Afghanistan

THIS CENTRAL ASIAN country, with a population of 28.5 million by 2004, has some of the worst health services in the world. In 1997, the country had an average of 11 doctors and 18 nurses per 100,000 people, and since that time, the number is believed to have declined. With its harsh climate, frequent wars, and low life expectancy, concern over deaths from cancer has been lower in Afghanistan than in many other countries. An example of cancer incidence rates in Afghanistan includes 159.9 cases of cancer in males per 100,000, according to the International Agency for Research on Cancer.

Cancer has claimed a number of prominent Afghans. One of the country's major national heroes, Ahmad Shah (1724–73), the founder of modern Afghanistan [Page 11]and the Durrani dynasty, is believed to have died of facial cancer in June 1773. He had been a general in the army of Nadir Shah, leading his army across the Indus River in 1748, eventually capturing Delhi and the Punjab. In 1761, he destroyed the Marathas at the Battle of Panipat. Three years later, it is believed that Shah started to suffer from cancer.

Until the 20th century, medical care even in the Afghan capital of Kabul remained largely underdeveloped. However, there was a growing awareness of cancer with the patients being treated at the Aliabad Hospital near Kabul. In an effort to raise money for the International Union for the Control of Cancer in 1938, the Afghan post office issued two stamps that commemorated the 40th anniversary of the discovery of radium. One stamp showed the Aliabad Hospital, while the other stamp showed scientists Marie and Pierre Curie. These stamps were compulsory for all mail posted in Afghanistan from December 22 to 28, 1938.

Throughout the 1960s and 1970s, healthcare in Afghanistan improved. On April 7, 1970, a series of two postage stamps showing the image of a crab publicized the country's fight against cancer. During this period, there were a number of foreign doctors working in Afghanistan involved in the treatment of cancer. They worked under the auspices of the Asian bureau of the World Health Organization (WHO). However, Neville M. Goodman, while working in the country, concluded in an article written for The Lancet (March 6, 1965) that cancer in Afghanistan remained rare.

In July 1973, the Afghan king Muhammad Zahir Shah was overthrown, and six years later, in December 1979, a pro-Soviet coup brought Babrak Karmal to power with a large Soviet military presence in the country that lasted for the next 10 years. The fighting that had been going on in rural areas escalated dramatically, while healthcare outside the major cities rapidly became impossible—and the healthcare available in the cities was largely concerned with treating the many people injured in the fighting. Some of the Afghan elite suffering from cancer were treated either in Soviet hospitals in central Asia or among the growing Afghan population in Moscow. In addition, many others fled to Pakistan on their way to settling in other countries, where those suffering from cancer were treated more easily than those who remained in Afghanistan. One of the Afghan elite who decided against returning to communist Afghanistan was Noor Mohammad Far-san (1940–2003), a paleontologist, who had run the Geological Institute in Kabul but was overseas when the Kamal government came to power. He remained in Europe and worked at the University of Heidelberg, Germany, from 1992 until his death from cancer.

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