Healthcare in Afghanistan: ‘doctors are threatened at gunpoint, even by civilians’

It’s dangerous to be a doctor in Afghanistan.

This is what the staff deal with most days at a hospital in the country’s north-west: physical attacks by patients’ relatives; gun-wielding soldiers inside the wards; and verbal assaults and threats of bodily harm against doctors and nurses who are only trying to help.

An Afghan surgeon I’ve met keeps a gun at home for protection, and I understand why.

Assailants recently attacked two female nurses, causing cervical spine injuries. Another nurse responding to a mass casualty event arrived at the hospital to be assaulted and choked by relatives of a wounded patient who were demanding immediate service.

Why does this kind of violence happen in hospitals in conflict zones? There is no easy answer to that question. A patient, relative or combatant could be in pain, confused and stressed, in a life or death situation and an unfamiliar environment. They may well be angry, armed or suspicious about our neutrality. They’re living in a community consumed by conflict. But that does not mean violence, of any kind, against medical professionals is acceptable.

Doctors and nurses, ambulance drivers and paramedics, hospitals and health centres have all come under attack in Afghanistan. This disrupts the delivery of medical care when people need it most. Patients – both civilians and combatants – die because they are prevented from receiving needed care. The disruption can be so severe that the entire system collapses.

‘No weapons’ signs are routinely ignored at the hospital entrance

“No weapons” signs are routinely ignored at the hospital entrance in Maimana, capital of Faryab province. Recently I watched two soldiers, M16 rifles dangling over their shoulders, standing guard over a wounded comrade. When I asked the staff why we didn’t disarm them, I was told they were protecting their fellow soldier.

Staff don’t dare tell the soldiers to leave their arms outside and you can understand why. When a military commander was shot dead inside the hospital by opposition fighters two years ago, the doctor on duty was the one arrested, although he was later released. Arms carriers have since become even more reluctant to yield their guns before entering the hospital.

The hospital security guards once tried to disarm men entering the grounds with guns and were beaten. When a hospital administrator tried to take away weapons from a security official, the official threatened to kill the administrator. He later apologised but the deed was done.

I have witnessed these violations while working on an International Committee of the Red Cross surgical team. We are carrying out short missions to some of Afghanistan’s most important hospitals to assist the medical teams and help them learn more advanced techniques.

The Maimana hospital is fairly well equipped, and has four skilled surgeons and good hygiene standards. That’s better than many Afghan hospitals. But police officers, soldiers and even civilians there routinely threaten doctors and nurses to compel them to provide priority care at the point of a gun.

Even health workers’ families are not safe. A surgeon’s child was briefly kidnapped just a month ago. Another doctor’s child was kidnapped a few months earlier, forcing the doctor to sell his home to pay the ransom. One surgeon and his family were so afraid of the recurrent threats that they simply packed their bags and left.

This all leads down a dangerous, deadly path.

My message to community leaders, fighters and even average citizens is clear. It is the same message that my colleagues are using in conflict zones across the world: if you don’t respect and protect the healthcare workers, you will soon find no one left to care for you.

Wars must have limits, so respect the laws of war. Respect hospitals and the staff working in them. Let them do their jobs.

Neill Kling is a surgeon with the International Committee of the Red Cross’s mobile surgical team in Afghanistan

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Healthcare in Afghanistan: ‘doctors are threatened at gunpoint, even by civilians’

Aid employees in Homs race to evacuate civilians prior to Syrian ceasefire ends

Humanitarian agencies are engaged in a desperate scramble to evacuate hundreds of civilians – including terrified and malnourished kids, the elderly, the sick and the injured – from the besieged Old City of Homs prior to a temporary ceasefire expires on Wednesday.

The United Nations has appealed to the warring factions in Syria’s civil war to further lengthen their “humanitarian pause”, which started last Friday, right up until all individuals who want to depart have been evacuated.

In chaotic scenes, convoys of flagged UN vehicles have been driving at large pace to the Old City’s major checkpoint to load up with civilians desperate to leave problems of excessive privation after 18 months of siege. Unverified video posted on the web showed ladies, laden with hefty suitcases and backpacks, clutching at the hands of children as they ran towards the automobiles.

Far more than 1,one hundred of the estimated 2,500 civilians trapped in Homs had left by the end of Monday, in accordance to the UN. “It is an extremely dangerous operation,” stated Jens Laerke, spokesman for the UN Office for the Co-Ordination of Humanitarian Affairs (OCHA) in Geneva. “But this is what the ordinary individuals of Homs have been residing with each and every single day for the previous 1 and a half many years.”

UN and Syrian Red Crescent cars had come underneath gun and mortar fire at the weekend, he stated, declining to speculate on the origin of the attack. Eleven civilians had been killed within the Previous City above the weekend despite the ceasefire, he additional.

The Outdated City and other opposition-held areas of Homs have been below siege for about 18 months, dealing with day-to-day bombardment and rapidly dwindling supplies of foods, drinking water and medicine. The city was the birthplace of the uprising against President Bashar al-Assad practically 3 many years in the past.

The terms of the “humanitarian pause” initially stated no males in between the ages of 15 and fifty five would be permitted to depart the Previous City. The stipulation was later relaxed, despite the fact that far more than 300 youths and men were detained for screening to ensure that there have been no fighters amid them.

The governor of Homs, Talal Barazi, mentioned he anticipated 80% of guys to be released after the “regularisation” procedure. Nonetheless, the fate of people not released was unclear, and the UN mentioned it was “deeply concerned”.

“It is vital that they do not come to any harm,” said Rupert Colville, spokesman for the UN large commissioner for human rights. “We will carry on to press for their proper treatment method according to the worldwide humanitarian and human rights law.”

Final month, proof smuggled out of Syria pointed to the systematic killing of around 11,000 detainees in the custody of regime security forces between March 2001 and last August.

Some 500 young children, most of them under the age of 15, and about twenty pregnant women had been amid those evacuated from the Outdated City given that Friday. Geoffrey Ijumba, of the UN’s children’s agency Unicef, who is primarily based in Homs, mentioned: “They appear unhappy and weak, dehydrated, emaciated – something but healthy.

“The youngsters are not in a very good psychological issue they are really frightened and are clinging to their dad and mom.”

None of the children inside the Outdated City had attended school for the past 18 months, he extra. “Most of them have been stuck at house, listening to shelling. Even right after they come out, you can see the dread in their eyes when they hear the sound of guns. They are terrified. They have witnessed deeply traumatic occasions.”

Evacuees had been visibly malnourished, according to humanitarian staff. “There is really little food obtainable in the Outdated City,” said Laerke. There have been modest quantities of flour and bulgar, but most of it was infested with insects. “They are consuming it anyway.”

Matthew Hollingworth, Syria director for the UN’s Globe Food Programme, informed the BBC that the “levels of destitution within the Old City are like nothing I have ever noticed before. Individuals are residing in tunnels underground, moving between shells of buildings to discover roots to consume – there has been little foods for numerous, several months now.”

Evacuees offered packs of food rations have been tearing them open to consume on the spot, according to the UN. Youngsters have been undergoing nutritional evaluation and, if essential, being place on a therapeutical feeding programme.

The corpse of a man who it was claimed had died of malnutrition was shown on a YouTube video getting loaded into a UN car. The sick and injured have been given quick healthcare consideration at a mobile clinic on evacuation, and hundreds of young children had been being vaccinated against polio, rubella and tuberculosis.

Residents of the Previous City have been forced to depend on a single field hospital considering that the siege began. “For numerous months it has been without ample medicine or gear. It is a spot for people to die rather than reside,” mentioned Laerke.

The World Overall health Organisation sent health-related supplies into the Old City at the weekend, including drugs to treat continual conditions this kind of as diabetes and hypertension, and 3,600 doses of polio vaccine.

The vast majority of people leaving the Old City have been heading for the residences of family members in other elements of Homs, according to the UN. There were at least a quarter of a million men and women living below siege circumstances in other components of Syria, said Laerke.

The Syria peace talks in Geneva had been producing tiny progress, the worldwide mediator Lakhdar Brahimi explained after the two sides held face-to-encounter talks on Tuesday. “The starting of this week is as laborious as it was the 1st week,” Brahimi told reporters. He called on the government and the opposition to quit the “nightmare” of the civil war.

On Monday, the Russian foreign minister, Sergei Lavrov, dismissed a draft UN safety council resolution calling for better entry for humanitarian aid as one-sided and “detached from reality”, according to Interfax information agency.

Syria’s civil conflict has claimed more than 100,000 lives since 2011 and has forced about 6 million folks from their homes.

Aid employees in Homs race to evacuate civilians prior to Syrian ceasefire ends