Afghanistan: rebuilding essential structures to meet urgent needs
18-01-2002 Operational Update
People deprived of their freedom
Wounded and sick
Working with humanitarian partners
The establishment of an interim authority and the deployment of an international force in Afghanistan lay the foundations for restoring stability there, but the conflict has not yet ende d: security is still uncertain for both Afghans and international organizations, as fighting continues in pockets; even where it has ceased, tensions between competing groups remain high. International actors returning to Afghanistan have begun planning post-conflict reconstruction, but widespread insecurity and large-scale humanitarian needs require that in parallel, emergency operations continue and the capacity to extend them be maintained. How emergency operations are planned and carried out has an important impact on prospects for reconstruction.
With ICRC Afghan staff still in place and running many of its programmes uninterrupted, returning expatriates have been able to swiftly resume suspended activities and adapt those which were ongoing. ICRC's priority activities are:
food and other basic assistance to drought and conflict victims in remote areas like Ghor, South Balkh, and Bamiyan: since their resumption in November ICRC rations distributions have reached over 325,000 persons;
visits to persons captured during recent fighting: since returning, ICRC has visited some 4,800 detainees and prisoners, including those held by the USA, and is starting visits to those transferred to Guantanamo Bay;
support to medical facilities: ICRC distributions of medical assistance continued through the international strikes, enabling Afghan hospitals to maintain surgical services; now assistance has been extended to more facilities and ICRC is rehabilitating looted hospitals in Bamiyan and Kunduz;
prevention of injury from mines and unexploded ordnance (UXO) and rehabilitation of mine/UXO victims: ICRC's six rehabilitation centres have maintained services for amputees and other disabled perso ns without interruption; mine awareness activities are now being expanded and adapted to new situations and risks, and mine/UXO data are being collected in health facilities treating the wounded, providing accurate information for demining and mine awareness activities.
Other current activities include re-establishing essential water and electricity supplies in urban areas, assisting vulnerable conflict victims (including IDPs), and supporting the reconstruction of the Afghan Red Crescent Society. Assistance is focused on areas most affected by conflict, particularly in remote regions that other international agencies are for the time being unable to cover. The ICRC strategy of working with Afghan authorities, the Afghan Red Crescent Society, other Afghan groups and communities reinforces existing structures and mechanisms at all levels.
United Front forces took Kabul on 13 November and the Taliban stronghold of Kandahar fell in mid-December. Residents who had fled and international political and humanitarian actors have begun a return to major cities, a s Coalition forces continue the pursuit of Taliban and Al-Qaeda forces in more isolated areas.
An interim authority established by the Bonn accord and headed by Prime Minister ad interim Hamid Karzai assumed leadership in Afghanistan on 22 December. By the end of its six-month mandate, a Loya Jirga, an assembly of Afghan leaders, should be organized to nominate an 18-month Transitional Authority. This authority will be responsible for developing a constitution and organizing elections. An international security assistance force , authorized by the UN on 20 December, is currently being deployed.
Fighting still continues in pockets of the southern and eastern areas of Afghanistan. In eastern areas a breakdown of law and order compromises security and access. Tensions between competing groups remain high in northern areas. As refugees and displaced persons return to their homes and reclaim their property, further tensions between groups can be expected.
Damage accumulated in over two decades of conflict and the devastation of three years of drought have left millions of Afghans with few means of livelihood. Recent military strikes have added to the destruction and disrupted the Afghan systems and international humanitarian programmes. Millions of Afghans remain extremely vulnerable to disease, hunger and death and unable to apply themselves to the tasks of rebuilding their communities and restoring their livelihoods until their survival needs are met.
In September, before it complied with the Taliban request that it evacuate international staff, the ICRC maintained a broad range of programmes of protection and assistance benefiting well over a million victims of conflict throughout Afghanistan. When international staff was withdrawn, ICRC's 1,000 Afghan staff members stayed on the job in Kabul and in its offices and subdelegations around the country, maintaining many of its assistance, water and sanitation, medical, and orthopaedic activities. However, protection activities and large-scale food assistance to isolated areas, including food relief targeting half a million drought victims in Ghor province, were suspended. Expatriate staff redeployed in neighbouring countries prepared their re-entry, expanding logistical networks able to supply operations inside Afghanistan and keeping contact with Afghan staff still running programmes there.
When the United Front advanced to take Afghanistan's major cities in November and December, ICRC expatriate staff returned to each area as soon as the security situation permitted, in most cases within days. The continuity provided by Afghan staff allowed them to swiftly resume suspended operations and to adapt those which were still running. In the new phase of activity since the international return, the ICRC has already provided essential food, shelter, water and sanitation, and medical assistance to benefit hundreds of thousands of Afghans. It has resumed protection activities, including visits to prisoners, around the country. Currently so me 100 expatriates and 1,000 Afghan staff members implement these activities out of Kabul and six other locations around the country.
While the ICRC focuses on emergency needs, its long experience in Afghanistan makes it mindful of the impact of emergency assistance on prospects for reconstruction. Its programmes involve local communities and institutions in planning and implementation and are designed to strengthen rather than replace Afghan structures and mechanisms. They encourage return and resettlement and seek to minimize disruptions such as displacement which make restoring normal activities so difficult. Rehabilitation is often an element of ICRC's programmes even during the emergency phase, but as the situation stabilizes this component takes the fore, even as the ICRC maintains its capacity to react to further emergencies.
Reinforcing security of civilians at risk
As groups return to newly-secured are as and the local balance of power between different ethnic or political groups shifts, risks of intimidation and harassment, property destruction, and similar problems may increase; where fighting continues, or should it break out in new areas, civilians may be targeted, caught in crossfire, or cut off from vital supplies and services. Preventing or curbing such violations of humanitarian law remains the most effective way to avoid emergency situations, to enable communities to restore normal activities, and to improve the overall prospects for post-conflict recovery. The ICRC maintains contacts with authorities from all sides, at all levels, to remind them of their obligation to protect the security, dignity, and livelihood of all civilians under their responsibility. Its extensive ground-level presence in assistance programmes which target areas of instability or conflict allows it to directly monitor conditions of populations at risk and gather accurate information on their problems. The confidence developed over years of working in the country enhance the effectiveness of ICRC's work to protect civilians.
Injuries from mines and unexploded ordnance (UXO), which have already disabled enormous numbers of Afghans, are a particular risk during periods when civilians try to take up normal activities and return to abandoned fields, pastures, or neighbourhoods. The ICRC supports Afghan Red Crescent Society activities in mine awareness, which continued through the international strikes and now are being adapted and expanded to meet new risks arising from recent military strikes. The ICRC has resumed its collection of data on mine/UXO injuries in a database of information based on interviews with mine/UXO victims in health facilities. The database now includes some 5,000 cases and provides over 80% of the information on new injuries in the UN Mine Action Program for Afghanistan (MAPA) database.
Helping drought and conflict victims recover food security
Once populations have been forced by drought or conflict to leave their land, tools, and livestock, dropping the maintenance of their irrigation systems and disrupting the communities that organize collective action, it is extremely difficult for them to return and recover productivity. Assistance offered only to those already displaced can actually accelerate this costly displacement, attracting families away from their villages where they still could maintain coping mechanisms. The ICRC's current relief strategy focuses on isolated areas that other humanitarian organizations are less able to reach and is designed to prevent further displacement, ease the return of those who have fled home communities, and help families meet survival needs so that they can turn efforts and resources towards longer term efforts to restore their livelihoods. It involves:
immediate, large-scale food and other essential assistance
assessment of specific needs in areas most affected by conflict and drought
mobilization of urgently needed seeds and tools to allow communities to plant in the coming spring.
In the longer term, ICRC food-for-work irrigation projects rehabilitate agricultural infrastructure, boosting productivity and providing temporary income for the poorest workers. In October and November 2001 ICRC continued its rehabilitation projects for 54 irrigation systems in central provinces, benefiting over 50,000 people.
In Ghor , the area hardest hit by drought and the most inaccessible province in the country, the ICRC began last summer to distribute three-month food rations targeting the provinc e's entire population and aiming to prevent further displacements. Distributions were suspended for security reasons in August, and were taken up again in November after international staff returned to the country. Since then the ICRC, the only international agency currently active in Ghor, has already distributed food to over 130,000 people there. Distributions are still in progress, and at the time of writing some passes leading into Ghor are still open, but the ICRC is pre-positioning trucks in Chagcharan to allow it to deliver air-lifted supplies if road access is blocked by snow. Residents of eastern areas of the province, where there is little irrigation and where fighting prevented autumn planting, are likely to need assistance for longer than those of western areas. In spring, before the next planting season, the ICRC plans to distribute seeds and restart irrigation system rehabilitation, backing these up in areas of shortage with food distributions to last until the next harvest.
In Bamiyan , a drought-affected area which was resistant to Taliban control and was the scene of recurrent conflict in recent years, the ICRC has targeted over 100,000 people for food and other essential relief in the first four months of 2002. Distributions now in progress have reached 49,000 people since November. Distributions have also begun in Dar-i-Suf and other drought-affected areas of the north which are affected by fighting and often cut off by winter weather conditions. ICRC is evaluating needs in Badghis and areas around Kandahar, and based on its findings is prepared to distribute large-scale food and other essential assistance there.
Food, shelter, and water and sanitation assistance for IDPs
The ICRC provides food, other essential materials and water and sanitation assistance to northern a reas near Mazar-i-Sharif with high concentrations of displaced persons. It has targeted over 170,000 persons for food distributions there in the first four months of 2002, and has already reached over 90,000 since November. It also has planned for well-drilling and latrine construction in IDP settlements in the area of Mazar-i-Sharif and other areas with heavy concentrations of IDPs.
Table: Summary of ICRC food assistance
November 2001- 17 January
January - April 2002
* planning figure; to be confirmed by assessments
Assisting city dwellers: rehabilitating shelter and utilities
In the first ten months of 2001, the ICRC improved water supply in Kabul by rehabilitating peri-urban water supply systems for up to 40,000 residents, and recomissioning pump stations feeding networks distributing water to a population of 100,000. During the air strikes, ICRC's Afghan engineering staff worked with local communities to repair damage to electrical and water supply systems, guaranteeing normal water access for over 500,000 Kabul residents. It also provided material assistance to help improve living conditions for over 1,800 families whose houses were damaged or destroyed. The ICRC now works with water authorities to restore and maintain essential water supply for a large part of the population in and around Kabul; this includes making repairs to pump stations, maintaining power supply for boreholes, and helping maintain water sewerage and heating systems at large apartment blocks. A similar programme has begun to ensure the water supply for 135,000 people in the central districts of Mazar-i-Sharif, and in Herat, Kandahar and Jalalabad the ICRC provides fuel and spare parts to keep open the boreholes that provide city water supply.
In 2001 the ICRC completed its programme to improve sanitation conditions by helping build or renovate 11,000 latrines for some 154,000 persons in Kabul's most highly-populated areas, which were in northern districts. Since its return it now focuses on the southwestern part of the city, where many of Kabul's poorest families, many of them IDPs, live in makeshift homes in destroyed and abandoned areas. In these neighbourhoods the ICRC has begun a winterization programme for 25,000 families, providing assistance to ensure basic shelter and heating. By mid-January it had distributed stoves, charcoal, blankets, material for roof repair and plastic sheeting to some 5,000 families; distributions are in progress for 5,000 families more. It is also working to repair 120 hand pumps to improve water supply in the neighbourhood, and has helped the municipality clean waste channels and organize the collection of tonnes of solid waste there. A similar programme for improving sanitation and water supply has been launched in Mazar-i-Sharif has been launched, and engineering teams are evaluating needs in other urban areas.
People deprived of their freedom
Since their return, ICRC expatriate detention teams have gained access to persons held by the International Coalition or Afghan forces, and have visited some 4,800 persons held in forty places of detention around Afghanistan. ICRC delegates have visited over 350 prisoners held by the USA in Afghanistan. A four-member ICRC team, including a medical doctor, flew into Guantanamo Bay on Thursday to begin visits on Friday (18 January) to those transferred there.
There is no centralized source of information on detainees and prisoners, who are scattered about the country, held by different authorities or entities, and frequently transferred between places of detention or to and from health care facilities. For these reasons, finding and following them up has required a great deal of effort and resourcefulness. The superimposition of an international armed conflict on an existing internal conflict has complicated legal issues, but has not prevented the ICRC from being able to register prisoners and detainees and visit them according to its standard procedures, which allow an accurate assessment of their physical and psychological well-being and form the basis for a confidential dialogue with authorities on their treatment and living conditions.
Wounded and Sick
Long-standing strategy: maintaining and reinforcing Afghan medical structures
Conscious that it is extremely difficult to rebuild collapsed medical services, the ICRC has for years pursued a strategy of supporting Afghan medical structures. Its assistance of medicines and medical supplies, maintenance and repairs, technical support/training, and staff support (temporary expatriate staff or salary supplements for Afghan staff) has helped re-establish and sustain surgical services countrywide, filling gaps created by conflict and maintained by authorities’ lack of resources and capacity. Surgical services are the focus of the ICRC because these are the most acute needs in conflict situations and the most complicated to maintain, but the ICRC extends its assistance to other essential services to keep them from shutting down during acute emergencies. In 2001 the ICRC maintained the regular support needed to uphold surgical services in key referral hospitals on both sides of the conflict, providing training and technical assistance to reinforce facilities'capacities and reduce their dependence on external assistance, and ad hoc assistance to over 20 other facilities providing surgical care or first aid. In 2001 facilities were providing surgical services for an average of over 3,000 inpatients and 20,000 outpatients per month.
Throughout the strikes: sustaining medical assistance
When ICRC’s expatriate staff was withdrawn in September, its Afghan staff continued to deliver assistance throughout the international strikes, enabling six key referral centres and over 30 other hospitals and first-aid posts to maintain surgical and first-aid services for the war-wounded and other surgical patients. As possible and needed, it also provided assistance in medical materials, food, fuel, and infr astructure repair to other medical facilities. ICRC-assisted facilities performed over 4,000 operations in September and October.
Rehabilitation of the disabled: services not interrupted
ICRC'S orthopaedic centres in Kabul, Jalalabad, Gulbahar, Faizabad, Herat, and Mazar-i-Sharif produce and fit artificial limbs and other orthopaedic devices, provide physiotherapy and help the disabled reintegrate into society through vocational training, schooling, microcredits and job placement. In the first half of 2001 they assisted over 22,000 disabled persons of whom over 3,000 were new patients, producing and fitting prostheses for over 6,000 persons. ICRC's trained and experienced Afghan staff have kept all of the centres running without interruption.
Adapting to meet new needs
Since returning in November, ICRC expatriate medical teams have surveyed major medical facilities around the country. On the basis of the needs and priorities identified, the ICRC:
continues the regular assistance that enables surgical departments in 6 major hospitals to provide surgical referral services
distributes medicines and supplies to other hospitals in Kabul, Panjshir and the Shamali plain, Herat, Kunduz, Mazar-i-Sharif, Shibergan, Pul-i-Khumri and other areas; in Kabul, for example it distributed medicines and medical supplies sufficient to cover the needs of 1,000 beds for three months to the 4 neediest hospitals
continues providing prosthetic/orthotic and physiotherapy for amputees in 6 ICRC orthopaedic centres that provide the only countrywide rehabilitation programme for amputees and other disabled persons
has begun provision of fuel, restoration of electrical supply, improvement of water supply, and repair of windows in 9 major hospitals in Kabul and selected hospitals and clinics in Mazar-i-Sharif, Herat and Jalalabad
has begun repair of looted hospitals in Bamiyan and Kunduz and mobilized equipment and supplies (including a field hospital supplied by the Norwegian Red Cross) and an expatriate surgical team to restore inpatient services for the populations of these areas, who total 200,000
has completed one-time food distributions to 27 hospitals.
Working with humanitarian partners
Within the International Red Cross/ Red Crescent Movement
During the strikes by international coalition forces, with the support of the ICRC and the International Federation of the Red Cross and Red Crescent Societies, the Afghan Red Crescent Society (ARCS) continued to assist victims of the conflict. Since the fall of the Taliban regime, the ARCS has undergone major changes and now has a new leadership. The ICRC is working with the Federation to support ARCS'efforts to re-establish itself: the most urgent tasks being review and revision of its legal basis, reassessment of its capacities at branch and headquarters levels, identification of trai ning needs, and redefinition of programmes in view of current needs and operational capacities. The three organizations have together elaborated a six-month plan of action.
Many National Red Cross and Red Crescent Societies feel compelled to help meet the enormous humanitarian needs in Afghanistan. With the political, military and security situation still very volatile, the ICRC assumes its lead role as articulated in the Seville Agreement. It has specified its Kabul delegation as the focal point for Movement field activity, and has established a list of possible projects in the fields of health, water and sanitation, relief, and cooperation with the ARCS which can be delegated to participating national societies (PNS). Short assessment missions are currently being organized for over ten National Societies interested in participating in field activities. These visits will provide a basis for defining the National Societies'possiblities for future involvement within ICRC's structure and operational approach. It is vital that the components of the Movement work together to mount a coherent response in the reconstruction process.
With other humanitarian actors
The ICRC coordinates closely with other organizations, and will be a predictable and open partner. As more and more international humanitarian organizations arrive to work in Afghanistan, effective coordination between all actors gains extreme importance. This requires addressing concrete and down-to-earth issues such as what criteria are applied in a given field of activity, who does the survey in a given region and how to avoid overlaps of mandate .... or gaps. The ICRC's broad mandate to protect and assist civilians, persons deprived of their freedom, and the wounded and sick, allow s it maximum flexibility in identifying unmet needs, filling gaps, and avoiding duplication through a variety of activities in different domains which reinforce each other in a unique, integrated approach.
For further information, please contact the External Resources Division.