Health Situation in Afghanistan
Wassay Niazi
Medical Microbiology & Infectious Diseases, University of Manitoba and Infectious Diseases,

Kabul Medical University

Dr Niazi gave this lecture at our office 264 Tache on july 27 th , 2006.

He may be contacted for more information.

Fig 1 Political Map of Afghanistan

Afghanistan vs Canada

Two official languages Pashtu/Dari English/French

Adapted from atlases and: World Health Organization (2002). Core Health Indicators:

http://www3.who.int/whosis/core/core_glance_process.cfm?strISO3=AFG .

http://www3.who.int/whosis/core/core_glance_process.cfm?strISO3=CAN .

Mortality of Afghan Women

•  About 20% of children die before their fifth birthday

•  About 16,000 out of 100,000 women die during delivery or related complications

•  Causes of high maternal mortality:

•  -TB 90% of all adult deaths are women

•  -postpartum infections

•  -postpartum bleeding

•  -shock (hypovolemic)

•  -malaria

•  Causes of infant and child mortality

•  -diarrheal diseases

•  -respiratory infections

•  -meningitis

•  -measles

•  Malaria

•  Malnutrition

•  diphtheria

Fig 2 The return of Afghan refugees from neighboring countries

• UNHCR (2001). Afghanistan: Refugees [United Nations High Commissioner for Refugees],

http://images.google.com/imgres?imgurl=http://i.cnn.net/cnn/SPECIALS/2001/trade.center/maps/map.refugee.

Fig 3 Afghan refugees wait along the fence to cross [into Pakistan at] the border at Torkham,

Pakistan-Afghanistan border post, 31 miles (50 kilometers) west of Peshawar, Sunday, Jan. 21, 2001.

Fig 4 Afghan refugees prepare food at Jalozai camp in Pakistan's northwestern frontier province on Tuesday, Jan. 9, 2001.  

http://www.afghan-network.net/News/Archives/2001/Refugees/refugees3.jpg&imgrefurl

Fig 5 3 million refugees are living in Pakistan and 2 million in Iran

1/2 million in Western countries

http://www.gospelcom.net/glia/2001/wv/images/121701a.jpg

fig 6

http://images.encarta.msn.com/xrefmedia/sharemed/targets/images/pho/000a4/000a4f72.jpg

fig 7 Areas Mined in Afghanistan

fig 8 Land mine injuries: scenes from the movie Kandahar

Fig 9

Fig 10-13 Victims of Mines in Afghanistan

Fig 14 Minesweeper

HIV status in Afghanistan

•  70 positive cases from 120,000 tested

•  Official estimated numbers 1500

Risk factors for HIV

•  50,000 intravenus drug users in country

•  Returning refugees from the countries with high prevalence of HIV

•  Lack of public awareness about HIV/AIDS

•  Low level of sterile practice in surgery

•  Increasing numbers of prostitutes

•  Man with boy sex and man with man

•  Large numbers of war widows (1 million): some of them have turned to prostitution

•  Illiteracy and lack of education

Progress achieved in 4 years after ousting Taliban

•  Establishment of national constitution

•  Formation of new government

•  Formation of parliament

•  Training NA and NP

•  Disarming of unauthorized armed groups

•  Establishing independent human right commission

•  Motivation of nation's children and providing opportunity for education

•  Doing and carrying out reconstruction activities

Challenges

•  Corruption in government organization

•  Lack of professional people in govt. structure

•  Warlords still in power in provinces, who are violators of human rights in the country

•  Even though an independent human rights commission has been established, their activities are limited

•  Slow process of training NA and NP which impacts on security in the country

•  Threat of Taliban and terrorism still remain

•  Interventions of neighbor countries and supporting Taliban keep Afghanistan destabilized

State of Surgery

•  Number of surgeons & training, Locations

•  Emergency

•  Cardiovascular & brain surgery

•  Neurosurgery

•  Orthopedic surgery

•  Pediatric surgery

•  Obstetric and gynecological surgery

•  How to help: books, diagnostic equipment, training

•  Thoracic surgery centre needed in Kabul

The Medical Libraries of Afghanistan

•  Kabul Medical Institute

1900 new books, 100 going to Dentistry, 200 to Nursing

•  Al Beerhuny University

1800 new books

•  Nangahar University*, #2 university

* still needs books

•  Balkh University*

30 year old collection of Russian books   

•  Khost University*, some Canadian aid while in exile

•  Herat University 200 books delivered, 1100 from U. Toronto going

•  Kandahar University, going: 400 books to Medicine, 200 to Nursing

•  Takhar University*

Fig 19 Magdalena Kujath, Jason Tapper & Kevin Warrian

Fig 20,21 Winnipeg Afghan Community joined in:
Mariam Omar, Drs. Wassay Niazi & Nourieh Sadiqi

Fig 22,23 Also Recruited Some Local Talent: Pam Green & Sally Beck

Sale of 2000 old books yielded $1000. Also raised $7000 in separate cash donations.

Fig 27 Job done, ready to be packed by staff at Login Bros.

Fig 28 6000 lbs of books arrive at Kabul Medical Institute Library

Fig 29 Dr. Cheragh Ali becomes aware that these really are new medical books. Lieutenant Colonel Carl Walker, commanding officer of health support services at Camp Julien in Kabul, is from Winnipeg

.

Fig 31,32 Books being unpacked in Kabul

Fig 33 A bookplate in each book

Fig 34 University of Western Ontario Volunteers, 2005/2006

Post meeting discussion:

We had a wide range of audience members with attendees from Columbia, Ethiopia, South Korea as well as Canada. Following Dr Niazi's talk there were several questions.

Dr Niazi mentioned that his organization is looking for Medical, Nursing and engineering texts no older than 10years. One attendee asked if mental health books could be submitted and he said yes. He may be contacted through his email for further questions about submission. He is not collecting elementary school books but there are other charitable organizations that do contribute to Afghan women's support.

One audience member mentioned that many countries including Canada have manufacture mines for foreign distribution. This is an issue that is being addressed by such organizations as Warchild

Several political obstacles from neighbouring countries face Afghanistan such as Russia's unwillingness to provide minefield maps to areas of Afghanistan they occupied as well as insurgents from Pakistan and Iran actions in trying to destabilize Afghanistan's situation. Dr Niazi pointed out that the International Community needs to put pressure in these regards to help out. He noted that at least one Canadian soldier's death was due to mines laid by Russia during their occupation that were detonated by Canadian soldiers. Although mines kill on average one Afghan per day the local people have developed an understanding where most mines are but the Canadian soldiers had not. The influence of South bordering Pakistan has supported Taliban trouble in nearby Kandahar where intense conflicts have killed Canadian troops. In these issues the problems that affect Afghans have also come to affect Canadians.

We encourage our readers to check recent facts on Afghanistan through the numerous links in Dr Niazi's presentation.

We would also like to advocate sponsorship for the Winnipeg Afghan community in developing an Afghan pavilion for Folklorama (Winnipeg's Annual Festival of nations).

He thanked the presence of Canadian troops for their bringing stability to Afghanistan.

We thank Dr Niazi for his time and efforts to explain Afghanistan's situation.