Afghanistan suffers from a high incidence of Tuberculosis, though the Ministry of Public Health says steps to prevent and treat the disease have resulted in the number of those afflicted by the disease coming down from 70,000 to 51,000 in the past nine years.
Afghanistan suffers from a high incidence of Tuberculosis, though the Ministry of Public Health says steps to prevent and treat the disease have resulted in the number of those afflicted by the disease coming down from 70,000 to 51,000 in the past nine years.
Dr Suraya Dalil, the acting Minister in the Ministry of Public Health (MoPH), said the disease was a serious concern as more than 9000 people died from it each year. 26358 cases were detected during 2009. The Afghan government hopes to eradicate tuberculosis from Afghanistan by the year 2014, or at least to bring down the incidence of the disease significantly, she said. Dalil said the Ministry had significantly expanded the facilities for treating patients and compared to 30 clinics in the year 2002, the Ministry now has over 1000 clinics.
Officials of the National Tuberculosis Center say that at present, tuberculosis is treated free of charge and they have opened over 1040 centers for this purpose. However Dr. Noor Agha Zahib a doctor at one of the centers says only half the afflicted patients reach the centres.
Women prone to TB
Afghanistan ranks 22nd on the list of 22 high-burden TB countries in the world. According to the World Health Organization’s (WHO’s) Global Tuberculosis Control Report 2009, approximately 46,000 new tuberculosis cases occur annually in Afghanistan.
Unlike many countries, almost twice as many women are infected as compared to men; that is women make 64% of overall TB clients attending health facilities. This is substantiated by the fact that women patients at the clinics outnumber men, even though women are less likely to have access to health facilities in Afghanistan due to cultural, social and economic constraints.
The proportion of women suffering from the disease in Afghanistan is almost double the global trend which shows women constitute only 37% of tuberculosis patients. The high incidence among Afghan women may be a result of reduced immunity due to bad nutrition and excessive work. The deputy director of the Tuberculosis National Center, Dr. Abdul Wudud Haidari told Institute of War Peace Reporting (IWPR) that too much work constantly weakens pregnant women as a result of which they are susceptible to tuberculosis.
Aziza, a 23-year old tuberculosis patient says that the house she had to move into after marriage four years ago in Kabul was a damp and dark mud house and made her sick. “There was no sunlight in the house and we had to spend the entire day in shade”. Aziza states her health condition deteriorated as she had to work hard to take care of her children and in-laws. “We’ve never had adequate food, especially when I have to provide for my husband and his family members”. She is now undergoing medical treatment along with other Afghan women at the Tuberculosis National Center in Kabul.
Prevention
As important as the treatment of infected patients is the prevention of the disease through awareness, hygiene and nutrition. Officials from the tuberculosis hospital in Ghazni say the main reason for the high incidence of the disease in their province is the lack of awareness. The hospital admits between 40 and 50 patients every day from the remote areas of the province says Dr. Shafiqullah Shafiq, a doctor at the hospital.
The head of the Ghazni Health Department, Zia Gul Asfandi acknowledges the challenges but adds that her department is implementing the policy of the Ministry with regard to preventing the spread of the disease including through an awareness campaign.
The province of Kandahar in southern Afghanistan presents an equally dismal picture. The head of the Kandahar Health Department, Dr. Abdul Qauom Pukhla says 1703 cases of tuberculosis were registered last year and 1168 cases so far this year. The province has 33 clinics for the treatment of the disease but is unable to provide critical care, says Pukhla. “We have resolved the problems of the people to some extent, but the facilities are limited so most of the time we refer our patients to other countries like Pakistan, India and China for medical treatment”.
Even where there are facilities, these may be hard to access. Mujtaba, a resident of Zerai district of Kandahar, says many families in the province are suffering from tuberculosis but cannot afford any sort of healthcare. He complains and says there are no medical facilities to treat even ordinary illnesses, let alone tuberculosis.
The head of the National Tuberculosis Center, Dr. Khalid Sidique says that NGOs provide basic services in remote districts and areas of the provinces but admits “NGOs are not able to properly deliver their services to areas that are volatile”. The acting Minister, Dr Dalil, states that to some extent the ministry has overcome some of these challenges with the help of the private sector.
She says that the National TB Control Program which was severely damaged by a long term civil war had been resumed not so later than the establishment of Afghanistan Transitional Government. In 2003 the very first strategic plan for TB Control Program was launched in cooperation with WHO and some other MoPH partners.
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