Health Sector Response to the Afghanistan Crisis
and 30 Day Operational Plan
World Health Organization Report for OCHA, 15 November 2001, short
Health Situation: In the midst of the double crisis of the worst drought and the most intense military
action, immense efforts have been initiated to prevent deterioration of the health situation. WHO
Afghanistan predicted, according to previous trends, that, in addition to casualties from war,
respiratory infections, maternal complications, and diarrheal diseases, would be the killers this winter
due to serious depletion of family resources, poor nutrition, exposure during displacement, diseases
increased due to crowding, and inadequate health care and referral services. Saving lives would
depend on having health workers in the field and sufficient medical supply in both peripheral and
referral centers as well as food, shelter and security.
Strategic Stockpiling: Supply hubs in Peshawar, Quetta, Mashhad, Turkmenabad, Termez, and
Dushanbe have been key to shipping food and emergency medical supplies across the border and
also have become coordination centers for flow of information and support to national staff in
Afghanistan. WHO and UNICEF shipped sufficient Emergency Health Kits into Afghanistan in
October to serve 1,420,000 population for three months. NGOs also stocked their health centers with
the medical supplies expected to be used in the next quarter.
While about 28% of the need has been met, more emergency medical supplies are still needed,
especially in the North and West where there are large IDP settlements, in the East and Central
where large populations live and are now displaced, and in the generally underserved areas of the
Southeast and Central Highlands. Additionally, measles immunization of all children aged 9 months
to 12 years among internally displaced populations is ongoing. Any damage to the cold chain must be
swiftly repaired. Further funds are needed for this cold chain support.
Increasing Health Workforce: To prevent excess mortality in Afghanistan this winter, more health
workers need to be mobilized. Three basic strategies have been identified:
 To maintain existing NGO supported facilities and increase their capacity to serve settlements of
internally displaced population.
 To support existing health centers where services are currently irregular due to lack of external
support for salaries and medical supplies.
 To initiate outreach services to needy areas where there is no health center.
The map in the annex shows which districts have health centers supported by NGOs, which have
health centers functioning without external support, and which districts have no health centers. Below
are the estimated populations in these areas without adequate health services:
Regions
Current IDP
populations
Population
with no
health
services
Population
with poor
health
services
Total
Hazarajat (Bamyan)
39,900
387,375
0
427,275
East -SE (Jalalabad)
50,000
668,822
0
718,822
North-East (Faizabad)
50,500
715,303
0
765,803
6,000
252,713
553,400
812,113
245,700
483,484
292,531 1,021,715
95,244
598,371
768,659 1,462,274
North (Mazar)
149,928
1,230,411
580,674 1,961,013
Total
637,272
4,336,479
2,195,264 7,169,015
Central (Kabul)
West (Herat)
South (Kandahar)
Prioritization is necessary and will require an analysis of where health workers can be identified and
supported and which areas are accessible, in addition to making a “needs -based” analysis, which
would also include the disease trends observed. Initial work on a population-based analysis is
illustrated in the second map in the annex.
In the next weeks, health sector agencies will be continuing their efforts to prioritize the areas where
further workforce support is needed and identify and mobilize that support.
30 Day Operational Plan: The current Crisis of combined drought, displacement and conflict has
called a halt to all efforts to improve health systems in Afghanistan. We are struggling now just to
avoid “excess” deaths. So far, estimating all health sector inputs, about 28% of the needed medical
supplies for the next three months have already been positioned, and health workers in NGO
supported clinics are still functioning. The plan for the next 30 days follows:
Procure and distribute medical supplies to fulfill remaining needs for 6 mo – WHO, UNICEF, NGOs $4,500,000
Procure and pre-position necessary cold chain replacements - $500,000 UNICEF
Place 30 more health workers in IDP camps for 6 mo – NGOs - $60,000
Identify support for health workers in 70 existing health centers for 6 mo – UNICEF and NGOs. $420,000
Mobilize an additional workforce of 400 doctors and mid-levels as outreach teams for 6 mo. WHO,
UNICEF, NGOs. - $800,000
The extent to which funds, supplies and workforce needs can be met may very well be the limiting
factors in the extent to which the health sector partners are able to mitigate the combined impact of
drought, displacement and conflict in Afghanistan.
Annex: