Afghan healthcare in crisis as hospitals struggle

Image copyright AFP Image caption Health care is often dire in Afghanistan

Correspondents say Afghan government services – such as education and healthcare – are being undermined by continued instability in the war-torn country.

The country has long struggled to provide basic services to its population.

Diagnosing a serious or life-threatening illness is often hard, not just for Afghans but for most doctors around the world.

According to healthcare workers, government procurement procedures are preventing vital supplies of medical equipment and medicines from reaching hospitals.

The United Nations says the situation is likely to worsen. It said that the main obstacles for aid agencies were “excessive pressure from the government to cut costs” and a lack of clear strategic objectives.

Aid agencies say that many Afghan government services have been disrupted by ongoing fighting in the country.

There is an acute shortage of doctors in the country. Last year alone, at least 6,000 doctors left, according to figures from the Ministry of Health.

The World Health Organization says that one in 10 Afghans has been forced to migrate, a number that is set to rise.

Disgruntled Afghan health workers accused the Afghan government in a new video campaign of not giving them enough money to provide basic services.

The Ministry of Health says it has invested in plans to supply doctors and nurses with basic equipment such as syringes, measuring cups and laboratory equipment.

But there are concerns that the equipment will not be available as quickly as healthcare workers need it.

Juliette Case, a health policy expert at Queen Mary University of London, said that there were major concerns about the state of government healthcare in Afghanistan.

“There’s not a sustainable system there. We need to be preparing ourselves for increasing supply of chronic diseases in particular, which means there’s going to be a huge need for healthcare services,” she told the BBC.

“There’s a lot of public anger about the role of the international community – often the UN – in Afghanistan and it’s a reflection of the Afghan government’s lack of commitment to building an effective system.”

Compounding the problems are shortages of critical life-saving vaccines and an acute shortage of some types of antibiotics.

A vaccination shortage is compounded by the fact that resources cannot be accessed in remote areas, so doctors are forced to rely on overseas volunteers and extended family members to make up the shortfall.

The World Health Organization (WHO) says that one in 10 Afghans has been forced to migrate, a number that is set to rise.

Dr Annemarie McDade, WHO country representative in Afghanistan, told the BBC that there was an acute shortage of antibiotics, which means antibiotics are not readily available to patients who need them.

“In some areas of the country, medicine is scarce,” she said.

“The area of shortages in medicines really is a push back towards an area of resistance where people start to build immunity and sometimes that means you can’t give antibiotics.

“But that’s an issue that we need to work on much harder,” she added.

By the end of 2018, the UN said that 145 international NGOs had closed operations in Afghanistan.

The closure of various humanitarian operations in the country has led to important projects coming to a halt, said Dr McDade.

“Without the international community, we have lost access to many of our partners in Afghanistan,” she said.

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