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Afghanistan - Kabul and the provinces of Kunar, Laghman and Samangan

Afghanistan - Kabul and the provinces of Kunar, Laghman and Samangan

»FIELD LOCATION
Kabul and the provinces of Laghman, Kunar and Samangan

»TARGET POPULATION
1,400,000 men, women and children

»A.M.I. TEAM
13 expatriates: head of operations, administrator, logistics coordinator, Health Messenger manager, laboratory head, medical advisers, logisticians, physicians, nurses
1,200 local staff members: health care personnel, administrative and logistics personnel

»FUNDING
World Bank, European Commission (EuropeAid), French Ministry of Foreign Affairs, United Nations food and Agriculture Organization (FAO), United Nations Population Fund (UNFPA), UNICEF, Save the children.


After the parliamentary election in 2005 and the swearing in of the government in May 2006, Afghan policy focused on security and reconstruction. The lack of security was intensifying throughout the country for all Afghans, and at the same time, the risk of abduction of foreign visitors increased.
Violence increased during 2008, marked by a high number of suicides. In these circumstances, over 45,000 foreign soldiers are participating in the International Security Assistance Forces (ISAF). Together with these military operations, the ISAF is associated with Provincial Reconstruction Teams (PRT).

Comprised of military and civilians, the PRT are responsible for carrying out reconstruction activities, which leads to confusion between military and humanitarian interventions. The economic and social situation is one of concern. Agriculture has suffered seriously from the war and from recent weather conditions. Infl ation has aggravated the poor living conditions of the people. Thus, needs are great, and reconstruction of the health care system is a priority for the Afghan government, within the scope of the BPHS (Basic Package of Health Services, established in 2003) and the EPHS (Essential Package of Hospital Services, established in 2005).



Afghanistan was the fi rst site of operations for A.M.I., and our teams have been on location for the past 29 years. In 2003, A.M.I. launched a large-scale program: the establishment of the Basic Package of Health Services (BPHS) and the EPHS in the provinces of Laghman, Kunar and Samangan, for the Afghan Ministry of Public Health.



A.M.I.’s mission in Afghanistan revolves around three programs: implementation of the BPHS and the EPHS, support for the expansion of the laboratories and pharmacies of Kabul’s two hospitals, and the publication of the continuous training magazine for health care personnel, the Health Messenger-Salamati.

» BPHS and EPHS
The BPHS, which aims to reconstruct the entire health care system of the three provinces, is part of the new health care policy, and is implemented through the following activities:
> support for 80 health care centers (primary, secondary and hospital), including the organization of direct transfusion services, reproductive health, health of the child, vaccination, nutrition, and monitoring/treatment of sexually transmitted diseases
> supply of medicines and equipment
> recruitment, management and supervision of personnel in the health care structures of the provinces
> training of personnel
> support for the laboratory personnel of the three provincial hospitals and auxiliary clinics (training and supervision) > reinforcement of the community network of health care agents (training for over 1,000 community health care agents)
> update of activities and launch of new activities such as mental health, physical disabilities, orthopedics and HIV/AIDS. Within the framework of the BPHS, A.M.I. teams have been working with health care authorities on three levels: the government ministry, health care structures and communities.

A.M.I. has adapted its operations to the situations in the three provinces. Accordingly, A.M.I. teams established a mobile clinic last August to deal with the arrival on a massive scale of displaced persons from Pakistan into the Kunar region. Later, an investigative team was formed to inquire into the quality of water following an outbreak of diarrhea.

» Support and expansion for pharmacies and laboratories of the University hospitals of Maiwand and Ali Abad, Kabul
The program of support and expansion of laboratories and pharmacies at the Maiwand and Ali Abad University Hospitals was continued in 2008, and included:
> training, supervision and help for the supervision of the personnel (25 people)
> technical support, including rehabilitation of premises, supply of reagents and disposables, implementation of procedures (management of inventory, sorting and disposal of waste materials)
> implementation of bacteriology services.
» Salamati-Health Messenger
The medical journal Salamati is a unique source of support for Afghan medical personnel and community health care agents. The journal has a circulation of 26,000 throughout the country. Some changes in layout were made in 2008, such as increasing the number of illustrations and diagrams, in order to improve the pedagogical aspect of the magazine and to increase the number of users.