Afghanistan: suffering continues amidst escalating conflict - Interview

The Afghan people have endured tremendous and seemingly unending suffering through nearly three decades of war, with no end in sight, as the conflict is currently intensifying and spreading. On the occasion of the 20th anniversary of ICRC's permanent presence in Afghanistan, Reto Stocker, the ICRC's head of delegation in Kabul, clarifies the current situation and explains why there is still so much left to do.

Given the intensification of the conflict over the last year, what is your reading of the current humanitarian situation in Afghanistan?

The conflict has both intensified and spread to the north and west of Afghanistan since 2006. The humanitarian situation remains extremely tenuous. Civilians are highly vulnerable to an escalation of the conflict and recurrent natural disasters. It remains very difficult for humanitarian organizations to have safe access to victims, especially outside major cities. Indiscriminate methods of warfare, including attacks that, while aimed at military targets, can be expected to cause many civilian casualties, or which are otherwise carried out without taking the precautions needed to spare civilians, have also increased the risks faced by the common people.

The ICRC is well placed to react to the changing circumstances because of our presence on the ground in major centres around the country, and our strong partnership with the Afghan Red Crescent Society (ARCS), which has an extensive network.

How is the ICRC helping Afghan people to cope with the day-to-day reality on the ground?

Our traditional activities such as support to medical structures have continued without respite. These services assist thousands of beneficiaries each year. We have even expanded these services in the troubled southern region by extending our support to all departments of the regional hospital in Kandahar.

We continue to improve the quality of people's lives with our water and habitat projects. We have also substantially increased our material support to the Afghan Red Crescent, so that they might increase their "humanitarian reach" to more remote areas where humanitarian action is much needed, however, is not always possible by the ICRC alone.

Would you say that today humanitarian actors are focusing on emergency situations rather than development?

You cannot properly assist the victims of an ongoing armed conflict without balancing emergency response and development. Traditionally, we have always tried to assist with the re-establishment and strengthening of existing social infrastructure, rather than replacing structures. We help the Afghan people to cope by helping themselves. We avoid creating long-term dependency. Our support to the teaching hospital in Jalalabad, the way in which we have built local capacity at hospitals in Shibergan and Kandahar, and our hygiene promotion activities, show that are maintaining a long-term health care focus.

Our work in support of the Afghan Red Crescent promotes local institutions such as rural clinics, with a view to the development of long-term capacity. Thus we maintain a strong commitment to development, despite many areas being so insecure as to limit development opportunities. At the same time we ensure that we are poised to provide humanitarian assistance to the victims of armed conflict when and where they occur. That is the delicate balance between development and emergency response.

Are you able to address the needs of the Afghan population throughout the country or are there particular security concerns?

Since 1978 we have assisted Afghan war victims; yet not since we established our permanent presence in Afghanistan in 1987 have we faced such acute restrictions on our work as we do now. Since early 2003, it has become increasingly difficult to access victims in more remote locations. Afghans have faced terrible hardship in areas where social infrastructure has been destroyed. There are many stories of people who have died of their injuries on the long road to the few remaining regional medical facilities.

We attempt to make our activities completely transparent to all parties to demonstrate we have a solely humanitarian focus, but insecurity and unpredictable criminality create dangers for our staff. Considering the difficult security environment, we do extremely well with the access we have. This is a positive reflection of the attitudes of all stakeholders towards the work of the ICRC and the quality and transparency of our national and expatriate staff.

What is the ICRC doing with regard to the large influx of war-wounded?

We are busy! Firstly, our concentration over many years on improving the long-term national and local capacity of major hospitals has had a huge impact on the quality of care available to the war- wounded, including trauma care for victims. Secondly, we have provided strong support to medical training through surgical seminars and by training the Afghan Red Crescent community-based first aid (CBFA) volunteers, 10,000 of whom take basic first aid and health care to remote areas, including the 16 most war-affected Provinces.

Finally, our good coverage through ICRC sub-delegations and offices allows us to monitor the humanitarian situation throughout the country and react quickly to the needs of victims, by providing war-wounded supplies to the areas required. Our long-term focus on emergency health care and capacity building is paying dividends.

What is the scope of your activities in favour of detainees?

The ICRC has worked in Afghan prisons for many years, to protect and assist persons who have been detained as a result of the conflict. We regularly visit over 80 detention locations here, including Pul-i-Charkhi Prison, National Security Directorate detention centres and the US detention facility in Bagram. We individually follow the fate of thousands of detainees. Regular visits enable us to identify problems that may exist regarding treatment of detainees, and to monitor judicial processes. Occasionally, we provide winter clothing or hygiene articles to detainees, and we run a capacity-building program to train health staff in five central prisons in different regions called "Health in Detention."

We also ensure that detainees maintain contact with their families through Red Cross messages - 6,000 RCM have been delivered with the help of the Afghan Red Crescent in the first three months of 2007 alone. Finally, we facilitate family visits to detainees at the newly built Pul-i-Charkhi detention facility. Some of these visits have been the first contact between detainees and their families for several years. As always, we maintain a confidential dialogue with detaining authorities, to ensure that minimum standards of detention are maintained.

What is the main focus of the ICRC's cooperation with the Afghan Red Crescent Society?

We have a really strong partnership with the ARCS, and it grows more solid as time goes on. The ARCS have a wide network throughout the country and they have access to areas where our physical movement is restricted. While we would say that we are generally most involved in building capacity in the ARCS, we also recognize the tremendous steps they have taken to bring humanitarian aid to beneficiaries, especially in remote locations. Our partnership involves collaborative work in the fields of assistance - especially health care, mine risk education, emergency assistance and communication. Afghans can be very proud of their national society - it is dedicated, victim-focused and well-led.

How do you think the humanitarian situation will evolve in the coming months?

It has never been easy to predict how Afghanistan's "humanitarian situation" will change. There are numerous shifts in the landscape at present including: increased and more geographically dispersed insurgency action, talk of negotiation between the government and armed opposition, and an increasing degree of dissatisfaction with some international forces due to high numbers of civilian casualties. There is always a risk that in the coming months the parties will worsen the humanitarian situation as they push hard to strengthen their negotiating positions; and soon enough, the cycle of natural disasters could also recommence.

The Afghan people have endured enormous suffering and we need to remain ready and able to assist them, whatever the short-term evolutions of the conflict. This will require a good understanding and respect of our humanitarian mission by the parties to the conflict, and access to do our work. We are cautiously optimistic that this will be the case.