08/24/2021, 09.03
AFGHANISTAN
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A demographic boom threatens Taliban rule

by Riccardo Lampariello*

In addition to internal opposition, Islamist militants will have to face and manage rapid population growth. More than four children per woman in the country. Every month about 600 pregnant women and 4 thousand Afghan children lose their lives at birth or soon after. Continuous violence and Covid-19 exacerbate the problem.

Geneva (AsiaNews) - A demographic boom threatens Taliban rule in Afghanistan. Islamist militants, who have seized control of the country again after the US and Nato military withdrawal, will have to face and manage the rapid population growth, in addition to internal opposition. With more than four children per woman, Afghanistan has grown almost by one million inhabitants per year, now at around 38 million according to the World Bank, causing further stress to a devastated country. The health system is particularly concerned.

In “normal” times, Afghanistan has struggled to provide basic quality healthcare services to the population. Despite major improvements in the last 20 years the country still scores one of the highest maternal and newborn mortality rates worldwide and the highest in Asia. For comparison, in the neighbouring Pakistan the maternal mortality is one fifth. Every month about 600 pregnant women and 4,000 babies have lost their lives at birth or soon after according to the World Health Organization (WHO).

Newborns die mainly because of preterm birth complications, intrapartum related events (e.g. asphyxia) or infections; mothers die because of haemorrhages, infections and complications of unsafe abortions. Most deaths are preventable with the provision of quality healthcare services during pregnancy, delivery and in the very first days of life. Though, fewer than 60 per cent of births are overseen by skilled health professionals in Afghanistan.

While a growing population would require additional doctors, nurses, medical products and infrastructure to satisfy the expanding needs, years of violence have exhausted the country’s fragile health system, which has relied on the services supplied by international humanitarian actors. As the healthcare workers are equally impacted by the fights – occasionally being the direct victims of assaults - health posts and maternity wards are left partially or totally unattended.

In addition, people are increasingly too afraid to leave their homes due to the violence, and so access to healthcare is dramatically low. With over 100,000 childbirths expected each month for the next months to come, there is an immediate need to ensure continuity of health services across the country. 

Apart from the maternal and child healthcare needs, the raging violence escalated trauma injuries requiring scaled-up emergency medical, surgical services and psychological support. Disruptions in the delivery of healthcare services would increase the risk of disease outbreaks. Almost half of the children population is malnourished.

Amid the violence, COVID19 brings further distress: WHO recorded a total of 152,448 confirmed cases of COVID-19 and 7,054 deaths in Afghanistan, with a large portion of cases not being reported. The ongoing violence and the Taliban traditional hostility towards vaccines will impact the ability to immunize the population (0.6% of the population is fully vaccinated on 20 August). The ongoing political turmoil may only fuel an uncontrolled wave of COVID-19, as it occurred in Myanmar, pushing the health system towards collapse.

An immediate cessation of violence and a commitment to a peaceful transition is urgently required. The WHO has called on all parties in Afghanistan to respect and protect civilians, health workers, patients and health facilities .Without a substantial international support to provide immediate relief and rebuild a broken health system, the situation will likely turn into a humanitarian disaster and the most vulnerable will pay the highest price. The clock is relentlessly ticking in Afghanistan: 3,500 women will give birth tomorrow. Who will assist these Afghan women and their babies?

*Head of Health Programme at the Terre des hommes Foundation. The opinions expressed in this article are the author's own and do not reflect necessarily the view of the organisation he works for.

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