Taliban Takeover: Afghanistan’s Broken Health Care System and The Politics of International Health Aid

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On August 16th, the world watched footage taken at the Kabul airport as Afghan citizens, desperate to flee the country, ran alongside and clung to the wings of a US military plane as it taxied on the runway [5]. This scene of intense panic at the airport quickly became the media symbol for the complete US retreat from Afghanistan and the chaos which ensued as the Taliban quickly took over the country. Despite US predictions that a complete Taliban takeover would require at least 18 months, it was only a matter of days after the US military left for the Taliban to occupy Kabul [5]. The scene at the Kabul airport represents a momentary glimpse of the immediate panic which ensued. While the social and economic consequences of the new Taliban regime have been popularized by the media, what’s less discussed is the impact the Taliban will leave on Afghanistan’s crumbling healthcare system. Their already fragile health system is devolving into an equally alarming state of chaos, as international aid has been ripped away from a state dependent on foreign money out of fear it would be financing the Taliban [6].

A complete cutoff from international aid organizations has immense and immediate consequences for the health of Afghan citizens, who are already suffering from political violence and persecution, as well as a fourth wave of COVID-19 [4]. According to the New York Times, the World Bank and other organizations suspended 600 million dollars in aid directed towards health care, which provided health care services for 31 of Afghanistan’s 34 provinces [4]. An interview with the Afghan Health Minister, Dr. Wahid Majrooh, confirms that in these 31 provinces, all primary health-care services are provided by NGO’s, saying clearly “The ministry is not directly involved in providing these services” [6]. Not only are funds for paying the salaries of healthcare workers missing, but medical supplies are lacking as commercial flights into Afghanistan are no longer being allowed. Even beyond physical or financial resources, Afghanistan has lost much of its more highly educated population to the “brain drain” exodus, and among them are many physicians [3]. While some recognize the difficult position of the World Bank and other NGO’s for their limitations in aid allocation, many humanitarian aid experts are criticizing these organizations for  “Abandoning Afghans when they most needed help” [4]. Afghan citizens were left in the hands of a militant regime without international aid, financial resources for health, a functioning health ministry, physical medical supplies or sufficient health care workers. Without an immediate and effective international plan, the pain embodied in people’s desperation as they ran and clung onto the US aircraft cannot begin to represent the suffering which will ensue as the Afghan healthcare system continues to crumble.

The Taliban’s takeover of Afghanistan and the decrease in international health aid will exacerbate existing gender inequalities in healthcare. Approximately 10,000 of the 20,000 female community health care workers are staying home from work out of fear of violence and retaliation from the Taliban [6]. Beyond the desperate need for any trained health care worker, many female patients are unable to seek care from male physicians. In a country where religious and cultural values frequently restrict women from seeing male doctors, specifically obstetricians or gynecologists, a decrease in working female health care providers leaves women in a dangerous and extremely vulnerable position [2]. When Majrooh was asked what kinds of procedures might not be available now because of the medical crisis, he responded “Every day 150 mothers require Caesarean sections, half of these emergency cases. Both mother and child are at risk of death if complications arise” [6]. Majrooh’s immediate reference to women’s health in response to this question speaks volumes to the precarious position of women’s health at this point.

Equally pressing is the fact that this health crisis also coincides with the global COVID-19 pandemic and an emerging fourth wave of cases in Afghanistan. Despite the global and national push for vaccination services, Afghanistan’s COVID-19 response infrastructure is now essentially nonexistent [1]. According to the UN, 37 COVID-19 hospitals have closed since the Taliban takeover, and systems which monitored surveillance, testing and vaccination are deteriorating. The difficulties associated with vaccine distribution, such as the necessity of a working vaccine cold chain and people to implement the vaccines, have led to 1.8 million vaccine doses  going unused [1]. Without medical supplies coming in, testing kits for COVID-19 are dwindling, leaving the country even more vulnerable to another deadly outbreak.

When Majrooh was asked if he was optimistic about the transition to a health care system controlled by the Taliban, he responded “How do you define optimism at this point?”[6]. As of now, no plans for international intervention or support have been set in place to help rebuild the ruins of the Afghan healthcare system. Afghan artist, Rada Akbar, who fled to Paris after the Taliban takeover said “They are not the reality of my country. They stole my land” [3]. Despite this powerful sentiment, the devastating and dangerous impact of the Taliban on Afghan citizen’s health is a reality that must be addressed. In a country already suffering from widespread political violence and persecution, what kind of ethical responsibilities does the international community have to help the Afghan citizens who were unable to escape the Taliban rule to secure the basic right to healthcare?

Edited by: Nick Rogers



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