A Country in Need: U.S. Forces Help Restore Afghan Health Care
By Linda D. Kozaryn
American Forces Press Service
WASHINGTON, Dec. 13, 2002 Pictures coming out of Afghanistan show a land seemingly forgotten by time -- and modern medicine. After 20 years of war, medical clinics and hospitals are in ruins and in dire need of basic medical supplies and equipment.
With U.S. and coalition aid, the situation is on the mend.
The United States has been "indispensable" in helping to restore health care in Afghanistan, according to Dr. Abdullah Sherzai, director of planning at the Afghan Health Ministry in Kabul.
"Just the presence of the American military creates the security background within which you can work -- from nutritional work, to health care, to reconstruction," he said. "The Afghan people understand this and we appreciate it."
Sherzai, a neurologist and a U.S. citizen, gave up his research work at the National Institutes of Health in May to go to Afghanistan. This week, he accompanied Health Ministry officials to Washington to meet with U.S. government leaders.
During a Dec. 10 interview at the Pentagon, Sherzai served as spokesman for Afghan Deputy Health Minister Ferozudin Feroz. Expressing the minister's appreciation for America's help, Sherzai said the Afghan people hope the United States intends to create a long-term partnership with Afghanistan.
"The purpose of our visit is to make sure that the world attention, specifically America's attention, is still kept on Afghanistan," Sherzai said. "We are very thankful for all the help, but there is a lot more needed. We're not even close to resolving our problems."
Afghanistan needs help rebuilding, equipping and supplying its medical facilities, according to Sherzai. The first step toward security is health care. It should be everyone's No. 1 priority, he stressed.
"There's nothing more primary and immediate than health care," he said. "Without health, women aren't able to secure the household and, therefore, society is not secure. Without health, men are not able to work and the household situation falls apart and, again, society is insecure."
The people suffering most in Afghanistan are women and children, he reported. Of every 100,000 pregnancies, an estimated 1,600 women die. In one province alone, 7,000 of every 100,000 pregnancies result in the mother's death.
"We would like your help to change these statistics and help us reverse the calamity that is the health care system for women in Afghanistan," Sherzai said.
The U.S. Defense Department, he pointed out, is helping to rebuild Rabia Balkhi, one of the major women's hospitals in Afghanistan. During the Taliban regime, it was the only women's hospital in operation. The hospital was completely destroyed after the Taliban fell, he said, and now "Americans are the main component reconstructing it."
According to Feroz, about 174 hospitals in Afghanistan need some reconstruction and refurbishing.
Afghanistan's overall health care system right now is "pretty basic," Sherzai said. "We are way below 'zero' at this point. We need a lot of help just to come to an even playing ground.
"There's plenty to be done," he affirmed. "We need a little bit of coordination, and if all our coalition partners and all our friends take one section, we'll be in good shape."
The U.S. military, in particular, Sherzai said, "has been of great help so far -- indispensable help."
U.S. medics are providing basic medical care to Afghan men, women and children. Military veterinarians are treating Afghan farm animals. U.S. forces have helped rehabilitate clinics around Bagram and completely refurbished and reconstructed one hospital. Troops have also dug several hundred wells.
"The American military has multiple campaigns of immunization, treatment and reconstruction going on right now," Sherzai said. Spanish and Jordanian medical officials have set up hospitals. Other coalition partners have focused assistance in different areas.
The Afghan people greatly appreciate these efforts, Sherzai said, and would welcome more U.S. and coalition medical care beyond Bagram and Kabul.
The DoD, Department of Health and Human Services and U.S. Agency for International Development are "an incredible force in Afghanistan," Sherzai concluded. "We appreciate the collaborative nature of their help, and (hope) they'll take a part in the reconstruction of a lot of the clinics in Afghanistan.
"We hope the Defense Department and the rest of the team will help in refurbishing those as well, because no matter how many clinics we have, when there are obstructive emergencies, the clinics can't take care of that, so there has to be a referral system that takes these patients from the clinics into the hospitals."
U.S. military officials are now seeking guidance from the Health Ministry on what they can do next. "They want to participate in a collaborative, organized fashion in rehabilitating and reconstructing the health care system," Sherzai said. "That's of utmost importance to us."
Helping the ministry gives legitimacy to the government, which is directly related to security, he said. At present, the Health Ministry is "semi-organized."
The ministry has the capacity to receive help and disperse it. "We don't need to have a middle man, or go through multiple levels," Sherzai said. "Hopefully, within a few months, we will have the financial structure to take the money, have accountability and transparency to show that what you gave was directly transferred into a clinic, directly linked to the health care of this woman and this woman and this woman."
Along with U.S. and coalition military forces, he noted, nongovernment organizations also have been an indispensable help.
As the Afghan government restores health care, Sherzai said, the NGOs and others can help in the interim. "They have to come with the realization that they have to work themselves out of business. They have to give capacity to the Afghan government itself and also to the private sector. But even in the next few years, they'll be indispensable. We need to use their help and their capacity building."
American church groups and private U.S. citizens are also doing what they can to help, according to Sherzai.
"The Memphis-Afghanistan Friendship Council has a relationship with us on a continuing basis. They came to educate people. Other Americans are coming to Afghanistan. There are a lot of American church groups that have come to Afghanistan and helped financially.
"Loma Linda University is directly helping our medical school. Tufts University is directly helping our nutrition department. Georgetown University has relations with Afghanistan. Johns Hopkins University is also helping us directly. National Institutes of Health has sent us equipment through Health and Human Services. Nebraska University is helping us with capacity-building and education."
Sherzai said people who want to help could communicate directly with the Ministry of Health by writing to firstname.lastname@example.org.