Health services for internally displaced families in Afghanistan

Health services for internally displaced families in Afghanistan
WORLD VISION NEW ZEALAND

Sangingul, a young mother of six, was running out of hope. Her youngest daughter Marzia had recently contracted severe pneumonia, and the family had no money to draw on for treatment. She had witnessed her one-year-old growing weaker by the day and felt helpless, unable to address the health issues that were threatening Marzia’s life.

Fleeing in hope of a better life

Sangingul and her family live in Afghanistan’s Ghor province, an area home to many internally displaced peoples (IDPs). Conflict and natural disaster forced them and hundreds of other families to flee their unsafe districts in different parts of the country. They came to the capital Chaghcharan seeking safe living conditions. “We had a good life in our village,” says Sangingul, “but here everything is very hard. Neither the government nor the locals care about us. There is no happiness in this settlement. The only [positive] thing is that there is no fighting.” 

Sangingul’s husband works as often as he can as a day labourer. Sometimes there is work, and sometimes not, so the family struggles financially. “If my husband works and gets the job done, he will receive only $5 USD per day.” 

The family’s financial difficulties complicate access to health services. The cost of care, coupled with the need to travel a long distance to a health facility has meant that Sangingul has had to play the role of doctor when her children get sick. 

When Marzia came down with pneumonia, Sangingul drew on the only resources she had and started a home treatment using herbs, but to her disappointment the remedy didn’t work and Marzia’s condition worsened. “I was just praying,” she says. “I didn’t have money to rent a car to take her to a hospital…[or] have money to buy medicine.” The doors were all closing. 

“No money, no relatives and of course no hope. This is life. If you don’t have money, people will even refuse to greet you.” 

“What should I do?” Sangingul asks. “With the [little] money that my husband makes, we have difficulty even filling our children’s bellies. How are we supposed to take our children to a doctor or buy medicine when they get sick?” 

The closest clinic is an eight hour walk from the family’s settlement. “If we go to the clinic, they write us prescriptions to buy in the bazaar - but who can afford to buy the medicine? So we have to come back home without it.”

A sign of relief for mothers of sick children

Painful stories like Sangingul’s are common across the provinces of Badghis and Ghor, which host a large number of IDPs. In Chaghcharan alone, approximately 1,350 IDP families are without access to basic health services as the government does not have sufficient resources to meet their needs. 

Even before recent events led to large scale population displacement, the host communities in these two provinces performed poorly compared to the rest of the country in the health, education and WASH sectors. 

In response to the needs of 30,500 men, women and children in the IDP and host communities, World Vision Afghanistan has implemented the “Improved access to emergency health services in high risk provinces” project, funded by the Central Emergency Response Fund through the United Nations Office for the Coordination of Humanitarian Affairs (OCHA) and World Vision New Zealand.

Pictured: Children gather the Mobile Health Team provides health services.

The project provides mobile health services to uncovered IDP families/host communities in targeted locations in Chaghcharan and Qala I Naw. 

In Chaghcharan, the mobile health team – made up of a doctor, midwife and vaccinator - operates five days a week providing free consultation and primary health care including maternal and child health, immunisation, public nutrition, essential medication and mental health and disability referral services based on Ministry of Public Health standards. 

This was the team that Sangingul saw when she thought she was out of options. “I was at the peak of desperation when I heard from our neighbours about a group of health workers coming to our area to examine sick people and give free medicine,” she recalls. “I don’t know how I [even had time to dress, because] I immediately took Marzia there for treatment.” 

According to Dr. Farjar, a member of the World Vision Mobile Health Team, “Marzia’s condition was very bad. She continually coughed and her breathing was not normal. We prescribed her baby antibiotics and gave her [mother] a consultation about [achieving] good nutrition from affordable food.”

Pictured: A woman is being checked by a midwife

The mobile team is usually able to see about 80 patients a day, including pregnant women and children. Most of them are poor and have difficulty accessing health services that are not free. 

“Most women who come here suffer from anaemia and their children mostly suffer from malnutrition, pneumonia and diarrhea,” says Dr. Farjar. “We provide them with counselling, awareness and education sessions around personal hygiene, vaccination [and other health issues].” 

Dr. Farjar adds that the patients who need additional care will usually be referred to advanced centres for treatment. “Last month we referred eight severely malnourished children to the pediatric hospital for advanced treatment."

A brighter future

Today Sangingul and her mother-in-law are visiting the World Vision health clinic, but not for any kind of medical reason. “[We] came here just to say thank you to the doctor and his team,” she says. “I have brought Marzia too!” 

She hoists the little girl onto her lap, tidies her hair and gives her a kiss. “Look, she is as healthy as if she had never gotten sick. The medicines I received from the team were very good. Thank you. God bless you.”