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Statement by the WHO Representative in Afghanistan

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24 August 2021 – Since last week, WHO has made several assessments to review the health situation on the ground. Apart from the first few days of the political and security changes, most major health facilities are functional and accessible. This includes health facilities supported by WHO that are providing trauma care to injured patients. However, health facilities across the country are experiencing critical shortages in medical supplies. 

Our assessments reveal that service delivery is being supported by Taliban health authorities without any pressure on health staff. Health workers have been called to return to/remain at their posts, including female health staff. However, some female health staff are not returning to their posts – and some have resigned their positions – due to the ongoing insecurity. Both male and female patients are seeking health services, although some female patients are also fearful of leaving their homes, unless for life-threatening conditions. 

Overcrowding among displaced people has limited infection prevention measures and increased the risk of transmission of different type of infections, including COVID-19. The country has already gone through 3 substantial waves of COVID-19. We are concerned that a new spike among displaced people could lead to further transmission across cities due to a very low vaccination rate with only 5% of the population being vaccinated so far. 

This will place an enormous burden on the health system, which is struggling to cope with escalating trauma and emergency cases and could leave some of the most vulnerable people without critical life-saving health care. WHO is working with health cluster partners to monitor the situation and scale up COVID-19 surveillance, testing, referrals and vaccination for displaced people to mitigate risks of increased transmission. 

Afghanistan reported over 152 000 COVID-19 cases and more than 7000 deaths as of 23 August 2021. However, there is a decline in testing due to the insecurity, with test rates last week declining by 77% in both public and private laboratories, compared to the week before. As a result, we know that there is under reporting of COVID-19 cases. 

Instability has put some key measures to strengthen the COVID-19 response on hold, including the establishment of new laboratories for testing, the installation of oxygen plants in hospitals, and the expansion of isolation centres and intensive care beds for COVID-19 in different provinces of Afghanistan. It has also made implementation of infection prevention measures extremely difficult across the country and impacted the COVID-19 vaccination programme.

As well as COVID-19-like symptoms among displaced persons, we have also received reports of an increase in cases of diarrhoea, high blood pressure, and reproductive health complications and malnutrition. 

As needs increase, we continue working. In coordination with health partners, 6 medical teams have been deployed in Kabul to provide lifesaving emergency primary health care services to more than 100 000 displaced people. Fourteen medical teams were deployed to provide health services in the eastern region of the country. Overall, more than 3000 medical consultations were provided in the last week, including outpatient, antenatal and post-natal care, immunization, and screening for malnutrition. 130 WHO-supported trauma care health facilities remained open and provided case management services. Critical polio surveillance activities continued largely undisrupted and polio vaccinations are continuing to be administered to children through permanent transit teams in most regions and at cross-border sites, including Friendship Gate (between Afghanistan and Pakistan). 

In the past week, WHO has delivered trauma kits, basic medical supplies and cholera kits to health facilities in Bamyan, Daikundi, Ghazni, Helmand, Kabul and Kunduz provinces. These supplies are enough to cover the urgent health care needs of 152 700  people. Medicines and supplies were also dispatched over the last 2 weeks to 22 malnutrition centres treating children with severe acute malnutrition. Additional supplies for a 48 more malnutrition centres are awaiting distribution. 

The past weeks have been challenging on both a personal and professional level for WHO staff in Afghanistan. But we are committed to staying and delivering. Health services must continue without interruption across the country.  

There is an urgent need for reproductive/child health services, mental health services, mosquito nets and hygiene kits for newly displaced people. Nutrition supplements are needed to address rising malnutrition among children, especially those affected by conflict. COVID-19 and other routine immunization, including polio vaccination, must continue without interruption to control infectious diseases prevent secondary health emergencies. And injured people – including women and children – need trauma care, as well as longer term rehabilitation to prevent life-long injuries. Mental health services are also needed now more than ever before.

For us to continue our life-saving work, we call on all parties to respect the neutrality of health and ensure critical health activities are not disrupted. And we need sustained and unimpeded access for supplies to enter the country, so that we can keep health facilities functioning and health services available for all.

During this difficult time, the well-being of all civilians — as well as the safety and security of our staff — in Afghanistan is paramount.