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Health workers on the frontlines against COVID-19

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19 August 2020 – Almost 6 months since the first case of COVID-19 was recorded in Afghanistan, the number of cases continues to rise. Ravaged by decades of war, socioeconomic instability and insecurity, the country has long been in a protracted humanitarian crisis. The growing public health emergency due to the pandemic, has made things worse. This has not deterred the resolve and determination of Afghanistan’s health workers who are on the frontlines in the battle against COVID-19.

On World Humanitarian Day we thank the real life heroes – front-line health workers who are doing extraordinary things to help the people of Afghanistan during these unprecedented times.

Here are a few snippets of their experiences, and the challenges they are facing in playing a role in the COVID-19 response.

The photo story features health workers from Kabul and Herat province but echoes messages of health workers from across Afghanistan.

Reaching the most vulnerable

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“Internally displaced persons (IDPs) live in very vulnerable conditions, putting them at a high risk of becoming infected by COVID-19. I have been working with my team to serve this community. We have been delivering COVID-19 prevention messages to people at the Herat IDP Camp, every weekend. Our team is also involved in carrying out COVID-19 surveillance so that cases can be reported and recorded promptly. We work quite closely with communities, which exposes us to the risk of getting infected but this is a very important job and needs to be done for the greater good.” Safiullah Surosh, Provincial Polio Officer, Afghanistan Polio Programme, Herat.

The Afghanistan Polio Eradication Initiative (PEI) programme has been supporting the COVID-19 response since March 2020, through integrated disease surveillance; training of health care workers, nongovernmental organizations and government staff and raising community awareness and peopl's perceptions of the virus.

Steadfast in the face of stigma 

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“Me and my team are with suspected or confirmed COVID-19 patients when they are being taken to the hospital. We’ve all had COVID-19 but we all came back to carry on with our work as soon as we recovered. Given our regular close contact with COVID-19 patients, our community members avoid us and sometimes are not sensitive in how they talk about us. If a patient dies in the ambulance while on the way to the hospital, we are often blamed and spoken to unkindly. We do not get upset about these things. We are here to serve the people, so we try to be as helpful as possible. We want to do our best to end COVID-19.” Syed Zaman Sadaat, Manager and Medical Staff, Kabul Ambulance Service, Kabul.

WHO has supported the training and capacity-building of the Kabul Ambulance Service to ensure staff practise effective infection prevention and control measures. Despite following strict prevention measures, health workers across Afghanistan remain at a high risk of becoming infected due to which they are facing stigma at a time when they need their community’s support the most.

Ready to respond

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“I’ve been with this rapid response team for the last 4 months. When the call centre receives a call, me and my team is sent to investigate the case to determine if samples for COVID-19 testing need to be collected. I’m doing my part to make sure we can defeat this virus. I come into contact with COVID-19 cases regularly, but I take precautions to keep myself safe. Apart from taking test samples, I also deliver prevention messages to everyone we visit so they can pass those on to their family and others. We can only win if we all work together.”  Nawrooz Amin, doctor, rapid response team, Herat.

Rapid response teams based across Afghanistan are playing a key role in responding to the COVID-19 crisis. These teams are quick at responding to those that either come to health facilities or reach out to call centres to seek advice if they are feeling unwell. To date, WHO has built the capacity of 190 teams on COVID-19 case definition, specimen collection, case investigation and advising confirmed cases on further course of action.

Keeping points of entries safe

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“I play a key role in ensuring the virus does not cross into Afghanistan. When travellers crossing the border into Afghanistan come to the Zero Point Clinic, my team and I screen them and deliver a basic training on prevention measures. This 10-minute long training happens 3 times a day, every day. I also make sure that all travellers observe social distancing measures while waiting at the clinic. It is a risky job as I come into contact with a lot of people daily, but I am not afraid. I am proud to help in keeping COVID-19 out of Afghanistan.” Muhammad Zia, Screening Staff, Zero Point Clinic, Herat.

WHO has been supporting the training and capacity-building of points of entry (POE) staff on screening and provision of health awareness. To date, 328 PoE staff have been trained, while a total of 1 792 890 travellers have been screened at various PoEs and provincial check points, through WHO’s support.

Test, test, test

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“Caution is everything in my job. Caution in protecting myself as I work in a high-risk environment and caution in performing tests to make sure I deliver correct results. People’s life depends on my work and I take that very seriously. This virus has taken a toll on all of us but testing and isolating infected persons is the most effective way of breaking the chain of transmission. Of course, I worry about the health risks but just like soldiers must remain steadfast at the frontline during wars, I too must remain at the frontline in the war against COVID-19.” Arshad Mohammad Shafaq, Laboratory Technologist, Kabul Central Laboratory.

When the pandemic began, there was no COVID-19 testing capacity in Afghanistan. WHO has since supported the Ministry of Public Health in expanding and establishing 12 COVID-19 testing laboratories across the country. WHO has also provided testing equipment and supplies to ensure smooth operation of these facilities, as well as trained 149 laboratory staff.

I am tough

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“People are understandably scared of COVID-19. Since I work closely with COVID-19 patients, my community stigmatizes me. They worry that I will bring COVID-19 into our community. Because of this, for the last 2 months I have not spoken to anyone or gone anywhere outside my home or work. But I am tough. I became a nurse to help people and this is the time I’m needed the most. I think of my patients as my family and take care of them like would of my family members if they were sick.” Shiba Azimi, Nurse, working at a designated COVID-19 hospital, Kabul.

High stakes, long days

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“I have recently started working at this hospital. Working in the intesnsive care unit (ICU) is high-stakes, I must give my all each day so my patients can get better quickly. I always tell them to not be afraid of COVID-19. I have to remain strong to give them strength. My work is very intensive. Things don’t get easy at home either. I can’t see my family when I get home as I am keeping myself in quarantine to protect them from any risk of infection. I do it all for my people and my community.” Hussain Qurban, MSF Herat Hospital, Herat.

To ensure designated COVID-19 hospitals and staff are able to perform to best of their ability, WHO has provided the Ministry with essential COVID-19 medical supplies and equipment for isolation centres and ICUs. WHO has also supported the training of 1509 health workers on case management and intensive care and 960 health workers on infection prevention and control.

Attacks on health care

Health workers are working selflessly to ensure those in need receive the care they deserve. Despite the heroic work they are doing, they remain at risk of attacks. Assaults on health care in Afghanistan have shown an upward trend since 2017. A total of 22 attacks on health care have already been recorded since January 2020.

The neutrality and sanctity of health care and humanitarian law must be respected. A continuation of attacks on health facilities will increase the number of people unable to access health care services.

Anytime, anywhere, aid and health works are not a target.

WHO is thankful to Afghanistan Humanitarian Fund (AHF), Central Emergency Response Fund (CERF), European Civil Protection and Humanitarian Aid Operations (ECHO)Office of U.S. Foreign Disaster Assistance (OFDA) and the Government of Republic of Korea for providing funding to support WHO’s activities to strengthen the ongoing COVID-19 response.

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