hierden concludes. “We call for global solidarity.”