Residents in one of the most remote and deprived districts of Helmand during the 20 years of the US-led war continue to suffer from a desperate lack of resources, especially in health care.
With only two female employees in health center of Musa Qala district, women are paying a particularly high price with many of them and their newborns dying in childbirth.
Residents say that at the time other provinces were receiving construction projects and health improvements, Musa Qala was overlooked due to its high level of insecurity and fighting, complicating any efforts at reconstruction and investment.
Musa Qala is 130 kilometres from the provincial capital of Helmand, Lashkargah, with the road being over 60 percent dirt, making it more difficult to transfer patients in need of urgent medical care.
Akhtar Mohammad, 33, is a taxi driver between Musa Qala and Lashkargah who has seen his clients die on route many times. “There are no female doctors in our area,” he tells Rukhshana Media. “We take most of the patients by car from the district to Lashkargah city or Kandahar city. Many of the patients, both women and children, die on the way.”
He says part of the problem is how slowly he has to drive due to the poor quality roads. “Because the car cannot go fast, most of the patients die,” he adds. “If the road was good, the car could go faster and less people would die.”
Akhtar Mohammad’s recalls a 30-year-old woman who died in immense pain in his car due to appendicitis. “It was around two o’clock in the morning when a person from the Nawi Dasht village came to me after a lot of hassle. She was in a great hurry. She said that she was sick and we should take her to Lashkargah city as soon as possible. After a short discussion about the car rental of 16,000 Pakistani rupees, (US $55) we left without wasting time. The patient was a 30 to 35-year-old woman who had appendicitis. But her condition was getting worse each moment and on the way, before reaching Grishk district of Helmand, her appendix burst. We took her to Grishk, but the doctors said that she has died.”
Abdul Saboor, 27, a resident of Sufian area in Musa Qala tells Rukhshana Media that the district only has one health center with two female employees. According to National Statistics and Information Authority (NSIA), the district has a population of about 126 thousand people.
“Our district is large, but there is only one clinic in the center of the district,” he says. “Its equipment and facilities are very small and not enough for our women, children and patients.”
“When a child is born, we bring a 60-year-old white-haired lady from another village to our village. She plays an important role in the delivery of our babies.”
Abdul Saboor says the lack of investment in the area reaches even further in Sufian, impacting telecommunications and schools. Telecommunication networks do not work properly in Sufian’s three villages, with its 800 residents resorting to traditional methods of communication with other areas of the district. If someone travels from Sufian village to the center of the district, they must inform the driver of the vehicle one day in advance. And as there are no schools in the Sufian area, children learn to read by being taught the basic Arabic alphabets and Holy Qur’an in the mosque with Mullah Imam.
Abdul Saboor retells the tragedy of one of his relatives who died before reaching the medical center in Lashkargah last year. “A 30-year-old woman from our family, who was giving birth to a child, had severe pain in the middle of the night. We woke up and sent someone on a motorcycle to look for the driver. After about 30 to 40 minutes, the car finally came. We were on the way to Musa Qala district center but the patient died about 15 minutes before reaching the clinic,” he says.
The young woman left behind three children – two sons and a daughter.
Before the Taliban takeover of Afghanistan in 2021, Helmand province was the site of heavy and continuous warfare more than most other regions of the country. Musa Qala is one of the largest districts in the north of Helmand, and was where some of the fiercest fighting between the foreign armies, the Afghan national security forces, and the Taliban took place. There was rarely a long lull in the war, and there is no sign of the reconstruction efforts or facilities other districts received. Many other districts of Helmand faced similar challenges, with residents of Sangin, Nawmish, and Marjah districts also deprived of access to health services due to lack of investment.
Abdullah Hamkar, 32, is in charge of the health department of the Musa Qala district. He says the services are poorly equipped and insufficiently staffed. But he says its not enough just to build more clinics. “There are problems in the health sector. We confirm we need other clinics. But we also need more schools and madrasas and roads. The most basic problem of our district is that we cannot get the patient to the center of the province [to improved medical facilities] on time. Because of this, most of the time patients die on the way.”
Even though fighting has now ceased in Musa Qala, there is little hope that the services and health care in the district will improve for some time. Johanniter International Assistance, a Germany-based NGO, says that with the Taliban taking full control of the country, Afghanistan’s health system has returned to the situation it was in 20 years ago due to the cessation of international development aid and economic isolation.
Médecins Sans Frontières says that Afghans are deprived of health services due to poverty, Taliban restrictions and a dysfunctional system.
