Brief Report of WHO Afghanistan activities since 11 September,
as of 9 October 2001
Support Office
As of 9 Oct 01 the eight WHO suboffices in Afghanistan are intact with
national staff present in each location, but communication continues to be difficult
from inside Afghanistan and UN vehicles cannot move.
The WHO Afghanistan international staff were evacuated from Afghanistan
and have been re-located to strengthen WHO Pakistan sub-offices in Quetta,
Pakistan (3 international, 1 national) and Peshawar, Pakistan (4 international, 2
national, plus car and driver). They are working to coordinate with UN agencies and
NGOs for Afghanistan on the overall preparedness and response to the present
crisis including mechanisms for delivering emergency medical supplies and to
assess the situation of potential refugees outside Afghanistan. A second general
objective is to prepare contingency plans for activities of polio eradication including
AFP surveillance and National Immunization Days.
In Islamabad, WHO actively participates in the Emergency Task Force and in
the sub-groups sharing information and drawing up contingency plans for health,
nutrition, and water and sanitation.
Health Sector Coordination Meetings
On 25 September and 2 October 2001 WHO office facilitated the meeting of
health sector UN agencies and NGOs at WHO Islamabad office. The meetings
have been well attended as agencies showed keen interest in coordination of an
inter-agency plan for health sector response to the Afghan crisis.
Pre-positioning supply
WHO Afghanistan is making every effort to pre-position 50 complete
Emergency Health Kits (nearly 50 tons of supplies) inside Afghanistan. As NGOs
were moving supplies to some of the inaccessible areas before winter season
blocked the passes, WHO has arranged that district hospitals and clinics in the
Hazarajat area and the Panjsheer Valley be supplied through two NGOs called
LEPCO and Aide Medicale Internationale. Further arrangements are being made
for a special convoy to Badakhshan and for commercial shipping across the border
points near Peshawar and Quetta in Pakistan. These Kits will be distributed through
the WHO sub-offices to hospital and health facilities where they are most needed.
Furthermore, WHO Afghanistan international staff are on missions to
Turkmenabad, Turkmenistan and Mashad, Iran (in process) to assess the potential
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mechanisms of sending supplies and other technical and material support to WHO
sub-offices in the North and West of Afghanistan.
NIDs
Fall National Immunisation Days (NIDs) (from 23-25 September 2001) were
completed in all regions of Afghanistan led by the World Heath Organisation and
UNICEF in combination with many implementing partners. Special teams were
assigned for cross-border areas in collaboration with NIDs in Pakistan to immunize
children whose families are trying to cross the border into Pakistan.
AFP surveillance
Contingency plans have been made for collection of stool specimens and
transferring them to the laboratory for analysis. One more case of polio was labconfirmed in the Southern Region, bringing the total to nine.
The international staff from each sub-office has been in contact with the
regional EPI officers regarding AFP surveillance. At least eleven AFP cases have
been detected from four regions, Northern (1), Western (2), Kunduz (2), Ghazni (4):
The specimens are kept in below zero freezers, and trying WHO is trying to
establish routes and means for transportation of specimens.
Herat IDP Camps
As well as chairing the health forum for the camps, and coordinating
response to potential epidemics, WHO tries to help the NGO clinics cope with large
numbers of patients by bridging the gaps in drug supplies that unpredictable funding
and outbreaks of disease bring. It also supports training of health workers in matters
from diagnosis and disease management to health education. WHO has initiated a
project for training 100 traditional birth attendants to work in the IDP camps in Herat
area.
Faizabad Water and Sanitation Projects
In northeastern Afghanistan, NGO activities and many UN activities are
continuing as normal. WHO, Afghanistan along with WFP, UNICEF and Faizabad
Municipality completed the second phase of the Faizabad Water Supply project in
2001. Presently Faizabad residents are able to get their domestic water needs
through 116 stand posts, installed mostly at congested parts of the old and new city.
This project has enabled all the citizens of Faizabad to enjoy access to safe
drinking water and hence be protected against different water related diseases.
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Since the completion of the water supply project the number of annual serious
diarrhea cases has been cut in half.
In August 2001, WHO Afghanistan initiated a water, sanitation and hygiene
education program for IDPs in Faizabad. To provide safe drinking water for about
450 IDP families are settled in three IDP camps in Faizabad city, a community water
treatment plant (consisting of sedimentation basins, slow sand filters and clear water
storage tanks) has been constructed. To fulfill the needs for a safe excreta disposal
for the IDP camps, construction of 90 cabins of VIP latrines along with 60 baths
were undertaken. In addition, WHO arranged for two teams of male and female
community health workers to visit the camps on a regular schedule and disseminate
hygiene education messages to women, children and men residing in the camps.
TB Control activities
For areas where TB control services have been cut back due to the
displacement of patients and staff, WHO has distributed a guideline for continguing
treatment either as DOTS or standard treatment depending on the circumstances.
In other areas such as Ghazni, WHO has increased monitoring activities. WHO sent
a regional TB Control Team to Gardez and Chamkani of Paktia and Khost provinces
respectively to monitor the activities of the TB Control Programme, to conduct on-job
training on different aspects of TB control for the TB control staff, to prepare TB
supply list, to distribute TB recording/reporting formats and to collect TB reports on
the 3rd quarter of the year.
IDPs of the North
WHO in Mazarisharif has provided back up to the NGO consortium
overseeing the Sakhi Camp in terms of disease surveillance and health supplies.
WHO provided 10,000 bednets for distribution to those at highest risk of malaria in
IDP camps in Balkh, Kunduz and Baghlan Provinces.
In Kunduz, WHO sponsored work on the water and sanitation projects for
Kundoz IDPs is going on well. About 65 latrines and 22 bathrooms have been
completed. WHO staff regularly monitor the projects.
Provision of essential obstetric care and clean delivery kits for mothers
In response to the current crisis, WHO, UNFPA, and UNICEF have formed a
sub-committee for coordinating activities with regard to provision of essential
obstetric care for both the displaced and internally stuck people (IDPs and ISPs)
inside Afghanistan as well as for the potential refugees in Pakistan. An estimated
5% of the population among the above will be pregnant and require antenatal,
delivery, post-natal or emergency obstetric care services. WHO has procured and is
in process of distributing inside Afghanistan disposable clean delivery kits for 4000
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expecting mothers and appropriate kits of drugs and essential obstetric care
supplies and equipment for every level of obstetric care provider and health
facilities- trained traditional birth attendants, midwives, basic health centers and
referral centers.
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