Afghanistan

Afghanistan is located in southern Asia, bordered on the west by Iran and the east by Pakistan. With an area of only 647,500 square miles, this small nation has some of the most rugged terrain in the world, ranging from the high mountains of the Hindu Kush to the arid, windswept plains in the north and the southwest.

More than 25 years of war has left Afghanistan's 31 million citizens with one of the worst health profiles on the planet. Life expectancy at birth is just 43 years. Only 2 percent of the population is over 65. Infant mortality is 160 per 1,000 live births. One in four children die before the age of 5.

Despite millions of dollars in international aid, the dozens of nongovernmental organizations that have flooded into the country since the fall of the Taliban in 2003 have barely been able to make a dent in the major health problems facing Afghans today. In many cases, they are not able to even reach the population that needs them most—the 80 percent of Afghans who live outside the few major cities. It is simply too dangerous and too difficult to move around outside [Page 29]these cities. There is no national network of clinics and hospitals, and there is no safe way to transport the sick to population centers for care.

More women die in childbirth in Afghanistan than almost anywhere else in the world, and 87 percent of these deaths are preventable.

Most Afghans suffer from inadequate sanitation and nutrition, falling prey to preventable waterborne illnesses such as hepatitis A, typhoid fever, and diarrhea. Communicable diseases such as measles, polio, and tuberculosis are rampant; leprosy exists in some areas. Malaria is common during the summer outside the mountains.

Afghans also have to cope with a variety of natural and man-made hazards. Earthquakes are common in the mountains, as are floods and drought. Sporadic tribal warfare and insurgency continue throughout the region. In 1996, it was estimated that there were more than 10 million landmines and other pieces of unexploded ordinance. It is not known how many people lose lives or limbs to forgotten landmines each year.

Women continue to suffer from inadequate health-care at a disproportionate rate. Afghan women marry very young and begin childbearing as soon as physically possible. They suffer from high rates of anemia and malnutrition. Spousal abuse is rampant and tolerated by society. Since 2003, there have been several cases of self-immolation, where desperate women commit suicide by setting themselves on fire.

Although gathering statistics has proven difficult given the closed nature of Afghan society, one 2002 report estimated maternal mortality at 1,600 deaths per 100,000 live births. More women die in childbirth in Afghanistan that almost anywhere in the world, and the death rates in the Badakshan region were the highest ever documented. The most common cause of death in childbirth was hemorrhage.

The same study found that 87 percent of these deaths were preventable. However, this would require the removal of barriers on several levels: educating women about the risks of pregnancy so they would know when they were in danger; bringing health resources to the most remote areas of the country; and ensuring that even remote healthcare facilities could care for crisis births in a sanitary manner. While there has been significant progress in these areas, the childbearing years remain a dangerous time for the majority of Afghan women.

...