KABUL, Afghanistan (AP) — The diesel fuel needed to produce oxygen for coronavirus patients has run out. There are no more supplies of essential medications. The unpaid staff still show up to work every month, even though they struggle to survive at home.

These are the conditions at the Afghan Japan Hospital for Communicable Diseases. It is the only COVID-19-certified facility that serves the 4 million Afghan-Japan residents. The coronavirus situation has improved in Afghanistan since the peak of cases a few months back, but it’s the hospital that is most at risk.

Its predicament is a symptom of the crisis in Afghanistan’s health care system, which is on the brink of collapse and able to function only with a lifeline from aid organizations.

“We face many problems here,” said Dr. Ahmad Fatah Habibyar, the hospital’s administration logistics manager, citing three months of unpaid salaries, shortages of equipment and drugs, and a lack of food.

He stated that staff members are sometimes in severe financial difficulty and have to sell their personal furniture.

“Oxygen is a big issue for us because we can’t run the generators,” he said, noting the hospital’s production plant hasn’t worked for months “because we can’t afford the diesel.” Instead, oxygen cylinders for COVID-19 patients are bought from a local supplier.

The omicron variant is feared to cause more infections, so doctors have begun to prepare for them.

Without outside help, “we are not ready for omicron. A disaster will be here,” said Dr. Shereen Agha, the 38-year-old head of the hospital’s intensive care unit. According to him, the hospital ran out of even basic supplies, such as exam gloves. The two ambulances that were there are still without fuel.

An Afghan nurse provides care for a baby at Malalai Maternity in Kabul.
Petros Giannakouris via Associated Press

HealthNet TPO is a Netherlands-based aid agency that had been contracted by the government to manage the hospital. However, the contract ended in November. The hospital was funded through a World Bank fund. Like most international communities, it has also frozen all payments to the Taliban government.

HealthNet TPO program manager Willem Reussing said the organization is in negotiations to secure funding, “but the donor community is very reluctant to continue support and has strict conditions.” The World Health Organization and UNICEF were only managing to maintain minimal services and did not cover the coronavirus response, he added.

“The health care system … is really on the brink of collapsing,” Reussing said. “The Afghan-Japan Hospital is a dire example, where we are nearly begging donors to step in and save lives.”

When the Taliban took control of Afghanistan in August amid a chaotic U.S. and NATO troop withdrawal, the international community pulled all funding and froze billions of dollars of Afghanistan’s assets abroad. These were terrible consequences for Afghanistan, which is heavily dependent on international aid.

With state workers often being unpaid, the economy was already in deep trouble under the prior government. The situation was made worse by the recent pandemic, which saw nearly half the population living in poverty.

The Taliban government wants the international community to ease sanctions and release Afghanistan’s assets abroad so it can pay civil servants, including doctors and teachers.

A woman holds her child while sitting on the floor of the emergency ward of the Indira Gandhi Children's Hospital in Kabul.
While sitting in the Indira Gandhi Children’s Hospital, Kabul, a woman holds her baby.
Petros Giannakouris via Associated Press

The United Nations has sounded the alarm over a hunger crisis, with 22% of Afghanistan’s 38 million people near famine and another 36% facing acute food insecurity.

“We’re seeing the economic collapse being exponential,” U.N. humanitarian chief Martin Griffiths said in an interview last week with The Associated Press. “It’s getting more and more dire by the week.”

Nowhere is that more evident than the malnutrition ward of the Indira Gandhi Children’s Hospital, where anxious mothers sit by emaciated children.

Mohammad aged two, with sunken cheeks and sparse hair, sipped from a cup of milk high in nutrients. Parwana, Mohammad’s mother, was beside him. Her mother, Parwana, was from the central Wardak province and had been staying in the hospital for six night.

“I don’t even have money to change his diapers,” the 20-year-old said. She lost her husband, who is a tailor and now has problems sitting up. Parwana stated that her brother and father are helping to support the three-person family.

In the next bed, 1½-year-old Talwasa lay covered in blankets. Her eyes were closed half the time.

“We are in a very bad situation,” said her mother, Noor Bibi, who has six other children. Her husband can’t find work, she said, and “we only eat dried bread and can’t find food for weeks and weeks.”

Dr. Abdul Bari Omar, Deputy Health Minister, stated last week that Afghanistan has 3.5 million malnourished kids. However, he pointed out that this data came from the former government.

“It didn’t happen in the last four months. Malnutrition was inherited from the previous system, but we are trying to find a solution for this problem,” he said, adding that the former administration also had failed to resolve shortages of medical equipment.

The deputy director of the children’s hospital, Mohammad Latif Baher, said the facility had seen 3,000 malnutrition cases in the last four months. 253 of those were admitted to hospital, while 250 others were managed at home.

The shortage of hospital workers is also a problem. They haven’t received their salaries in several months.

“We are loyal to our homeland and our profession. That’s why we still continue our jobs and provide services to our patients,” Baher said, noting they have gone without salaries for five months. The hospital has also run out of drugs, such as special food supplements, analgesics, and anesthetics. Some aid agency supplies had been brought in, he said, but there was still more.

Wazir Muhammad Akhbar Khan national hospital was experiencing a similar situation, with supplies running out. Patients must purchase their own medication, as with all state-run hospitals. The staff can only access emergency supplies to those truly in need.

Sometimes doctors are forced to give smaller doses of drugs because they simply don’t have enough, said Ghulam Nabi Pahlawi, the emergency department’s head nurse.

But it is in Kabul’s COVID-19 hospital where the situation seems most severe. Bilal Ahmad, a pharmacist said that more than 36 of the most important medications were out of stock and others have expired. Another 55 prescriptions will be out of stock in the next three months according to him.

“The requirements, we cannot fulfill them,” Ahmad said.

Source: HuffPost.com.

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