The Islamic Transitional Government of
Afghanistan
Ministry of Public Health
Health and Nutrition Sector Coordination Report
Reporting Period: 28 June – 5 July 2002
Email to submit information for next week's newsletter: wro@whoafg.org (mention in subject line: “for
weekly update on health sector”. Reports can also be requested through this address.)
Contents
Program Secretariat / Coordination
Sub-sectors
Regional overview
Missions to Afghanistan, international meetings/ training & workshops
Surveys and assessments
Calendar of forthcoming activities
Coordination
Meeting on Program Secretariat – Health and Nutrition
On Wednesday July 3d, the new Health and Nutrition Program Secretariat working group met to define
the future coordination structure for the health and nutrition sector. The Program Secretariat working
group is composed of MOPH, WHO, UNICEF, UNFPA and 4 NGOs: AMI, Medair, CHA, IAM. The NGO,
GMS, was also present at the meeting.
As per the letter of understanding of the Program Secretariat (PS), coordination of the sector shall be
implemented by the Program Secretariat and through the Ministry of Public Health (MOPH). In order to
facilitate the process of coordination, the sector of health and nutrition shall be divided into task forces
representing sub-sectors. Each task force can be divided further into working groups if deemed
necessary. Each task force shall adopt a participatory approach. A team leader for the task force shall be
elected in the first meeting and terms of references will be developed.
Eleven task forces have been identified, according to the MOPH organogram. Some may be merged after
few months, with a decrease of the workload and identification of close links.
A general panel meeting will be convened bi-weekly that may still maintain the name of NTCC. Its goal is
to present to all stakeholders the work of the different task forces and share any other information. The
Technical Advisory Committee (TAC) will also be maintained as the policy and planning cell of the PS.
At the regional level, WHO sub-offices will also support the regional health directorate; the regional health
coordination committee will present information about the work of the task forces. The task forces shall be
determined by each region’s capacity, even though some including nutrition, EPI, MCH are to be
developed in all regions. Proper link-up shall be maintained with the PS at the national level.
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Task Force for Aid Coordination (MoPH, WHO, UNICEF, UNFPA, ICRC, EC, USAID and SCA)
An ad hoc meeting of the Task Force was held on 4 July 2002 on Capacity building for health information,
surveillance and data management inside the MoPH, with the participation of MoPH, WHO, UNICEF,
ICRC, MSH, and SCA. It has been agreed that the MoPH should be the place where data on health
would need to be available and analysed, be it coming from surveys or surveillance systems. For this
purpose, capacity that is now concentrated at the multi-sectoral level (such as in AIMS) is to be seconded
to the health sector.
Currently MoPH at the central level is at the very beginning of building capacity for data management and
health information. However, in some regions (e.g. Herat) the capacity in the MoPH is more advanced.
Participants agreed to the idea of a joint unit inside the MoPH, which would gradually incorporate data
management activities that are currently not managed by MoPH. This unit would be supported by the
secondment of staff of the agencies currently working in this field. Some discussion among participants
concerned the time period that is needed before capacity can be increased by supporting agencies,
ranging between immediately to up to 18 months. A meeting will be held to talk about a draft discussion
document on the topic.
Capacity Building Exercise
A fifth exercise of a joint mission, composed of UNAMA and AACA, visited Faizabad, Kunduz and Takhar
in northeastern Afghanistan:. The overall purpose of the mission was to engage in constructive dialogue
with local authorities and the assistance community, to assess the needs in the area and to jointly
establish opportunities for capacity building in the future.
Sub-sectors
Primary Health Care
A training course on primary health care for health personnel of Kabul province Basic Health centers and
staff from the MOPH has been conducted from June 23 to July 04 2002 in the MOPH library. Trainers
from WHO and MOPH facilitated the course. It was attended by 23 health professionals.
EPI & Polio Eradication
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Micro plans for Sub-National Immunization Days (SNIDs) have been finalized. Training of
volunteers will start from 2nd week of July.
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Three AFP cases have been reported, two from Kandahar and one from Faizabad, Badakhshan.

AFP surveillance activities have been intensified in all regions to achieve the target of interrupting
the transmission of the wild polio virus in Afghanistan by the end of 2002.
Maternal and Child Health

The SMI (Safe Motherhood Initiative) Task Force meeting was held on July 2d at UNICEF.
Representatives of MOPH, UNFPA, UNICEF, WHO, international and national NGOs
participated in the meeting. There was an update of the support to the Malalai hospital which
has been chosen as a future center of excellence for SMI. Task force discussed the need for
training of TBAs, particularly in remote areas, where there is no MCH center available. It is
important to discuss the role of TBAs to provide awareness to the community with regards to
women’s health. This issue will be presented by WHO and Ibnsina in next SMI Task Force
Meeting, end of July.
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A MCH Task force meeting will be conducted in late July 2002, which will be chaired by Director
of MCH Department of MoPH and sponsored by WHO.

WHO plans to launch a safe motherhood needs assessment in 12 provinces of Afghanistan.
WHO will carry out the survey in places not covered by the UNICEF survey.
Mental Health
The training course on Mental Health Nursing ended on June 30 th. Eighteen nurses, 14 from Mental
Health Hospital and 4 from Neuropsychiatry service of Aliabad hospital attended the course. Only 3 of
them were female nurses. Dr Temorshah Mosamim, Deputy Director Mental Health, and Mr Khair
Mohammad Nekyaar, Head clinical psychologist from mental health department, facilitated the training.
The training included theory and practical sessions. All topics began with group work presenting their
presentations followed by lectures for comparison. Copies of materials in Dari were distributed to the
participants.
A team of nursing staff headed by Mr.Masood Totakhail, Head of Nursing Unit, Mental Health Department,
was established to implement newly acquired skills in mental health nursing in hospitals. The priority is to
observe the right of patients suffering from psychological disorders by providing humane treatments. The
team will have weekly meetings to discuss difficulties encountered and monitor the process. Patients’
relatives will also be trained on the topic.
Communicable Diseases
Several rumors of cholera outbreaks have come from different regions of the country, but none has been
confirmed. (Ed’s note: Since the publication of this report, three cases of cholera have been confirmed in
Kabul. See Central Area report.)
Guidelines for the Control of Diarrheal Diseases in Dari and Pashto have been reprinted and will now be
sent to the areas to be used during training sessions for basic health care workers. Reporting and
surveillance data forms have been distributed during the last weeks and are available at WHO and MOPH
offices of communicable diseases.
2000 vials of anti rabies vaccine have arrived in Islamabad. The vaccine will be made available in Kabul
and other WHO sub-offices next week.
Emergency Preparedness and Response
International Relief is preparing a 2 days workshop on EMS on July 18 with MOPH, Office of Disaster
Preparedness (ODP), WHO and the Norwegian Red Cross. The goal is to build networks, capacities and
to plan for emergency response at central level with all partners involved.
Last week, WHO received verbal information about an increased number of cases of viral Hepatitis B in
Logar province. A WHO/EHA officer went to investigate the situation.
Water supply and sanitation
A mission was conducted by CWS staff to highlight the IDPs water and sanitation activities in Kunduz.
CWS staff participated in a meeting organized by MoPH to discuss the existing environmental health
situation in Kabul and the ways to improve it.
The list of required pumps, pipes and other materials for Chare-Kar (Parwan) was finalized and sent for
procurement from the international market. Additionally, a training program is planned for water supply
engineers working in Herat to acquaint them with the available on-site water quality-testing techniques.
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Health Promotion
The Afghan Ministry of Public Health, supported by WHO, is launching a nationwide radio campaign
focusing on control of diarrheal disease. The radio campaign is accompanied by a door-to-door house
education campaign in the old town of Kabul for the next two weeks. This MoPH activity is being carried
out with the technical support of Save the Children-US.
A health promotion coordination workshop will start on Monday, June 15th at the Kabul Hotel. Participants
will work to design a common and coordinated approach to health information dissemination in the next
six months, focusing on prioritized health issues and filling in gaps nationwide in delivery of health
education.
Overview by Geographic Areas
Central Area
Seven suspected cases of cholera have been reported in 6 different hospitals of Kabul. Stool samples
have been collected and sent to the National Institute of Health (NIH), Islamabad, to confirm the
diagnosis, but results are pending. The Department of Communicable Diseases of MoPH conducted
investigation and sensitization in the affected households. The CDD Task Force is meeting weekly to
monitor the situation and has begun activities to improve access to safe and make emergency stocks of
medical supplies available.
.
North-Eastern Area, Faizabad
A training course was conducted on AFP surveillance for district health coordinators, at the Faizabad
hospital. Added training on cholera preparedness and response, on HIS and on malaria control was
included in the curriculum, to respond to actual needs.
On June 25Th started a distribution of 5000 bed nets for most vulnerable people in the region jointly with
health education and sensitisation about their use and their importance.
Northern Area, Mazar
Training of Trainers on Control of Diarrhoal Diseases began this week for 22 members of NGOs and
MOPH. These trainees will then train the medical staff in their respective provinces. In total, 180 doctors
and nurses will be trained during the coming weeks.
Also, two teams of 5 people have been trained on the spot to initiate surveillance and quick response in
case of emergencies, cholera guidelines were distributed and specific health education was conducted in
schools, mosques and health structures.
An assessment was conducted in Saripol province, to answer to rumors of malaria outbreak. In Sayad
District, 2% of slides were positive for malaria (all P. Vivax), in Soozma Qala district, 25% of slides were
positive for malaria, of which 95% were identified as P. Vivax and 5% P.Falciparum. In Sheram, all slides
were negative for Malaria.
In Balkh province, SC UK is rebuilding the Dehdadi clinic and Samaritan Purse the Khulm district hospital
Ibn-Sina will take over the programs of IMC in Bodana Qala. In Faryab provinces, ICRC will run Kohuistan
clinic and CHA will repair Sherin Tagab clinic.
Southern Area
Assessment mission in Zabul Province, one of the most drought-affected provinces of the southern
Afghan area: Six of the nine districts do not have health facility and the entire region suffer from a huge
shortage of health workers, especially female. The Qalat Hospital provides OPD-IPD; Lab and X-Ray,
and EPI activities. 180-200 consultations per day are registered at the OPD service, laboratory offers
routine blood, malaria, glycemia, uremia and LFT analysis as well as urine and stools examinations; even
though there is no shortage of vaccines, epi coverage is very low. The NGO Doctor World Wide supports
staff incentive, food for patients, and reagents for the hospital.
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Joint assessment mission in the villages hit by bombing in the Dehrawood district of Urozgan province this
week was led by local authorities. The number of damaged houses was documented, proper number of
casualties is still unclear. There is no more need for added emergency relief after WHO support with new
emergency health kits and burn kits at the main hospital and Unicef support with Non Food Items.
Mirwais regional hospital has expanded the number of beds of the infectious diseases ward from 22 to 44
beds, with the support of MSF, in addition the ward has a specific cholera treatment center with a capacity
of 100 beds.
Missions completed
Community Based Initiatives and Healthy Lifestyle Promotion
A team from WHO EMRO Regional Office, Dr. Sussan Bassiri and Dr. Mubashar Sheik, visited
Afghanistan from July 2-7 to prepare the plan of action for the expansion of Basics Development Needs
programs in Afghanistan during the next 12-18 months. The Regional Office has allocated funds to
develop this project based on the realization that, to have real impact on the quality of life of the people
and to gain substantial and sustainable health gains, it is necessary to address all determinants of health
and to support the individuals, families and communities to attain self sufficiency and self reliance through
integrated and comprehensive development. This is why EMRO is actively promoting, among member
countries, community based initiatives like Basic Development Needs (BDN), Healthy Cities Program
(HCP), Healthy Villages Program (HVP) and Women in Health and Development (WHD). These
approaches require communities to assume greater responsibilities in defining their needs, identifying
priorities, mobilizing local resources and developing necessary local organizations. The goal is to create
supportive political, physical and economic policies and plans producing a positive impact on the overall
environment and quality of life.
Considering the gravity of the situation in Afghanistan and problems faced at the grass roots level, it is
very appropriate to strengthen BDN. Program activities have demonstrated the positive impact on health
and well being of the concerned communities, but the coverage of the program has remained limited so
far. The reconstruction phase offers an excellent opportunity to spread the benefits of integrated
development to a wider segment of the society.
After meeting with various donors and other UN agencies as well as a meeting with Her Excellency
Minister of Public Health, the team visited a BDN site in Ghazni in Rabat village. Then they conducted a
two-day workshop with five WHO National Health Coordinators and their MOPH counterparts in order to
finalize a plan of action and a timetable for action.
Ongoing Missions
Dr Nabila Metwali, WHO Regional Advisor for Laboratory, Blood Safety and Medical Technology, is on
mission in Afghanistan from 6 to 16 July to support and assist the development of laboratory services in
the country.
Dr. Nadia Teleb, WHO Regional Advisor for Communicable Disease Surveillance and Response; Dr.
Gooya, Communicable Disease Officer, MOH, Iran; Dr. Nassehi, TB Control Officer, MOH, Iran, Dr.
Faizullah Kakar, Epidemiologist / Medical Officer, WHO Pakistan; Dr. Phillipe Calain, CSR, WHO HQ; Dr.
Salah Ottmani, TB Control Program Officer, WHO HQ are on mission in Afghanistan from 11 to 18 July to
advise MOPH on Communicable Disease Control and provide a global perspective on CD Control during
the Workshop in Kabul.
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Meetings & workshops
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July 10, MCH Task force meeting
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July 13: Malaria and Leishmaniasis Coordination Meeting, Kabul (Sitara Restaurant)
July 14 - 16: National Workshop Communicable Disease Control, Kabul (Sitara Restaurant)
July 17: Health information and surveillance meeting, Kabul (MoPH)
July 17: National Interagency Coordination Committee for TB control, Kabul (Sitara Restaurant)
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July 14-15, UNJLC Winterization Planning Workshop, UNJLC office, Kabul
July 15-18, Health Promotion Coordination Workshop, Kabul Hotel
July 18-19, Emergency Medical Services Workshop, sponsored by International Relief.
July 21st, Nutrition Coordination meeting (10:30am): MoPH

July 22 – 24, Khost Province: Redevelopment Conference to address the goals, requirements and
issues for the redevelopment of Khost through workshops that bring together government
departments and redevelopment partners
Calendar of forthcoming activities

15-17 July, Merlin course in teaching and training methods.
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13-27 July, Joint donor mission’s visit to Kabul and other areas of Afghanistan

21-26 July 2002, second regional training workshop on management of data for the global youth
tobacco survey, in WHO regional office for the Eastern Mediterraneen, in Cairo.

1-31 August 2002, Agha Khan University, Karachi: Course on epidemiology, biostatistics and
surveillance.
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5-6 October 2002, 3rd DOTS/TB expansion working group meeting, Montreal, Canada

21-23 October 2002, International conference on wastewater management and its effect on the
environment in hot and arid countries, Muscat, Oman.
Other news

Dr. Isabel Hemming will work as Health System Development officer in WHO Afghanistan.

Mr. Charles Peetree will take the position of Director at the UNAMA policy, planning and
assessing branch.
For more information:
WHO Afghanistan Office
House No. 249, Street No. 10
Wazir Akbar Khan Mina
Kabul, Afghanistan
Tel: (93) 702-79010..12
Fax : (47) 233-08112, ext 2207
E-mail: WRO@whoafg.org
WHO Afghanistan Support Office
P. O. Box No. 1936
House 218, Margalla Road, F-10/3
Islamabad, Pakistan
Tel: (92 51) 221 1224, 2104770..4
Fax: (92 51) 228 0830
E-mail: supply@whoafg.org
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