Not enough doctors

Health care is far from a basic right for people in three border provinces.

The districts of Shorawak and Registan in Kandahar province have neither a primary health centre nor a doctor. In case of emergency, patients have to be taken to Kandahar City

Health care is far from a basic right for people in three border provinces.

The districts of Shorawak and Registan in Kandahar province have neither a primary health centre nor a doctor. In case of emergency, patients have to be taken to Kandahar City or across the border into Pakistan.

The authorities in the directorate of health, Kandahar, cite poor security as the reason for the lack of health facilities in the two districts. Local officials seem helpless. Abdul Nafea Barech, governor of Shorawak district says, “There is no health centre in our district. Most patients have no choice but to endure the difficulties and go to Pakistan (for treatment). Those who cannot afford to pay the fare have no choice.”

He points out that maternal mortality is high in the district with many pregnant women dying of complications before they can reach a hospital.“Many women have died in child birth,” he says. “The road to Kandahar City is long, and bad. People prefer to go through the mountains into Pakistan.”

Hamidullah Faizi, acting director of the directorate of health, Kandahar, promises to establish health centres in Shorawak as soon as the security situation improves. “We recently evaluated the health problems in the province. Only two districts are not covered,” he reiterates.

However, Kandahar Governor Humayoon Aziza believes 60 percent of his province’s population has no access to health facilities. There is also an acute shortage of female doctors in the districts.

A majority of health centres are public. In Kandahar City, construction of a 350-bed hospital is on going. Recently, a fresh batch of some 144 new doctors – both women and men – graduated from a medical college in Kandahar. Dr Nasrin Barakzai, head of Kandahar Institute of Medical Sciences, feels it will solve the major problem of staff shortage. Acting Director Dr Faizi called the graduation “good news”.

Paktika

In neighbouring Paktika, a province of half a million people, there is only one female doctor. The BBC reported six months ago that Dr Homa Amiri was transferred to Paktika.Ahmad Jan who has traveled from Orgoon district to Sharana, the provincial capital, says women, children and the elderly in Paktika succumb to diseases that could easily be treated by a doctor. “There is no female doctor in the whole of Orgoon district; only one in Sharana,” she says.

Dr Amiri told Killid she was happy moving to Sharana. “I feel the women are faced with so many problems. People are very happy with me and bring female patients from all the districts and I do my best to treat them,” she says.

Zargoon Shar district is only 50 km from Sharana, the centre of Paktika. Gulab Torakai from Zargoon Shar says there is only a 10-bed clinic made out of mud. Yet patients flood this the only clinic for 12 districts

Samad Khan has taken his wife from Khoshamand district to Zargoon Shar clinic in a rented car that will cost him 3,300 Afs (48 USD). Except there is no empty bed in the clinic which was established 74 years ago when the area was not so populated. “I don’t have relatives here. I have to take my sick wife back home since I am a poor and cannot afford to take her to Sharana,” he told Killid.

Abdul Qadeer Mayar, a pediatrician in the clinic says, “Some 400 patients come to the clinic daily. Most are turned back because of lack of space.”

Dr Mohammad Ibrahim, deputy director in the Paktika health department, admits doctors are in short supply, and “most clinics do not have proper buildings.” Though the province has an estimated population of one million, the only hospital in Sharana has only 60 beds that “cannot meet the needs of people at all.”

Meanwhile, Dr Waligul Kharoti, head of the Paktika health department is optimistic that some 23 women who are soon to graduate from a high-level midwifery course will be absorbed in jobs in districts in the province. “The girls are all residents of Paktika. People are very happy for them,” he says. “Mother and infant mortality rates are bound to fall under their watch,” he hopes.

Some change

In Nangarhar, another province on the long border with Pakistan, mother and child mortality levels have recently shown signs of falling. It seems additional training for midwives has stemmed the slide.

Dr Moqadas Meraj, deputy director at the Nangarhar health department says earlier some 1,600 women out of 100,000 lost their lives during childbirth. The number is down to 300. “The level of mortality of mother and child has lowered due to training for midwives,” she says. As per her records, there are some 5,000 midwives across thecountry. “The number was 1,500 previously,” she says.

Lema from Laghman province is continuing her studies in nursing. She says, “I and my family’s wish was that I should become a doctor but I failed in the university entrance exam. Now we are very happy that I am studying nursing.” Lema says she is prepared for any duty to “deliver (health) services to my sisters.”