Gulf Times, January 10, 2010
Afghanistan’s neglected casualties of war
“Afghanistan today is without doubt the most dangerous place to be born.”
By Cesar Chelala/New York
A Unicef-supported study found that the majority of children under 16 years in Kabul suffer from psychological trauma. Children in Afghanistan are exposed not only to violence related to acts of war but also to violence resulting from accidents, beatings by close relatives or neighbors or seeing close relatives being beaten or executed.
The year 2009 has been the deadliest for Afghan children since 2001, according to the Afghanistan Rights Monitor, a Kabul-based human rights group. From January to December 2009, about 1,050 children died in suicide attacks, roadside blats, air strikes and in the cross-fire between Taliban insurgents and pro-government Afghan and foreign forces, states ARM.
Today in Afghanistan more than one in five children dies before the age of five, often of a preventable cause. Many children who survive birth then die because mothers stop breastfeeding them too soon. Traditionally, the women are not allowed to decide when to start or to stop breastfeeding or how to give supplementary food. Usually, that decision is reserved for the elders of the family, generally men.
More than 60% of all child deaths and disabilities are due to respiratory and intestinal infections, and of such vaccine preventable deaths as measles. Widespread malnutrition acutely affects children’s growth. It is estimated that 7.5mn children and adults are presently at risk of hunger and malnutrition.
“Afghanistan has the highest infant mortality rate in the world,” states Catherine Mbengue, Unicef’s country representative. Other indicators are equally appalling, such as 70% of the population lacking potable water. Diarrhoea in particular kills tens of thousands of children every year and is, in Afghanistan, a particularly serious health risk.
Some cities, such as Jalalabad, the largest city in eastern Afghanistan located at the junction of the Kabul and Kunar rivers, are high risk areas for polio. This is due to some high risk factors for the disease such as massive and continuous population movements from and into polio infected areas, a large presence of Afghan refugees from Pakistan and a high population density. In South Asia in 2000, over 40% of the confirmed cases of polio occurred in Pakistan and Afghanistan.
To control the spread of the disease, Unicef and the Department of Public Health in Nangarhar have launched the “Women Courtyard” initiative, aimed at giving local women an understanding of polio and other vaccine-preventable diseases as well as such related issues such as hygiene and water-borne illnesses.
Although this is an important initiative some popular traditions still constitute an impediment to carrying it successfully. One such tradition is that babies shouldn’t be taken to the front door before their 40th day after birth, which prevents many newborns from being vaccinated.
Afghanistan is one of the most heavily mined nations in the world. It also has one the highest proportions of disabled people, due in large part to the landmines placed extensively throughout the country. Children are landmines’ most vulnerable victims, since they can be affected while playing, going to school, tending animals or scavenging.
To make matters worse, deadly attacks have targeted schools and impeded access to critical health care, according to Unicef. “We have had attacks on villages and on schools by both anti-government elements as well as by coalition forces and international troops that have hit civilians,” stated recently Daniel Toole, Unicef’s South Asia Director.
None of the children growing up today in Afghanistan has known peace in his lifetime. Children’s deteriorated mental health is one of the consequences of a permanent state of war in the country. A Unicef-supported study found that the majority of children under 16 years in Kabul suffer from psychological trauma.
Exposure to traumatic events has been shown to be associated with serious mental health problems. In this regard, the experience of five or more traumatic events substantially increases the risk of psychiatric disorders and post-traumatic stress syndrome. Children in Afghanistan are exposed not only to violence related to acts of war but also to violence resulting from accidents, beatings by close relatives or neighbors or seeing close relatives being beaten or executed. As a study in the Lancet points out, “In Afghan children’s lives, everyday violence matters just as much as militarised violence in the recollection of traumatic experiences.”
At a news briefing in Geneva, Daniel Toole remarked, “Afghanistan today is without doubt the most dangerous place to be born.” This may also be one of the saddest statements about that besieged country.
Dr Cesar Chelala is an international public health consultant. He is the foreign correspondent for the Middle East Times International (Australia).
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