War Zone Hospitals in Afghanistan: A Symbol of Wilful Neglect

"Health is a fundamental human right indispensable for the exercise of other human rights. very human being is entitled to the enjoyment of the highest attainable standard of health conducive to living a life in dignity". World Health Organisation

Hospitals in Kandahar and Helmand are dilapidated, barren and filthy.

In Kandahar and Lashkar Gah, the hospitals are in a state complete decay. Around Kandahar and Helmand province there are at least ten makeshift refugee camps, each providing shelter for as many as 75,000 people. A public and glaring symbol of the international community’s evident lack of concern for the Afghan people. (Infant mortality rate (per 1,000 live births) 2006 : Canada 5 Afghanistan 165 )

The absence of basic war zone trauma treatment, medical diagnostic and treatment equipment, medicines, oxygen, and trained staff, contrasts dramatically with the sophisticated medical services that the international military and NATO have installed on their bases.

5 years of military operations involving air strikes, bombing, ground assaults, have taken their toll on the people, houses, public buildingsand services as well as transport infrastructure, safe drinking water, and sewage management. Famine and drought complete the miserable picture.(Life expectancy at birth (years) 2006 : Canada 80 Afghanistan 43).

The result of this disregard for the welfare of Afghan people results in anger and frustration. Support is lost and is transferred to other well funded, armed groups supporting a variety of causes but all united in the desire to rid their country of the Americans and their European allies.

Kandahar Hospital has been the recipient of trumpeted interventions by the United States-led Provincial Reconstruction Team (PRT), who "refurbished the women’s wing and rebuilt the infectious disease ward in early 2005." However, there are no signs of such interventions. The wing remains untouched by renovation or equipment. During on-site visits, nothing was witnessed other than women labouring in pain.
The British government, charged by NATO with military operations in Helmand, has provided a
generator for the Bost Hospital at Lashkar Gah and paid for steel containers to replace the morgue – each at the cost of £600,000. The UK Gubment and its Department for
International Development (Prop. The Viscount Stansgate's son, Hilary Benn) direct their health sector development funding through the European Commission (Britain provides 19% of the €1 billion pledged to Afghanistan by the EC).

Further reconstruction aid is sent through the British-led PRT in Helmand, who have a £6.5 million budget for quick-impact projects, (Ho.Ho.Ho.) but the budget for healthcare in comparison with other projects is limited. In terms of healthcare, the region surrounding Lashkar Gah is devoid of any visible sign of PRT projects, as of 31 January 2007.

Canadian International Development Agency (CIDA) donations were being assigned to multilateral projects rather than to specifically Kandahar-based ones: according
to the committee, “CIDA activity in the Kandahar area has been sparse.” In February
2007, the only sign of CIDA’s presence in Kandahar are bright yellow garbage cans
sporting the Canadian flag distributed along the main roads of the city. Since the report,(Canadian Senate Standing Committee on Defence) Canada has refocused aid towards Kandahar, with the announcement of CAD$11.5 million earmarked for reconstruction in the province, including CAD$350,000 for UNICEF to establish a maternal “waiting” ward near Mirwais Hospital. As far as could be seen from site visits to the hospital at the end of January 2007, construction has not yet started. (Health expediture per capita per annum : Canada (US$ 2989 Aghanistan US$26)

In 2001, Non-Governmental Organisations were providing and managing 80% of
healthcare services in the country. The highly regarded Médécins sans Frontières was obliged to leave the country after attacks on its staff in 2004 - they have not returned.

The fiction persist that Afghan is not "occupied" , but the Afghan civilians have become the unwilling victims of a war that is not their own." Minimis(ing) civilian suffering in a time of war," required by the Geneva Conventions is seen as an irrelevance - professional soldiers are engaged in combat not comforting the wounded.


Not enough has been done - Senlis make 5 recommendations -

1. Introduce emergency field treatment of civilians injured in fighting and
bombing

2. Immediately Provide Mobile Field Hospitals

3. Rebuild existing hospitals to help Afghans and provide jobs

4. Implement outreach and training programmes to foster sustainable
improvements in health

5. Build new hospitals to international standards to meet Afghans’ expectations

Codifying the Right to Health in Afghanistan
“The state shall provide free preventative healthcare and treatment of diseases as well as
medical facilities to all citizens in accordance with the provisions the law. Establishment and
expansion of private medical services as well as health centers shall be encouraged and
protected by the state in accordance with the provisions of the law.”
Article 52, 2004 Afghan Constitution

Countering the Insurgency in Afghanistan: Losing Friends and Making Enemies - Report by the Senlis Council Published today Senlis Council