Expert Speak Health Express
Published on Apr 19, 2020
The COVID19 reality of Afghanistan

Over the last few decades, Afghanistan has been struggling with issues such as poverty, a civil war, a weak establishment and political turmoil, but today it faces something much bigger – COVID19. Besides the obvious challenges, what exacerbates the situation is that as a whole, Afghans are known to be very social in nature and as a religious practice, Islam also lays emphasis on the importance of community and communal gatherings.

Then, there’s politics. Earlier this year, two people took oath for office. President Ashraf Ghani and Chief Executive Abdullah Abdullah claimed to have triumphed in the presidential elections held in September, 2019 but Ghani was officially declared the winner by the Independent Election Commission of Afghanistan. The controversy continues to plunge the country into further political uncertainty and can lead to total chaos.

As political uncertainty continues, government institutions continue to weaken. In February 2020, Afghanistan’s public health ministry designated the Afghan Japan Hospital in Kabul as the capital’s primary coronavirus treatment facility. There was one major drawback to this - the hand sanitizer procured by the Ministry and distributed throughout the hospital was tested and found to have zero alcohol content. The gel wouldn’t have rubbed ink off of a white board, much less disinfect the hands of the hundreds of staff and patients. According to hospital staff, the sanitizer has since been disposed of and replaced by the World Health Organization (WHO).

A WHO spokesperson acknowledged the existence of “inauthentic” sanitizer. There is also a startling shortage of coronavirus testing facilities and ventilators. WHO gave Afghanistan 1,500 testing kits, but only two laboratories in the country are equipped with machines which can process the test samples. Further, the United Arab Emirates and China have also agreed to donate tens of thousands of additional kits. As of today, over 950 cases have been detected, out of which 20 are from the Presidential Palace of Afghanistan. The Public Health Ministry estimates that 25.6 million Afghans will be infected and 1,10,000 Afghans will die of COVID19.

Work at all government institutions has been halted because of the coronavirus scare, except at the Ministry of Public Health and in the security sector. Due to an increase in infected COVID19 patients, President Ghani issued a decree on April 15, 2020, in which all three deputy ministers of the Public Health Ministry were dismissed and new appointments were placed.

Afghanistan’s decades of war have finally been brought to a place of possible discussion between The Afghan Taliban and the Afghan government, but the possibility for negotiations to move forward has been halted due to COVID19. The Afghan National Defense and Security Forces is still defending Afghanistan against the Afghan Taliban, regional and international terrorists, and criminal activity. Despite social distancing measures by the security sector, when on the battlefield, the visible threat of bullets from life and death becomes more prominent. The police department of Ghani province in Afghanistan said it has distributed protective kits to security forces to help them combat the coronavirus. However, they said their safety is compromised because there aren’t enough equipment for each member of the force.

The Afghan Taliban has seized on the COVID19 crisis to present itself as an entity capable of governing more effectively than the elected and internationally recognized government in Kabul. Currently, the Afghan government controls only 133 of Afghanistan’s 407 districts, according to an ongoing security assessment by FDD’s Long War Journal. The Taliban controls 75 districts, while 189 remain contested. While it is still unclear whether the government can access those 189 districts it is definitely clear they cannot operate e under Taliban control, which is nearly a fifth of all districts. The Afghan Taliban launched an awareness campaign in Logar province by distributing pamphlets with advice on prevention of coronavirus.

As COVID19 started to spread around the world, it didn’t faze the people of Afghanistan even as cases were identified in its Herat province due to the never-ending challenges described above. However, as the number of infected increased, the government locked down three provinces bordering Iran: Herat, Nimroz and Farah. Steps were taken by the Afghan government to slow down the spread of the coronavirus. On March 14, the President of AfghanistanAshraf Ghani, told the public to avoid large public gatherings and to pay attention to hygiene in order to prevent the spread of the disease. On March 18, the Ministry of Interior Affairs officially banned all large gatherings. It also ordered the closure of venues which attract large crowds such as entertainment areas, sports grounds, swimming pools, fitness clubs and wedding halls. Shortly after that, the Ministry of Interior Affairs implemented quarantine and lockdown in most provinces, especially urban cities such as Kabul, Kandahar, Mazar, Logar and Jalalabad.

The multi-generational war in Afghanistan has resulted in millions of internally displaced people in Afghanistan. Most recent records show that over 2.5 million were displaced in 2018.  Usually, the Afghan joint family system comprises of two to three generations, but due to the displacement, occasionally, there are four to five generations restricted to two bedroom spaces or even less. Social engagement lessens the burden on joint family systems as it creates alternate support systems. As the COVID19 pandemic sweeps across Afghanistan, it is causing stress and fear among all, especially, the elderly. The psychological impact will bring anxiety, fear, stress and anger.

The economic crisis interferes with even the most basic efforts to face the challenges brought about by COVID19. Most Afghans rely on daily wages to feed their families. Locking down cities and closing markets pushes them to hunger. Another financial aspect is the government budget. Public Health Minister Ferozuddin Feroz stated that they will need $100 million while, right now, what they have is only $18 million. The World Bank’s Board of Executive Directors have approved a grant of $100.4 million for Afghanistan’s COVID19 Emergency Response and Health Systems Preparedness Project. This is to help the government take effective action to respond to the threat posed by COVID-19 and strengthen its public health preparedness.

The Ministry of Public Health developed an app in collaboration with the Ministry of Communication and Information Technology, which provides information on COVID19. This innovative method is only feasible in Kabul and a few other urban cities. Recently, the Ministry of Education worked on a plan to provide online education through websites, radio and television, as educational centers have been temporarily suspended amidst the pandemic. Residents of western Ghor told Radio Azadi that over 80 percent of the students would be deprived of education as the province is struggling with a shortage of electricity and essential media sources. The head of the Provincial Education Department, Ahmad Sabir Noori, confirming the issue said that they are planning to open education centers in open areas with half the number of students per classes.

Islamic scholars released a fatwa that all religious practices including the upcoming fasting and breaking of fast for Ramadan should be conducted at home. In addition to this, the pandemic has inspired a shared sense of responsibility and spontaneous acts of generosity. Afghans have stepped up to share the little that they have, tapping into a culture of generosity, volunteerism and care. Landlords have waived off rent, tailors have handed out thousands of homemade face masks, youth groups and athletes have delivered food to hospitals and families in destitution. Local television stations have run live fund-raising events, while wedding halls and private schools have volunteered to be turned into hospitals.

Even as the Afghan people rally together to battle the pandemic as community, Covid19 could yet be another huge tragedy for Afghanistan.

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