International Medical Corps has worked in Afghanistan since 1984, supporting and rebuilding the health infrastructure of a country that has seen decades of conflict and instability.
Today, Afghans have one of the lowest life expectancies (44 years) and highest infant mortality rates (over 150 deaths per thousand live births) in the world. One of every four Afghan children dies before their first birthday. Continued armed conflict makes security a constant dilemma for Afghan civilians, who find it difficult to obtain basic services when much of the country is inaccessible to international assistance agencies. About three-quarters of the population have no access to clean drinking water.
Since 2004, International Medical Corps has supported five rounds of Community Midwifery Education (CME) in Khost province, training 30 new community midwives each year. These new graduates are then deployed to health facilities throughout the province to provide maternal-child health services. International Medical Corps began training a new batch of 30 midwives in March 2011, who will be trained for two years according to the extended curriculum recommended by the Afghan Midwives Association (AMA) and approved by the Afghan Ministry of Public Health.
We recognise that the obstacles for trainee midwives in Afghanistan do not end in getting accepted onto a training programme.
International Medical Corps is also supporting a newly established CME programme in Paktika province, through which we provide 25-30 midwifery trainees with classroom and practical trainings under the AMA’s extended two-year curriculum. Due to security concerns, many of the CME trainees live in a hostel renovated by International Medical Corps. We also supply all of the training materials and equipment for the programme, including furniture, text books, computers, internet, stationery, meals, transportation and even lab coats.
We have helped hospital staff to develop effective administration systems, expand the use of information technology and modernise records systems. International Medical Corps has also sought ways for the hospital to achieve greater efficiency in the use of medical supplies and equipment, and establish effective quality control mechanisms. As part of our three-year programme at WAK Hospital, International Medical Corps has developed a training plan for all departments in the hospital.
In the remote and mountainous Paktika Province, bordering volatile Pakistani tribal areas, International Medical Corps overcomes difficult security conditions to implement our second hospital management programme. We operate at the main provincial hospital in the town of Sharan, in addition to smaller facilities elsewhere in the province that include district hospitals in Urgon and Khirkot and a chain of 20 comprehensive and basic healthcare centres. Collectively, these medical facilities serve a target population of approximately 400,000 and treat about 20% of the population each month.
International Medical Corps supports the administrative and clinical teams at the facilities in order to build their capacity and resources to better manage their large caseloads. By improving the infrastructure and structural safety of the main mental health facility, hospital staff will be able to increase the number of outpatient services and outreach programmes into the community.
We are also working closely with the Ministry of Public Health and the Ministry of Higher Education to improve how psychiatry is taught in Afghanistan.
These projects are funded by the European Union
We deliver services through two district hospitals and 15 smaller facilities located around the province. These services focus on seven high-impact areas of primary care: maternal and newborn health, including reproductive health and family planning; child health and immunisation; prevention and referrals for acute malnutrition; treatment and control of communicable diseases; mental health; physical disability; and provision of essential drugs to all health facilities where we work.
International Medical Corps integrates nutritional services into all of our primary and secondary health facilities in Afghanistan, in order to tackle the alarmingly high rates of under-nutrition. By building the capacity of health care workers and caregivers, we help raise awareness of the causes of acute malnutrition and its consequences for early childhood development. These local health workers are then able to take appropriate action when they see patients showing symptom of under-nutrition.
Since 2009, International Medical Corps has included a focus on the prevention of gender-based violence (GBV) and care for GBV survivors in our refugee and returnee community health care programmes. Our behavioural change programme, targeting both male and female community members, aims to increase the awareness and skills of health care providers and other community leaders to respond to GBV. The first of its kind in Afghanistan, our GBV programme provides discreet counselling and care for at-risk women and their families, as well as support services for men and women. We also spread awareness about GBV and the rights of women and girls among decision makers and influential leaders at the community, district and provincial levels.
International Medical Corps UK recognises the invaluable support of the following European donors to make our work possible.
Just 22 hours after the devastating 7.0-earthquake hit in January 2010, International Medical Corps’ Emergency Response Team was on the ground in Haiti providing medical care to survivors. Our doctors and nurses were able to mobilise on an unparalleled scale to provide 24-hour emergency care to the acutely injured at the Hôpital de l’Université d’État d’Haiti (HUEH), a 700-bed hospital in Port-au-Prince. HUEH was badly damaged in the earthquake and many local health care professionals were missing. We were able to save thousands of lives through emergency and trauma care in the critical days following the earthquake.
At the height of emergency operations at the hospital, International Medical Corps treated approximately 1,000 patients per day. Our early entry also gave us the foundation to rapidly expand our operations to 15 mobile clinics throughout Haiti to provide critical services. Through the hospital and mobile and fixed clinics, International Medical Corps teams provided more than 110,000 patient consultations during the first year following the emergency.
When reports of acute diarrhoea emerged from the north of Haiti in October 2010, International Medical Corps doctors and nurses immediately deployed to the region providing emergency relief for the growing cholera crisis. Our network of rapidly constructed cholera treatment centres, supported by 820 community health volunteers to educate communities on how to prevent and identify cholera, meant that more than 30,000 cholera patients received life-saving treatment within the first year following the outbreak.
International Medical Corps was among the first organisations to enter Libya once the conflict began in February 2011, providing emergency medical care to casualties from the fighting and support to hospitals with medical staff and supplies. Among the first challenges our Emergency Response Teams encountered was a chronic shortage of nurses, as thousands of foreign nurses had fled the country. In partnership with the Jordan Health Aid Society, International Medical Corps immediately deployed volunteer nurses to health centres across eastern Libya moving them to towns and cities throughout the country as access permitted. Volunteer nurses trained the local counterparts while working alongside them.
At the country’s borders and within Libya, we supplied those displaced by the fighting with essential relief items, including blankets, bottled water and food. Recognising the danger posed by communicable diseases, our sanitation and hygiene specialists constructed latrines and washing stations in transit camps along the Tunisia borders.
As the fighting went on International Medical Corps worked as close to the front line as possible, providing emergency treatment to those injured in the conflict, and medicines and supplies to besieged towns and cities. In Misurata, inaccessible by road, we evacuated nearly 500 injured civilians by boat. International Medical Corps’ mobile field hospitals treated the wounded from battles in Tripoli, the Western Mountains, Bani Walid, Sabha, Jufrah and Qaddafi’s hometown of Sirte.
International Medical Corps mobilized an emergency response in Mali in January 2013 after rebel armed forces from the north began moving south, triggering French military intervention. In Timbuktu, which had spent months under the control of armed Islamist rebel our team were amongst the first international organisations to arrive and found pillaged clinics, missing medical personnel and damaged health infrastructure.
We immediately began supporting eight strategically targeted health clinics in remote areas around Timbuktu, where the Malian Ministry of Health has been unable to maintain adequate services to local communities. By providing medicines, training staff and recruiting qualified doctors and nurses, we can ensure local people will now have access to basic primary and secondary health care for the first time in months
True to our mission to build self reliance, International Medical Corps is also already training community health workers to go out to local markets and spread essential hygiene, reproductive health and nutrition messages. We are also working to rehabilitate clinics damaged during the conflict, by building or repairing latrines, water systems, solar panel systems and other infrastructure repairs, enabling health workers to have stable and well-equipped facilities to help the people of Mali.
Basanti, a young mother of two in Nepal, returned home from fetching water for her family to find her 8-month old son Bishal had fallen into the open cooking fire. Basanti was in shock, but she wrapped her baby in blankets and ran for help. No one in their village or at the local health post knew what to do so she had to travel more than six hours by bus to seek emergency care at the closest hospital. The district hospital could only stabilize Bishal and wasn’t able to treat his wounds properly. As a result, his little fingers contracted into a fist as the burned skin contracted and “healed” over the coming year, making it impossible for him to use his hand. His cheek, lips and eyelid also contracted and tightened, threatening his vision.
After selling part of their farm to pay for transportation to Kathmandu, Basanti sought further treatment for her baby. However, two hospitals in the nation’s capital could not help either. Adding to Basanti’s struggles, her husband abandoned the family, leaving her alone to care for Bishal and his four-year-old sister.
Thankfully, Basanti heard about the surgical care available through ReSurge International, our trusted partner with a 43-year history of serving burn victims. Dr. Rai, ReSurge’s Outreach Director in Nepal, and his team restored Bishal’s eyelid and his hand will soon be surgically repaired as well.
Even though it took more than a year for him to get appropriate treatment, Bishal is one of the lucky ones. Thousands of children never get the care they need to live a normal life after a disabling burn.