Afghans see slow healthcare improvements
Standards of healthcare in Afghanistan have improved significantly since the fall of the Taliban, but there are still variations in quality of care between rural and urban areas.
Most of our travelling around Afghanistan involves being thrown around in the back of an ageing 4×4 vehicle as it bashes around on unmade, potholed, rutted roads. So it was with our trip to Pashtun Zarghun in the western province of Herat, two hours each way trying to not smack your head on the doorframe.
Properly laid, tarmacked roads transform rural communities. They let farmers take their goods to market while others can access better healthcare in urban centres. Roads can also open up closed communities to new ideas and different ways of thinking. It is also harder for the Taliban to plant homemade bombs under tarmacked roads, whereas it is easy to bury one under a few centimetres of gravel.
There was a bomb planted along the road we travelled to Pashtun Zarghun. As we hurtled down the dirt road we saw the army ahead, directing people around where the bomb had been planted. A villager had tipped-off the police. The army officer in charge told us that it was a remote controlled device adding that our team might have been the target. We always take a police escort on journeys into rural areas. It is possible news of our plans leaked out.
Anyway, this area is supposed to be comparatively safe. The North Atlantic Treaty Organisation (NATO) forces handed over security responsibility to Afghan forces six months ago. But the Afghan officer at the bomb site said that, in the last three to four weeks, the Taliban have started to reappear in the villages on the way to Pashtun Zarghun.
Our focus this time in Pashtun Zarghun was healthcare.
There have been major improvements in the last ten years. Afghans can expect to live up to 64 years, up from 50 a few years ago, according to a survey conducted by the Afghan foreign ministry that was paid for by foreign donors. But rural healthcare is basic. Children get immunised and there are midwives to deliver babies.
However, if a pregnant woman starts bleeding or showing other complications she will have to make the 60km journey to the main hospital in Herat city. That means a two-hour drive on the rutted dirt road. There’s an 80 per cent chance she will die on the journey, according to a doctor at Pashtun Zarghun’s clinic.
Ghulam Naby Azizi, Pashtun Zarghun’s district governor, told us that he was desperate for a road to link to Herat, and that he had been promised one five years ago.
“With all the aid that has been given to Afghanistan in the past 10 years nothing has come to Pashtun Zarghun. You have seen the road – we do not have one laid road in Pashtun Zarghun,” he said.
Azizi has been district governor for 10 months. Locally he seems popular, particularly for co-ordinating operations against the Taliban. The area is still safe he says. But at the end of the interview Azizi tells us he’s just resigned his post, because, he says, he’s not been paid since he started the job.
So soon, Azizi will make the bone shaking journey out of Pashtun Zarghun along the unmade road where the Taliban is regaining influence.
Follow Bernard Smith on Twitter: @JazeeraBernard