Kabul – In the last year the world has reckoned with the sacrifice made by many health workers – doctors, nurses, lab technicians and others – risking their lives daily to care for the sick, as the COVID-19 pandemic claims millions of lives.
Everywhere, health workers on the front lines are at the highest risk of being exposed to COVID-19 infection, but, in Afghanistan, they face additional threats due to conflict, disaster and insecurity.
This has not dissuaded dozens of women on the International Organization for Migration’s (IOM) health teams from donning masks, gloves, and lab coats and going to work.
“I know that the coronavirus disease is very dangerous for me and my family,” said Dr Afsana, who works with IOM in western Herat province. “But I still come here to work for my people because I am motivated to help those in need. There is simply nowhere else they can go to be tested or receive care for this disease.”
Like hundreds of thousands of health-care workers across the world, she contracted COVID-19 a few months ago. Luckily, she recovered and is now back on the front lines helping others.
Afsana serves as a doctor on one of IOM’s 18 Rapid Response Teams, which move throughout four of Afghanistan’s provinces with the highest number of migrant returns from Iran and Pakistan, offering health-care services, COVID-19 sample collection and risk communication to curb the spread of transmission in underserved communities.
Among the people they serve are the over one million Afghans who have returned home from Pakistan or Iran during the past year.
Nooria, 24, screens returning Afghan migrants for COVID-19 at IOM’s reception centre on the border with Pakistan.
“Most people coming back from Pakistan do not have enough information about COVID-19. We don’t want to scare them, but we screen them for symptoms and provide the necessary information to keep them safe when they arrive,” explained Nooria. “We advise them to wash their hands, keep physical distance from others and avoid crowded areas, which can protect them and their families.”
“This is important for the safety of communities, because if one person is infected with COVID-19 and then continues their journey onward into Afghanistan, it can put others at risk,” Nooria added.
Many of the returning migrants have exhausted their savings and taken on significant debt, just to get home. Often, health care is unaffordable for returnees who find themselves settling in areas where the nearest clinic may be dozens of kilometres away, and people internally displaced by conflict or recurring annual climate events face similar barriers to accessing care.
“COVID-19 is a really big problem in an informal settlement like this because many people are living in one room together, so isolation or physical distancing is not possible. They don’t even have enough money to go to the hospital”, explained Dr Rahima, a doctor at IOM’s mobile health clinic in an informal settlement for internally displaced persons (IDPs) in Herat province.
“If IOM was not here, there would be many more problems,” she added.
In Herat province alone, which borders Iran, IOM is responsible for 90 per cent of all sample collection and support for follow up testing and care.
Ensuring gender parity on IOM’s health teams is crucial. Women like Dr Rahima make up 50 per cent of IOM’s health-care teams and are at the core of IOM’s efforts to screen, educate and prevent the spread of the disease.
“We continue to see a rising number of women coming to us for COVID-19 information and screening because they are the ones staying home and taking responsibility for the health of their families,” said Dr Salma at a health education session she led at a women’s community meeting in an underserved rural area on the outskirts of Herat city.
She notes that the pandemic has affected women differently. Particularly as they are more likely to contract the disease from family members. Many spend the majority of their time caring for loved ones at home – while the men go out to work – staying indoors attending to large inter-generational families, in one- or two-room dwellings, and caring for the elderly who tend to be more severely affected by the disease.
According to Dr Salma and other IOM health staff, most women in Afghanistan are unable to seek care in facilities where only male medical staff are present.
“Women need to be central to the COVID-19 response because other women trust us. We understand the culture and we respect the confidentiality of women’s health issues and their histories,” she explained.
“Women would never go to a male doctor due to cultural sensitivities. This is changing gradually, now that we have female staff with whom women can openly discuss their health. We can go freely to their homes and they feel safe to speak with us,” added Dr Halima, who works in an IDP settlement in southeastern Kandahar province, on the other side of the country.
Women like Rahima, Nooria, Halima, Salma and Afsana have provided a lifeline to other women who have been typically left out of receiving the most basic health services.
These women also look forward to the day when their influence will positively contribute to the roll-out of COVID-19 vaccines, which have started to arrive in Afghanistan, to ensure greater vaccine access and equitable distribution to those most in need, including women and girls in the communities where they work.
“Getting the vaccine to places like these is extremely important, to people who live in poverty, who don’t have sanitation services, who lack education; they need to be among the first in line,” concluded Dr Rahima.
Not only have they filled a glaring gap in Afghanistan’s health response, but they also serve as role models for younger women who aim to have a career in medicine.
“The first thing women need to do to become leaders is to become educated, and then to be brave and have the courage to work. I’m very proud to have this duty and to serve my people,” said Nooria.
This article was written by Angela Wells, IOM Public Information Officer for Operations and Emergencies.
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