18 - 24 October 2001
Issue No.556
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Al-Ahram Weekly Online 18 - 24 October 2001 Issue No.556 |
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Prevention is the best medicine
Health is a basic human right, even in an emergency, writes Haitham Khayat*
The World Health Organisation (WHO) has been inside Afghanistan for 50 years; it was operational at the time of the mujahidin with the umbrella support of Operation Salam, and is so today as a specialised agency of the United Nations system, working throughout the country. The WHO, as the leading health agency of the United Nations system, will continue to advocate and ensure that the health needs of the Afghans are being addressed.
The current crisis within Afghanistan has resulted in women, men, and children seeking refuge within bordering countries. This mass exodus is exacerbated by a four-year drought, which has depleted essential food stocks and drinking water supplies, and accelerated migration to the major urban centres.
To describe the situation as critical is a gross understatement. Afghans face insecurity, hunger, malnutrition, disease and possible death from the quickly approaching harsh winter as well as a number of endemic diseases such as poliomyelitis, malaria, tuberculosis, acute respiratory infections, and cholera. Clearly, the situation is desperate.
Health is a basic human right for every individual, and the WHO has been instrumental in ensuring that the enjoyment of the highest attainable standard of health is one of the fundamental rights of every human being without distinction of race, religion, political belief, economic or social condition.
In recent years, we have managed to decentralise our presence throughout Afghanistan in order to work more efficiently with all factions and local authorities. We have established eight operational sub-offices in every region of Afghanistan, supported by both international and national staff in various technical capacities. This extensive network of human and physical resources has enabled the WHO to articulate clearly the health needs of vulnerable groups such as women and children, the elderly, nomads, and internally displaced persons. In collaboration with local health authorities on both sides of the front line, the WHO has been a conduit for implementing National Immunisation Days (NIDs). These are instrumental in eradicating polio from Afghanistan and in generating awareness to ensure that routine immunisation programs function to prevent death or disability due to vaccine-preventable diseases. Additionally, the WHO supports a number of disease control and prevention programmes, such as tuberculosis, malaria, leishmaniasis, and cholera. Moreover, it has been a key figure in persuading local authorities that the cultivation of poppy and selling of opium is clearly against the teachings of Islam. As a result, the vast majority of the poppy fields have been destroyed and the production and export of opium has been reduced dramatically.
As the current crisis unfolds, the WHO is repositioning staff and essential supplies in both Pakistan and Iran to meet the emerging health needs of refugees. Experts in refugee health have been deployed to both neighbouring countries and will coordinate relief efforts with various stakeholders, disseminate key health information and ensure that health needs are met. Critically, the organisation must balance the needs of the refugees with those of neighbouring resident communities. It will play a critical role in coordinating health sector partners -- various NGOs, local authorities, and UN agencies on the ground. Currently, the WHO has opened temporary sub-offices in Mashhad and Zahedan (Iran) and strengthened existing offices in Peshawar and Quetta (Pakistan) to facilitate humanitarian assistance to refugees. The organisation is also shipping over 30 tons of emergency medical supplies to sub- offices inside Afghanistan. These emergency medical kits will provide the essential drugs required to service the health needs of a total population of 300,000 individuals over a period of three months. Caravans of supplies will also be carrying mosquito nets and anti-malarials, important in the prevention and control of malaria.
The immediate health risks to the refugee population consist of potential outbreaks of measles, cholera, malaria, malnutrition, and possibly injury and/or trauma cause by migration. The WHO will initiate disease surveillance within the proposed camp sites and ensure access to primary health care. The refugees will be seeking food, shelter and security. Hence, we will be working in close consultation with the United Nations High Commissioner for Refugees (UNHCR) to ensure access to safe and clean drinking water and adequate sanitation within the established camps. The provision of essential emergency obstetric care is equally critical for pregnant women.
The WHO's objective is to reduce suffering, and immediate and long-term avoidable mortality, morbidity, and disability related to this emergency. We have developed a number of core commitments to an emergency: Identifying priority health- and nutrition-related issues and ensuring that these are properly addressed in an integrated primary health care approach that preserves and strengthens local health system.
Strengthening health and nutrition surveillance systems to enable monitoring of any changes, early warning of deterioration, and immediate life-saving action through outbreak response and technically sound nutrition interventions.
Ensuring the control of preventable ill health, particularly communicable and vaccine- preventable diseases, and the recognition and management of risks related to the environment.
Ensuring the quality of and access to basic preventive and curative care, including essential drugs and vaccines for all, with a focus on those who are most vulnerable -- the elderly, the very young, pregnant women, the disabled and the chronically ill.
Ensuring that humanitarian health assistance is in line with international standards and local priorities and does not compromise future health development.
Advocating and negotiating for secure humanitarian access as well as the neutrality and protection of health workers, services and structures.
Ensuring that the lessons learnt in a crisis are used to improve preparedness for future crises.
Defining an integrated health policy for preparedness, emergency response and, post- conflict, coherent health sector development resilient to emergencies; linking relief efforts with national capacities and initiating future health system reform.
* The writer is senior policy adviser to the regional director for the Eastern Mediterranean regional office of the World Health Organisation.
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