Kabul (ICRC) - The recent rise in violence in Afghanistan, combined with targeted attacks against health-care facilities, threatens to reduce or prevent access to health services for millions of Afghans that more than ever need health services with the outbreak of COVID-19, the International Committee of the Red Cross (ICRC) said on Wednesday, 17 June 2020.
"The recent trajectory in Afghanistan is of great concern. After the hope brought by a relative reduction in hostilities in February and March, we again see more violence. Civilian casualties are on the rise while the country is battling against COVID-19," said Juan Pedro Schaerer, the head of the ICRC delegation in Afghanistan.
Afghanistan, like many war-torn countries, has an overstretched health system that is challenged by limited coverage in conflict-affected areas, poor specialized healthcare, and now the outbreak of COVID-19. Attacks against health staff or health facilities, such as the deadly assault in May against the MSF-supported maternity hospital in Kabul, only exacerbate the situation.
"COVID-19 has challenged the world's most advanced nations. A country where gunmen attack a hospital stands no chance at providing quality care. We see it in health facilities in conflict-affected areas and in prisons, where people have already limited access to health care," Schaerer said.
In Afghanistan's largest hospital, Mirwais Regional Hospital in Kandahar, which the ICRC has supported for over 20 years, the staff continue to provide obstetric care and surgery for people wounded in war. Due to an increase in COVID-19 cases, the hospital now operates at a reduced capacity despite the near-usual rates of patients wounded in fighting and child deliveries.
Mirwais Regional Hospital is the only regional hospital servicing approximately 6 million people in southern Afghanistan. Many of the patients, especially in the surgical ward, come from areas where fighting between the Taliban and government forces continues.
Worryingly, a substantial number of COVID-19 cases in Afghanistan are health personnel, which puts more strain on the entire system. Mirwais hospital regularly faces a shortage of masks and hand gel as the outbreak disrupts logistics pipelines. As well, blood donations have decreased but the need for blood has not.
"There are some challenges like the supply pipeline that the ICRC can help with," said Erin O'Connor, the ICRC's Mirwais hospital project manager. "But getting donors to come to give blood amid COVID-19 is more challenging."
The fight against COVID-19 needs commitments from all parties to the conflict. ICRC calls to protect medical missions and strengthen health care systems in the places, like detention facilities, where such links are the weakest.
"We battle a worldwide enemy and need a country-wide agreement on how to address COVID-19," Scharer said. "As a start, full respect of international humanitarian law by all parties, without exception, is needed to protect civilians in Afghanistan."
To help reduce the spread of COVID-19 outbreak in Afghanistan, the ICRC together with the Red Cross and Red Crescent movement partners:
- Support the Kabul District Hospital of the Afghanistan Red Crescent Society (ARCS) with training, infection control, hygiene and patient care protocols, material equipment and the long-term infrastructure upgrade of electricity, water and sanitation, and waste management facilities.
- Provided 12 field hospitals and first responders with personal protective equipment (PPE) including mask, gloves, hand sanitizer and advised on surgical recommendations for the staff to operate safely in a COVID-19 environment.
- In detention places, donated PPE, contact-free thermometers, medical items and hygiene items such as chlorine, soap and detergents, and installed hand washing basins besides rebuilding and rehabilitated isolation rooms, and works to improve ventilation.
- Distributed hygiene item in our seven physical rehabilitation centres in Afghanistan to reinforce preventive measures against COVID-19 where thousands of people with disabilities are assisted.