Editor in Chief: Moh. Reza Huwaida Friday, April 20th, 2018

State of Healthcare in Afghanistan

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State of Healthcare  in Afghanistan

Ten years after the ouster of the Taliban regime in Afghanistan and the dawn of a new era that promised to be a far better deal for Afghans, access to quality healthcare still remains elusive for an overwhelming majority of Afghans. Whether for the urban rich, who tend to be more health conscious compared to their rural peers, or for poor and impoverished villagers across the country, treatment for a wide array of diseases and medical conditions is still unavailable.

The chorus in Western media celebrating Afghanistan's progress in healthcare provision is deafening. From Western morning newspapers and TVs to the heated debates in their Parliaments and to the boardrooms of their NGO's in Afghan cities and onwards to the healthcare authorities of Afghanistan government, what one encounters ad nauseam are colorful statistics about how many Afghans have been provided healthcare in this province and how many others in that province.

While for them, patients, healthcare, medical care and hospitals remain not more than mere statistics; countless Afghans lose their lives to easily curable diseases and a healthcare system that remains primitive and dysfunctional. As accurately assessed by an Afghan commentator a few days ago and published in this newspaper, these colorful statistics about the purported progress Afghanistan has made in healthcare provision are "highly questionable".

As the driver of a government ambulance service in Kabul said the other day, only God may come to the rescue of Afghans should any of them be down with a difficult disease. Hospitals, clinics, Basic Healthcare Units (BHUs) and Comprehensive Healthcare Units (CHUs) in many cities, towns and villages across Afghanistan can provide healthcare not beyond some simple diseases and medical conditions.

The quality of existing healthcare services for these simple diseases are below-average if not poor and qualified doctors and specialists are rare. For complicated diseases such as cancer, there is not even one center in the whole of Afghanistan where cancer patients can receive some sort of a treatment.

For the villagers and rural population, being down with a complicated disease beyond common cold, diarrhea or TB means that they have to travel all the way from their villages to the district center or from there to the provincial capital in search of a doctor who can at least diagnose what the medical condition is.

Most of the time, they have to travel all the way to Kabul, Kandahar, Herat, Mazar-e Sharif or other large cities to get a diagnosis of their medical condition; whether the diagnosis is correct or not is another story! In case of more complicated diseases, patients, whether in provincial capitals or large cities, many never find out what is wrong with their health. Qualified doctors and specialists are a rare-breed, who gets to cater mainly to the urban rich. A poor Afghan villager with no money or connections and down with a complicated disease is condemned to a slow, painful death.

Those Afghans, who can afford traveling to neighboring countries such as Pakistan, India and Iran for treatment, embark on a difficult and expensive journey to Peshawar, Islamabad, New Delhi or Mashahd and Zabol in Iran to get treatment.

Many branches of Care Hospital in New Delhi, the Indian capital, are filled with Afghans who are spending their lifetime savings or have sold whatever property they had in order to finance a trip they hope can give them their health. Indian doctors in hospitals in New Delhi can speak a measure of Dari these days; thanks to planeloads of Afghan patients who arrive in New Delhi every day.

Cancer, the silent killer!
Every year, more Afghans die because of cancer than war and bombings. According to a study conducted by the American Center for Disease and Control, cancer is a fairly prevalent disease in Afghanistan. Among men, stomach cancer and among women, breast cancer, are the most common types of cancer.

Currently, there is not even one center in the whole of Afghanistan that can offer treatment for cancer. Dr. Nadera Hayat Borhani is the deputy minister of health in the government of Afghanistan. Her remarks in this regard paint a grim picture of the situation: "Nobody in Afghanistan has access to health facilities for cancer.

It's the same situation for the children, the men, the women, the elderly — nobody has access...When the doctor sees some sign or symptom that a patient has cancer – the option is to send the patient to Iran, or to go to Pakistan, or to India, as their economic situation allows. But Afghanistan has a low economic situation, and most of the people are very poor, so most of them don't go.

We need a cancer registry in Afghanistan to see the numbers and different types of cancers in the country. Sadly in Afghanistan, we do not know this. We need this information to make our policy. We have some data from the pediatric hospital in Kabul. They now have about 75 children with leukemia. But the real number I think is much greater, because the doctors send cancer patients to the foreign countries for treatment, or home to die."

Over the past ten years, many private hospitals have sprung up throughout Afghanistan that offer healthcare services to people. A government healthcare system that is in disarray has forced many people to seek treatment in these hospitals.

Lack of government regulation and sheer profiteering by the operators of many of these hospitals mean that the services provided in these hospitals, in many instances, are no better than those offered in the government sector. Qualified doctors and specialists are few and many, who have never been to medical schools and are not qualified as doctors, masquerade as doctors.

Fees and prices charged by private hospitals are exorbitant and for those Afghans who come all the way from villages for treatment, rundown government hospitals are the only option.

Beyond some simple diseases, an overwhelming majority of Afghans have no hope to be cured of the likes of cancer, cardiac diseases or neurological ailments. Affording trips to foreign countries is a luxury of a few and for the majority of Afghans, going back home and waiting out the remainder of the days or years for death to embrace them is the only option. Talk about the post-Taliban progress!

The author is the permanent writer of the Daily Outlook Afghanistan. He can be reached at outlook afghanistan@gmail.com

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