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Afghanistan: renewed fears of an escalation in fighting

12-04-2012 Operational Update

Alongside ongoing tensions, there are fears that as the snows melt, and parts of the country that are difficult to reach in winter become accessible again, fighting will escalate. Afghans, who recently celebrated their new year, are once again facing another year of insecurity.

The ICRC is once again reminding all parties to the conflict, including both international and Afghan government forces, armed opposition groups, pro-government and pro-opposition militias, and national and local police units of the imperative need under international humanitarian law to protect civilians caught up in the conflict or living in conflict-affected areas.

"We are also urging all parties to ensure that the sick and wounded have safe and timely access to medical care, even in the most remote and insecure rural areas," said Reto Stocker, the head of the ICRC delegation in Afghanistan.

Medical personnel must not be prevented from carrying out their duties. Medical facilities – including clinics and health posts – must not be targeted or used for non-medical purposes. Transport used exclusively for carrying the sick and wounded to a health facility must not be unduly held up or delayed.

The year 2011 saw a marked increase in the number of rural health services that were unable to function properly owing to fighting, intimidation of staff, or closure. As a result, communities for whom such services are their only locally available source of medical care suffered. "We noted an increase in epidemics of whooping cough and measles," said Mr Stocker. "Both are highly contagious diseases, and easily preventable with routine childhood vaccinations." The first three months of 2012 have seen little improvement in the situation, and with the fighting set to intensify now that spring is here, health care is an issue of great concern to the ICRC.

Detainee welfare remains another ICRC priority. The ICRC's dialogue with both international and Afghan officials on detention issues and international humanitarian law is frank and open, focusing on ensuring humane conditions and treatment, and on the need to put in place procedural safeguards and judicial guarantees. "It is essential that strong and well recognized mechanisms be put in place to respect detainees' rights and dignity."

Dialogue also continues with the armed opposition about the fact that they, too, have an obligation under international humanitarian law to treat detainees humanely.

Visiting places of detention and restoring family links

The ICRC monitors the conditions in which people are held and the treatment they receive in places of detention worldwide. In Afghanistan, ICRC delegates regularly visit prisons run by nations contributing to the NATO-led International Security Assistance Force (ISAF), by US forces and by the Afghan authorities. The ICRC also helps family members separated by conflict to stay in touch with one another, and endeavours to trace missing persons.

From January to March, ICRC staff:

  • carried out 75 visits in 60 places of detention;
  • monitored 1,484 detainees individually and visited 528 of them for the first time;
  • paid the transport costs for 10 ex-detainees to return to their home villages;
  • collected 4,823 Red Cross messages and distributed 7,710, mostly between detainees and their families, with the help of the Afghan Red Crescent Society;
  • facilitated 1,517 video telephone calls between families and their relatives held in the US-run Parwan detention facility at Bagram airfield;
  • facilitated 841 family visits by providing transportation that enabled the families of detainees held in the Parwan facility to visit their loved ones in person.

Providing health care

The ICRC provides medicines and medical support to Sheberghan Hospital in the north and Mirwais Regional Hospital in the south, both of which are run by the Ministry of Public Health. Some 20 ICRC expatriate doctors, nurses and administrative personnel are supporting the staff at Mirwais. The ICRC also provides technical and financial support and medicines to 47 Afghan Red Crescent clinics, and to community-based first-aid volunteers who deliver health care to people in conflict-affected areas.

In the first quarter of 2012, Mirwais and Sheberghan Hospitals admitted 12,454 inpatients and held 31,445 outpatient consultations between them. A total of 3,001 surgical operations were performed in the two hospitals.

In addition, during the same period, the ICRC:

  • delivered medical supplies to the front lines to treat people injured in the fighting;
  • provided first-aid training for 566 combatants and police personnel;
  • made monthly deliveries of drugs and other items to three ICRC-run local health posts in the south and east.

Providing limb-fitting and physical rehabilitation services

The ICRC runs seven prosthetic/orthotic centres which provide rehabilitation services for amputees and others with disabilities. The centres support the social reintegration of disabled people by providing vocational training, micro-credit loans and home education. There is also a home-care service offering medical, economic and social support to paraplegics. The ICRC has been providing these services in Afghanistan for over 20 years.

From January to March, the seven ICRC centres:

  • registered nearly 1,670 new patients, including 238 amputees;
  • assisted 18,614 patients;
  • fitted almost 3,220 prostheses and orthotic devices;
  • held more than 48,650 physiotherapy sessions;
  • granted micro-credit loans to some 170 patients to help them start small business ventures;
  • provided vocational training for 246 patients, 58 of whom completed their training during this period;
  • conducted 1,635 home visits to treat patients with spinal cord injuries.

Distributing food and other aid

This remains one of the ICRC’s major activities in Afghanistan. The service comprises emergency food distribution, "food-for-work" projects and support for agriculture and livestock programmes. The ICRC provides this aid to communities displaced by conflict or natural disaster in close cooperation with the Afghan Red Crescent.

From January to March, the ICRC and the Afghan Red Crescent:

  • distributed 166 metric tonnes of wheat, 11 metric tonnes of rice, and 83 metric tonnes of beans to 1,417 participants in food-for-work projects;
  • distributed one-month food rations and household items to 20,248 families displaced by conflict or natural disaster;
  • provided oil presses and micro-credit loans for income-generating projects benefiting 1,060 families, in addition to providing farmers with seed, tools and fertilizer to help them increase almond and pistachio production.

Improving water and sanitation services

ICRC water engineers work closely with local water boards on urban and rural projects. The ICRC also promotes hygiene awareness in detention centres and madrassas, and with families in their homes.

Between January and March, the ICRC:

  • installed pipelines and drilled wells as part of an effort to bring clean water to over 84,300 people in urban areas of Herat, Nangarhar, Kandahar, and Kunduz provinces;
  • installed hand pumps and trained people to maintain them, and upgraded spring catchments as part of an effort to bring clean water to over 37,230 people in rural areas of Farah, Nangarhar, Balkh and Kunduz provinces;
  • carried out hygiene-promotion sessions for some 10,450 people in Kabul, Herat, Farah, Laghman, Jalalabad, Kunduz and Balkh (Mazar-i-Sharif);
  • helped improve water supplies and sanitary conditions for 1,619 detainees in three provincial prisons;
  • continued renovation work at Mirwais Hospital in Kandahar.

Promoting compliance with international humanitarian law

Reminding warring parties of their obligation to protect civilians is a fundamental part of the ICRC's efforts to promote compliance with international humanitarian law worldwide. The ICRC also spreads knowledge of international humanitarian law among civil-society groups, government bodies and academics.

From January to March, the ICRC:

  • gave presentations on international humanitarian law to over 770 members of the national army, the national police and local police units, armed opposition groups, and the National Directorate of Security;
  • held briefings about the mandate and work of the ICRC attended by nearly 800 people, including community elders, religious scholars, members of provincial councils, political authorities, NGOs and beneficiaries of ICRC assistance programmes.

Working in partnership with the Afghan Red Crescent Society

The ICRC provides the Afghan Red Crescent Society with technical and financial assistance to help it deliver services to the community and to implement a range of programmes.

Between January and March:

● with support from the ICRC, the Afghan Red Crescent Society distributed food, household items, seed, fertilizer and tools to thousands of families affected by conflict and natural disaster.

Afghanistan is the ICRC's biggest operation in terms of committed resources. The organization has more than 1,600 national staff and 146 expatriates based in its main delegation in Kabul and in five sub-delegations and 11 offices countrywide. In addition, it operates seven prosthetic/orthotic centres.

For further information, please contact:
Jessica Barry, ICRC Kabul, tel: +93 700 282 719
Abdul Hassib Rahimi (Dari and Pashto), ICRC Kabul, tel: +93 700 276 465
Christian Cardon, ICRC Geneva, tel: +41 22 730 36 26 or +41 79 251 93 02


Paediatric unit, Mirwais Hospital, Kandahar, Afghanistan 

Paediatric unit, Mirwais Hospital, Kandahar, Afghanistan. Zulmia with her eight year old son Mohammed, who is in a coma after contracting meningitis due to an untreated infection. The conflict is depriving most children in the provinces of Helmand and Kandahar of simple vaccines, making them vulnerable to avoidable diseases.
© ICRC / K. Holt / v-p-af-e-01651

ICRC physical rehabilitation centre, Kabul. Karima, a physiotherapist, treats a child born with a club foot. 

ICRC physical rehabilitation centre, Kabul. Karima, a physiotherapist, treats a child born with a club foot.
© ICRC / J. Barry

Intensive care unit, Mirwais Hospital, Kandahar, Afghanistan. An ICRC nurse looks after a patient who was badly injured in a bomb explosion. 

Intensive care unit, Mirwais Hospital, Kandahar, Afghanistan. An ICRC nurse looks after a patient who was badly injured in a bomb explosion.
© ICRC / K. Holt / v-p-af-e-01642

Maternity ward, Mirwais Hospital, Kandahar, Afghanistan. 

Maternity ward, Mirwais Hospital, Kandahar, Afghanistan.
© ICRC / K. Holt / v-p-af-e-01704

Afghanistan. Detainees' bedding and clothes are packed into large bags and taken out into the prison courtyard before the cells are cleaned to rid them of scabies mites. Books and personal possessions are packed separately and stored safely. 

Afghanistan. Detainees' bedding and clothes are packed into large bags and taken out into the prison courtyard before the cells are cleaned to rid them of scabies mites. Books and personal possessions are packed separately and stored safely.
© ICRC / J. Barry

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