‘I stay up at night thinking about the children we can’t reach’: Afghan doctors at breaking point as pneumonia and hunger soar – Afghanistan

– More than half of families surveyed were unable to get health care when they needed it, new data from Save the Children reveals.

– Nearly 60% of those who could not get health care said they had no money to pay for it. 31% of respondents said they would only go to a clinic if it was a life-threatening illness.

– In December, 135 children died in or about to be treated in an overwhelmed hospital, the majority struggling to breathe from pneumonia

KABUL, 31 January 2022 – Cases of pneumonia are soaring in Afghanistan, killing children who cannot access health facilities, Save the Children said today.

An assessment by the children’s agency found that in December more than half (55 per cent) of households surveyed who needed healthcare in the previous three months were unable to get it . Half of the parents surveyed said their children had had pneumonia in the previous two weeks.

Childhood pneumonia is on the rise amid a hunger crisis that is ravaging young immune systems. The collapse of the health system, caused in large part by the freezing of financial assets and the withdrawal of aid, is having a deadly cost for Afghan children.

A doctor at a hospital in the north of the country said he had never seen so many cases of childhood pneumonia and severe malnutrition. The children lie two, three or even four per bed. He told Save the Children that 135 children died in hospital or on the way to hospital in December – the majority battling breathlessness due to pneumonia and 40 suffering from severe malnutrition.

If the malnourished children had arrived at the hospital, they almost certainly would have survived, he said.

Wazhma*, nine, lives with her family in a village on the outskirts of Kabul, where many have lost their jobs and parents go without meals to feed their children.

Wazhma fell ill with a high fever and continuous cough which prevented her from breathing. Her parents tried home remedies, but they didn’t work. They knew she had to go to the hospital, but they couldn’t afford it. Wazhma’s father, Samir*, had to ask a friend for a loan.

Samir said, “*If he hadn’t given us the money, I’m not sure Wazhm* would have survived. She was having trouble breathing, it was scary.*

“*It’s because of freezing temperatures and people here not being able to heat their homes. Many children here are cold for most of the day and as a result become very sick.”*

In the hospital, Wazhma needed oxygen to help her breathe, but doctors said they could only give her for 30 minutes because they were so short of oxygen cylinders. Doctors were treating up to three children crammed into one bed.

Wazhma said, “I felt very bad, I slept a lot and moving hurt my body. I felt hot and tired. I was scared when I was in the hospital. I had trouble breathing. »

Thanks to medication and limited oxygen, Wazhma eventually recovered, but many children in Afghanistan are not so lucky.

Even before the latest crisis in Afghanistan, pneumonia was responsible for more than one in five deaths of children under five and globally kills more young children than any other disease.

Save the Children’s mobile health clinics travel to remote areas to provide lifesaving healthcare. The team leader of a mobile health clinic, Dr Sadat*, said: “Cases of pneumonia are increasing every day, the number of patients coming to our clinics has doubled or tripled in recent months. They have nowhere to go. It’s much worse than last year. Sometimes hundreds of mothers and children are waiting for us when we arrive. They simply cannot afford the food and heating they need to stay healthy. Malnutrition and pneumonia are a deadly combination.

“Children with severe pneumonia have a severe cough and their chest rises and falls rapidly as they struggle to breathe. Their faces change – they swell and darken. We see too many children like that.

“Every day we send several children directly to the hospital for oxygen and emergency care. Recently, a baby did not survive. I called his mother to see him and she told me he was dead. It’s the worst feeling imaginable.

“Often we cannot treat everyone, we are overwhelmed. We need more equipment like pulse oximeters and nebulizers. And we can only be in one place at a time. There are so many more sick families out there. I lay awake at night thinking about the kids we can’t reach.

The free fall of the Afghan economy threatens to leave more than 95% of the population living in poverty. Save the Children’s assessment found cost to be the biggest barrier to healthcare.

Clinics across the country have been forced to close as salaries for health workers have dried up. Save the Children said the collapse of health services is one of the direct impacts of the global asset freeze and the suspension of development aid, both of which are stifling the health system. When sick children need care, they find only closed doors and empty pharmacies. The aid agency calls on the international community to release vital funding.

In 2021, Save the Children’s mobile health clinics in Afghanistan performed nearly 375,000 health check-ups and treated more than 12,000 malnourished children. The aid agency is distributing cash, winter clothes and fuel to families in some of the hardest hit areas to help keep them warm and fed during the harsh winter.


* Names changed to protect identities

Notes to editors:

Save the Children’s assessment took place between 18 November and 2 December 2021. There were 1,209 adults and 1,206 children interviewed, evenly split between the provinces of Balkh, Faryab, Jawzjan, Kabul, Nangahar and Sar- shoulder. The assessment of adult respondents revealed:

  • 725 households reported that one or more family members had pneumonia in the previous two weeks (60% of all households)

  • 591 households reported that one or more children in the family had pneumonia in the previous two weeks (48.9% of all households)

  • 930 cases of pneumonia have been reported in total

  • 716 cases of childhood pneumonia were reported (77% of total pneumonia cases reported)

  • 396 cases of pneumonia in children aged 0-5 years have been reported (42.6% of total pneumonia cases reported

  • 85.2% of households said they needed medical assistance in the past three months. Only 44.6% of these households were able to obtain the medical assistance they needed. Of these, 57.6% said they could not afford to pay for it. 47.1% said distance to health facility was a barrier. 31.2% said security was a reason and 20% said they couldn’t afford transportation.

  • 30.9% of households said they would only seek medical assistance in life-threatening situations

  • 81.1% said that access to the nearest health facility was difficult (46.6%) or very difficult (34.7%).

While it is clear that COVID-19 cases are increasing in Afghanistan, due to lack of testing, it is difficult to assess the role that COVID-19 plays in childhood pneumonia. Across the country, countless families are battling the harsh winter in freezing, damaged homes, unable to afford heating, with their children going to bed cold at night without blankets or warm clothes. Combined with a million children suffering from severe malnutrition, all the ingredients exist for a resurgence of pneumonia, whatever the pandemic.

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