Afghanistan: Asia's next coronavirus epicentre?

Afghanistan: Asia's next coronavirus epicentre?
With tens of thousands of new arrivals from neighbouring Iran, which has recorded over 1800 deaths, Afghanistan's war-weary healthcare system could collapse.
4 min read
25 March, 2020
A volunteer in a hazmat suit spraying disinfectant on vehicles in Kabul [Getty]
Afghanistan is sinking into a seemingly inescapable political quagmire.

Earlier this month, two rival politicians declared victory in presidential elections, carrying out parallel inauguration ceremonies.

With the prospect of building a team to represent the government in upcoming negotiations with the Taliban dwindling, the US has been again forced to intervene, as it has done in three out of four previous Afghan elections.

This time however, Secretary of State Mike Pompeo meted out a uniquely scathing punishment: a $1 billion cut in funding.

Not only is this a heavy blow to basic government spending, but the Afghan national forces will now be unable to sustain their fight against the Taliban beyond six months, according to statements by Ashraf Ghani - one of the country’s two leaders.

However, there is now an altogether different foe - yet one equally formidable - knocking on the country’s western border.

On Tuesday, Ferozuddin Feroz, the country's health minister, warned that half of the population – a staggering 16 million people – were at risk of developing a COVID-19 infection. Citing a WHO estimate, he said that 100,000 could die.

While the minister’s stark warning is at odds with the current statistics - no more than 80 cases and two deaths have been recorded in the country - the fears reflect an all-too-palpable reality in a country which neighbours the Middle Eastern epicentre of the virus - Iran.

Crippling US sanction are said to have damaged the Iranian healthcare system.

Yet even still, the difficult situation pales in comparision to what may unravel in Afghanistan.

Iran boasts more than 10 doctors per 100,000 people.

That figure is less than a third for Afghanistan, whose healthcare system is a casualty of a decades-long conflict.

Per capita health spending in Iran is estimated at over $1,000, according to 2014 WHO statistics - possible reason, perhaps, for why a health ministry spokesman in the Islamic Republic lauded the country’s self-sufficiency after an MSF team was expelled on Tuesday.

Read more: Iran refuses coronavirus help from ‘foreign’ MSF

In comparison, per capita healthcare spending in Afghanistan hovers around $150.

Herat, where the UN estimates tens of thousands of people have arrived from neighbouring Iran in recent weeks, is where 54 of Afghanistan's 75 COVID-19 cases are found.

Despite calls for a total shutdown, authorities have taken to implement a partial lockdown in its fight against the pandemic.

Religious leaders in the conservative province have refused to heed global Muslim calls to allow citizens to be distanced from their mosques, where tightly-packed congregations provide ripe conditions for the spread of the virus.

While local government have scrambled to construct a 100-bed hospital, a blind eye has been turned to the tens of thousands of Iranian arrivals who have returned to their homes beyond Herat.

The disease has now reached 11 provinces, including those in the country’s south, east and north.

Mitigating this spread is compounded by virtually non-existent tracing mechanisms.

Stefani Glinksi, last month, noted only three devices in the entire country capable of diagnosing the novel coronavirus, all located in a single laboratory in Kabul.

Ali Latifi, a freelance journalist in Kabul, told The New Arab that while doctors have masks and gloves, crucial supplies are still under strain.

Some hospitals in the country are forced to ration hand sanitiser among patients, while others lack clean running water altogether.

An ever more pressing concern is how potential outbreaks would be managed in rural populations, outside the realm of government control.

In areas controlled by the Taliban, the militant group have said they are willing to cooperate with international healthcare workers, openly admitting they lack adequate facilities or personnel to deal with a possible crisis.

Yet even in the major cities, a deep sense of mistrust pervades public sentiment towards leaders and their lax attitude to their new, emerging enemy.

Grassroots efforts to spread public health awareness have taken hold in some places, with citizen's groups handing out flyers in the capital, according to Latifi.

In the event of sudden surge in cases, locals have expressed fear for the devastating impact a shutdown of commercial centres could have on their livelihoods.

In the capital, a decline in upmarket, hygiene-weary customers have meant local business owners are already feeling the crunch.

A local waitress in a shisha bar in Kabul describing 4.500 afghanis ($60) of daily revenue offset by daily expenses of 15,000 afghanis ($197).

Yet the informal economy, where the crumbly Afghani banknote reigns supreme, remains a principal source of sustenance among the country's population, 54.6 percent of which live below the poverty line.

With American aid slowly sucked out, for the masses of workers there would be simply nothing to fall back on.

According to Tolo News, the Ministry of Economy on Tuesday warned that a COVID-19 outbreak would harm Afghanistan ''more than other countries in the region or the world''

Kamal Afzali is a journalist at The New Arab

Follow him on Twitter at @KNIAfzali

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