Canadian Physician Describes Healthcare in Afghanistan

In response to the rumours being circulated around on the Internet that the Taliban Islamic Movement is oppressing women in Afghanistan:

I never respond to the recipients of forwarded messages like this but I feel professionally compelled to address this one. The message does not produce any evidence to support the allegations made in it. There are no information sources quoted and yet more than 350 people have e-signed this document.

I am a Canadian-trained family physician. I recently returned from a medical/fact finding mission to tour the hospitals and cities of Jalalabad and Kabul in Afghanistan to get a first hand perspective of the social and health care problems there. I stayed with an Ottawa, Canada based NGO in Kabul who helped me tour the health care facilities and cities. I personally witnessed the situation in the hospitals and cities and conducted two clinics in Kabul.

Here is a summary of my observations.

1. There is an entire hospital dedicated to the complete care of women in Kabul. It is called the Womens Gyne and Maternity Hospital of Kabul.Another hospital, the Indira Gandhi Childrens hospital also takes care of women. It, like all hospitals in Afghanistan, suffers from severe medication and supply shortages. I saw doctors in emergency wards using their bare hands to stitch up wounds. Surgeons at the children's hospital see 2-3 cases a day of young children with bowel obstructions caused by severe intestinal worm infestations. This is completely preventable through improved hygiene. Health care is equally dismal for all Afghans - male AND female.

2. There is a high incidence of vaccine-preventable diseases (I saw my first case of tetanus/"lock jaw" in Jalalabad).

3. Doctors (both male and female) are leaving Afghanistan in large numbers as the monthly salary of a doctor is only 6000 Afghan Rupees (about $15CDN). Nurses make only 3000 rupees (about CDN$7.50) monthly while janitors make only 2000 rupees.

4. Most Afghans cannot even afford to buy the prescriptions the doctors write for them and their children. Many go out into the street, holding their prescriptions and begging people to give them money to buy the medications for their children.

5. The 400-bed children's hospital has a diesel powered heating system which is operational, but they cannot afford to run it in winter as fuel costs 15000 Afghan rupees (about CDN$30 per hour) to run it. Temperatures can dip to -15 deg celsius or colder.

6. There are schools in Laghman province which teach women employable skills such as sewing, and weaving. Other schools run by western NGOs were closed by the Taliban because they refused to segregate males/females or operate under the rules of Islam. There are many girl schools operating in Afghanistan.

7. With regards to daily life, I saw countless women walking freely in the markets alone or with their children, unaccompanied by any male escort. Many were even wearing high heel shoes. None were being stoned or beaten.

8. I saw many women who were not wearing the burqa (head and body covering with a net opening over the face) but were wearing colourful head scarves that would also cover their mouths and upper body. They were not beaten or stoned.

9. I did not see any windows that were painted to prevent women from being seen. Afghan homes are not built the same as western homes. Almost all Afghani homes are surrounded by a tall external mud/straw wall which provides the ultimate privacy to homes and families. Afghans are very private people and do not like others looking in on them, especially women.

10. There is great poverty in Afghanistan and I saw many suffering men,women and children. Families are selling their household belongings (furniture, clothes, utensils, cooking pots) to help them buy food for their families. Once they can't sell anything more, they are forced to beg in the streets.

11. While there were many people forced to beg in Afghanistan, one must remember that begging is not a problem restricted to Afghanistan.

12. Kidnappings, rapes, prostitution, robberies, and murders committed by bandits and dacoits were rampant in Afghanistan in the years after the Russians retreated. When the Taliban took control, all 41 brothels in Kabul were closed and the bandits fled to neighboring countries for refuge (i.e.,Pakistan, Iran). Afghans now freely travel even at night.

13. The Taliban have instituted strict Islamic shariah in Afghanistan. They have closed cinemas, prohibited the photography in any form of live people, banned gambling, prostitution, etc. They "enforce" morality on their people.

14. The UN confirms severe drought conditions for Afghanistan for the next two years. Rivers that run turbines to generate electricity are almost dried out. As a result, electricity is only available for 5-6 hours during the day.

15. The Afghan infrastructure is almost completely destroyed from war. There are almost no jobs. Only now are some of the major roads linking the major cities being repaired.

The Afghan people gave 1.8 million lives to gain their freedom to their land and religion from the Russians. The suffering is indeed great. The Taliban may not be the most perfect government around but we must not ignore the needs of the Afghan people, particularly the many widows and children. Messages like the one below not only help to propogate false information but can also hurt the innocent people it is trying to help (e.g., through further UN sanctions and restrictions.)

I challenge everyone who has signed this list to go to Afghanistan themselves, just as I did. See for yourself whether the allegations in the message below are true or not. See the magnitude of the poverty and the suffering which is partly being caused by messages like the one below which is being conveniently p! ropogated through the internet. Try to open your mind to the "big picture" and only after seeing the hard facts and evidence,deecide whether you should support this petition.

Let's try to use our energies to help those who are suffering the most -i.e., the widows and orphans. I am working with Health and Education Projects International, based in Ottawa, Canada which is running a number of projects for women and children. In the next few weeks I will be helping to set up the following projects with them

A) Physician/Nurse income supplementation fund - to help retain existing health care staff (believe it or not, the main objective is $10 per month per physician which can make a big difference).

B) Regular shipments of primary care medications and supplies and equipment to be sent every 6 months through an agreement to be negotiated with the Canadian military. To be sent to the Jalabad Public Hospital and the Indira Gandhi Children's Hospital in Kabul.

C) Regular shipments of donated shoes, sweaters, blankets and sleeping bags (as Kabul gets very cold in winter and heating is extremely expensive)

D) A fund to help hospitals purchase adequate cleaning supplies and hire cleaning staff.

E) A fund to purchase milk cows to help feed the needy.

I welcome anyone to contact me regarding questions or requests for documentation and/or video footage. And, oh yes, please copy and forward this message to as many people as possible.

Raza M. Khan, BSc, MD, CCFP.
Family Physician.