The trauma care unit of Kunduz Regional Hospital sustained minor damages during armed clashes in 2016. Photo: WHO/S.Ramo“I worry for my life every morning I go to work”

Kabul 19 August 2017 – As the conflict in Afghanistan escalates and expands, healthcare comes under attack. Since January this year, 164 health facilities have been forced to close temporarily due to insecurity and conflict and 45 facilities remain closed. In 2017, 24 health facilities have been attacked and damaged either deliberately or as collateral damage. The forced closure of health facilities is currently affecting around 3 million people’s access to healthcare in Afghanistan.

“Before 2015, most of the attacks occurred in so-called traditional conflict areas such as Kandahar province in the south and Nangarhar in the east. However, in the past two years, attacks on health facilities and healthcare workers have become more common throughout the country,” said Dr David Lai, Health Cluster Coordinator at WHO Afghanistan.

“We have recently started to gather more comprehensive data on attacks on healthcare and the findings are alarming. In 2014, 25 attacks on health facilities were reported, whereas last year the number was 53, representing an increase of over 100%. Similarly in 2016, 189 health facilities were forced to close due to conflict, up from 72 two years before,” said Dr Lai.

“We live with violence all the time”

Health workers face the risk of assaults, abductions and killings as they carry out their work in health facilities and communities around the country. In a recent assessment carried out by WHO in four conflict-affected provinces, 42% of healthcare workers reported experiencing threats to their personal safety while at work. Dr Yousefzai during a consultation at a basic health centre in Jalalabad. Photo: OCHASince the beginning of 2017, 12 aid workers have been killed and as many injured while delivering healthcare and essential services to those in need.

“We live with violence all the time. It has become part of our lives,” says Sediqa (name changed), a vaccinator working in a health facility in Herat province in western Afghanistan. Sediqa has faced harassment, threats and physical violence at work.

“When I go out to the community to vaccinate children, I sometimes get shouted at, pushed and threatened. One time, a man threatened to shoot me when I was delivering vaccines to children in his community,” she says. Sediqa has also witnessed several incidences of armed men storming into health facilities while she was on duty.

Dr Yousefsai, a medical doctor in charge of a clinic in the outskirts of Jalalabad, is also experiencing the impact of conflict in his work. “I worry for my life every morning when I go to work, not only for myself but also for my family. We all could be targeted by criminals or be kidnapped or caught up in an explosion. We work in a stressful situation with an uncertain future,” said Dr Yousefsai.

An alarming increase in attacks

“There is a staggering and an unacceptable number of violent attacks on healthcare in Afghanistan and an alarming lack of respect for the neutrality and sanctity of healthcare and for international humanitarian law. Medical personnel are attacked or threatened, patients are shot in their hospital beds, hospitals are bombed. This must stop,” said Dr Richard Peeperkorn, WHO Country Representative in Afghanistan.

Photo: WHO/S.Ramo“These increasing attacks on health workers and health facilities bring about devastating effects for health service delivery which is already under-resourced in many parts of the country. Attacks put the lives of health workers at risk but they also deprive Afghans of urgently needed care,” Dr Peeperkorn adds.

Attacks against health workers in conflict areas are on the rise all over the world. In 2016, 863 health workers were injured or killed in attacks globally, an increase from the previous year. In Afghanistan, 154 health workers have been injured due to conflict this year.

Despite the growing insecurity and escalating conflict, brave and dedicated medical professionals continue delivering healthcare where it is needed the most, often risking their lives to treat the wounded and save lives.

Dr Sakhi, 48, has worked as a general surgeon in Nangarhar Regional Hospital for over 10 years. He worries for his life and for the safety of his loved ones.

“There is no security for us. There are often attacks and explosions in our area and many of the casualties are brought here. Sometimes we cannot take care of all of them. Beds and supplies are limited and I worry that if things get worse, we cannot cope with the situation anymore,” he said.

“There are threats against the hospital, there are abductions and overall the situation and our future is very uncertain.”