The Collapse of Public Health Care in Afghanistan: A Tragic Reckoning

The several rooms are filled with sick children, at least two in each bed, their little bodies pneumonia. While only two nurses take care of 60 children.

In one room, there are at least twenty children who appear to be in serious condition.

Children have to be constantly monitored in their critical condition, which is impossible in this hospital.

However, for the millions of people living in Ghor state, this basic facility is still the best equipped public hospital they have access to.

Public health care in Afghanistan was not sufficient. The foreign funds that supported it were almost completely frozen in August 2021, when the Taliban seized power.

And with the Taliban’s recent ban on women working in NGOs, it has become more difficult for humanitarian agencies to operate, putting more children and infants at risk.

“We don’t have equipment and there is a shortage of trained staff, especially female staff,” says nurse Edema Soltani of Ghor Hospital. “When we take care of so many people in serious conditions which child should we check first? We can do nothing but watch children die.”

In this hospital, a child named Tayyibullah died while the BBC staff were present. The two-year-old Gulbadan also suffers from a heart problem since birth.

Doctors told the BBC that her problem was neither unusual nor difficult to treat. But Ghor’s primary hospital is not equipped to perform routine surgery to treat her. In addition to the lack of medicines needed by the child.

Her grandmother said the family borrowed money to take her to Kabul, but they couldn’t afford the surgery, so they brought her back here.

Doctor Ahmed Smadi, who works at the hospital, told the BBC that Gulbadan needs “two liters of oxygen every minute”.

He added, “When this bottle is empty, if we don’t find another one, she will die.”

This is exactly what happened when the BBC team returned later, the gas ran out and the child died.

The hospital’s oxygen production unit cannot produce enough oxygen because it only works at night, and there is no steady supply of raw materials.

Two children died within two hours, from preventable or treatable diseases. It’s heartbreaking, but everything seems familiar to Dr. Smadi and his colleagues.

Smadi said he feels exhausted and in pain: “Every day we lose one or two children from Ghor. We are almost used to it now.”

The scenes at Ghor Hospital raise serious questions about why public health care in Afghanistan has collapsed so quickly, after billions of dollars were poured into the sector by the international community over the 20 years to 2021.

Where was this money spent, if the district hospital did not have a single respirator for its patients?

An arrangement to fill the gaps is currently being worked on. Since money cannot be provided directly to the Taliban government, which is not recognized internationally, humanitarian agencies have stepped in to fund the salaries of medical staff and the cost of medicine and food, which is only relevant to keeping hospitals like the one in Ghor running.

This funding, already largely ineffective, could further dwindle or even disappear, as aid agencies warn that donors may cut back because the Taliban’s restrictions on women violate international laws, including its ban on Afghan women working for the United Nations and organizations. non-governmental

Only 5 percent of the needs included in the UN appeal for Afghanistan have been funded so far.

The BBC team examined a cemetery on one of the hills near Ghor Hospital. There are no records, not even an overseer, so it is not possible to know who the graves belong to, but it is easy to distinguish between large and small graves.

The number is disproportionate, at least half of the new graves belong to children.

A man who lives in a nearby house told us that most of those buried these days are children. There may be no way to count how many children are dying, but there is evidence everywhere of the scale of the crisis.