AAEM/RSA INTERNATIONAL COMMITTEE
International Health Pearl – Taliban Afghanistan Crisis
Jasmin Custodio, MS, Tracie Dang, MS4, Ava Omidvar, MS3 MPH FP-C, and Matt Carvey, MD EMT-P FP-C
I
nternational Health Pearls, a new project by the AAEM/RSA International Committee, introduces and highlights the ongoing foci in global health, while simultaneously raising awareness for certain international crises that may impact health care from a universal perspective.
Who are the Taliban? Predominantly Pashtun, the Taliban, are an Islamic fundamentalist group that returned to power in Afghanistan in 2021 after waging a 20-year insurgency.1 The Taliban’s lead council, the Rahbari Shura, makes all decisions regarding political and military affairs of the Emirate.1
What is the Taliban’s role in Afghanistan? Soviet influences left Afghanistan in 1992, giving rise to the Taliban’s rule and promising a restoration of order.2 In 1997, the Taliban gained control over most of the country and imposed their rule, which ultimately restricted women’s rights.2 After September 11, 2001, a US-led military invasion targeted the Taliban and Al-Qaida, forcing the Taliban to retreat and relinquish their grip over Afghanistan.2 In 2006, US and NATO forces supported Afghani defenses against the Taliban as they started to re-emerge.2 During May of 2021, the Taliban began usurping power over vast areas and by August, they seized control of key cities and provinces. This rise led to a seize on the capital, ultimately falling under Taliban control.2
What does their battle look like now? Taliban officials insisted they only aim to implement an "Islamic government" and will not pose a threat to any other country.3 Many are concerned for women's uncertain future in their freedom to work, gain an education, dress as they choose, access health care, or leave their home without a chaperone.3 Women’s rights within the country have already been curtailed since the Taliban came into power in August. North American and European countries also fear the country would once again become a training ground for terrorism.3,4
What are the health concerns? Due to restrictions placed on women during Taliban rule, Afghanistan faces an increased risk of overall decline in women’s health. Restrictions to women’s lives allowed only female health workers to examine them, limiting their access to quality health services. Women are more reluctant to seek health care, driving more women to give birth at home without prenatal or reproductive care. As a country with one of the highest rates of maternal deaths in the world, Afghanistan currently has 638 deaths per 100,000 live births and the number is more likely to increase with current circumstances.4 Political unrest and a growing humanitarian crisis in Afghanistan pose a major threat to the country’s crumbling health care system. With reduced numbers of health care workers, minimal personal protective equipment, hospital closures, low COVID testing and vaccination rates, and rising COVID cases, Afghanistan faces great danger in terms of fighting COVID.5 Increased risk of polio and measles outbreaks are also worrisome, as both are endemic to Afghanistan.6
What is being done now? The UN stated it is releasing $45 million from the Central Emergency Response Fund to “help prevent Afghanistan’s health care system from collapsing.”6 The UN set goals for 2030 which include reducing global maternal mortality to <70 deaths per 100,000 live births.4 The UN and the Taliban have both agreed to campaign for increased measles and COVID vaccinations, as well as polio eradication to prevent future outbreaks of preventable diseases.7
Impacts on health care in the region. Many international donors suspended aid to Afghanistan, which decreased financial support to humanitarian projects in a country that is heavily dependent on international aid and funding. Reduced donations to Afghanistan’s largest health project, Sehatmandi, left health facilities without medications, medical supplies, fuel, and salaries for medical workers.6 As a result, health care access in Afghanistan is even more limited with fewer resources.
Afghan refugees and the impact on US health care. Primary care clinicians are now faced with diseases afflicting the refugees that are uncommon in the US, such as TB, leishmaniosis, malaria, polio, and measles.8 Of the refugees who arrived in the US, 40% are children with an increased risk of malnutrition. With the relocation of many Afghani families, these diseases are introduced in non-endemic areas around the country, including areas with less access to health care.9 This introduction of people and pathogens requires further monitoring.
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