2023-05-15 09:44:59
Tayabullah, three months old, is quiet and immobile. His mother, Nigar, removes the oxygen tube from his nose and places a finger under her nostrils to check if she is breathing.
She begins to cry when she realizes that her son is fading away.
In this hospital in Afghanistan, there is not a single working fan.
The mothers are holding oxygen tubes close to their babies’ noses because there are no special masks for them and they are trying to do what the medical team would do.
Every day, 167 children die in Afghanistan. due to preventable diseases, according to the United Nations Children’s Fund (Unicef).
The number is staggering, but it is only an estimate.
And following this BBC investigation, for which a team of journalists entered the pediatric ward of the main hospital in the western province of Ghor, the question remains whether the estimate is low.
Overcrowded and Overwhelmed
Several rooms in the health center are full of sick children. There are at least two little ones for every bed, their little bodies ravaged by pneumonia, and just two nurses caring for 60 patients.
In one room, the BBC saw at least two dozen babies who appeared to be in serious condition. The children should have been continuously monitored in intensive care, something impossible in this hospital.
However, for the million people who live in Ghor, this facility remains the best-equipped public hospital they can access.
Public healthcare in Afghanistan has never been adequate, and the foreign money that has financed it almost entirely for the past two decades was frozen in August 2021, when the Taliban retook power. Over the past 20 months, a BBC team has visited hospitals and clinics across the country and witnessed their collapse.
The Taliban’s recent ban on women working for non-governmental and charitable organizations makes operations for humanitarian agencies increasingly difficult, putting more children and babies at risk.
an unequal battle
Defeated by the lack of resources, the doctors at Ghor hospital used what little they had to try to revive Tayabullah.
Doctor Ahmad Samadi checked the baby’s condition, fatigue and stress were visible on his face. The doctor put his stethoscope on Tayabullah’s chest and checked that her heart was still beating weakly.
Nurse Edima Sultani ran in with an oxygen pump. She put a mask over Tayabullah’s mouth and blew air into it. Then Dr. Samadi used his thumbs to perform chest compressions on the child.
Looking on with a stricken look was Tayabullah’s grandfather, Ghawsaddin. The old man said that his granddaughter suffered from pneumonia and malnutrition.
“it took us eight hours traversing the rubble-strewn roads to bring it here from Charsadda, our district,” Ghawsaddin said. The family, who can only afford to eat dry bread for meals, raised money to pay for the trip.
Efforts to revive her child continued for half an hour. Nurse Sultani then turned to Nigar and told her that Tayabullah had died.
The sudden silence that had enveloped the room was broken by Nigar’s sobs. Her baby was wrapped in a blanket and handed over to Ghawsaddin. The family took him home.
Tayabullah should be alive: all the diseases I had were curable.
“I am also a mother and when I saw the baby die, I felt that I had lost my own son. When I saw his mother crying, my heart broke. My conscience hurt,” said the nurse, who often works 24-hour shifts. hours.
“We do not have equipment and there is a lack of trained personnel, especially female staff. When we are caring for so many in serious conditions, which child should we check on first? We can’t do anything but watch babies die,” she lamented.
little hope
Minutes later, in the next room, we saw another girl in serious condition, with an oxygen mask on her face, struggling to breathe.
Two-year-old Gulbadan was born with a heart defect, a condition called patent ductus arteriosus. She was diagnosed six months ago at this hospital.
The doctors explained that the condition is not rare or difficult to treat. However, the center is not equipped to perform the routine surgery that might fix it or You also don’t have the medicines you need.
The girl’s grandmother, Afwa Gul, held the little girl’s arms to try to stop her from pulling down her mask.
“We borrowed money to take her to Kabul, but we mightn’t afford the surgeryso we had to bring her back,” he said.
The woman reported that they approached an NGO to obtain financial help, but have received no response.
Gulbadan’s father, Nawroze, stroked her forehead, trying to calm his daughter, who was shivering with each breath she took.
Stress is etched on the face of Hungry, who recounted that Gulbadan had recently started speaking, forming his first words, calling out to him and other family members.
“I am a worker, but I do not have a stable income. If she had money, she would never have suffered like this.. Right now, I can’t even afford to buy a cup of tea,” she admitted.
Dr Samadi was asked how much oxygen Gulbadan needs.
“Two liters every minute. When this cylinder is emptied, if we don’t find another one, it will die.“, he sentenced.
Returning hours later to check on Gulbadan, we were told that the terrible prophecy had come true: the oxygen cylinder had run out and she died.
The hospital’s oxygen production unit cannot produce enough oxygen because you only have power at night and there is no constant supply of raw material.
In a matter of a few hours, two children died from diseases that might have been prevented or cured. It’s a crushing blow but all too familiar to Dr. Samadi and his colleagues.
“I feel exhausted and agony. Every day we lose one or two beloved children of Ghor. We’ve almost gotten used to it now,” he admitted.
Walking through the rooms, we saw an overwhelming number of children in distress. One-year-old Sajad’s breathing was rough. He is suffering from pneumonia and meningitis.
In another bed is Irfan. When his breathing became more labored, his mother Zia-rah was given another oxygen tube to hold near her nose.
Wiping the tears that rolled down her cheeks with the upper part of her arm, the woman carefully held both pipes as steady as she might. Her mother said that she would have taken Irfan to the hospital at least four or five days earlier if the roads had not been blocked by snow.
Many simply cannot make it to the hospital, and others choose not to stay once they get there.
“Ten days ago a child was brought here in a very critical condition,” said nurse Sultani. “We gave him an injection, but we didn’t have the medicines to cure him and then his father decided to take him to his house: ‘If you have to die, die at home’“.
justified doubts
The sight in Ghor raises serious questions regarding why public health care in Afghanistan is crumbling so fast, when the international community invested billions of dollars in it over 20 years until 2021.
¿What was that money spent on?if a provincial hospital does not have a single ventilator for its patients?
There is currently an interim agreement in force. Because the money cannot be given directly to the internationally unrecognized Taliban government, aid agencies finance the salaries of medical personnel and the cost of medicine and food to keep hospitals like the one in Ghor.
Funding, already highly inefficient, might also be at risk. The agencies warn that their donors might make cuts in opposition to the restrictions that the Taliban have imposed on women, including the ban on Afghans working for the UN and NGOs.
Until now, Afghanistan has only received 5% of the funds requested by the UN.
Near the hospital in Ghor there is a cemetery. There are no records here, not even a caretaker. So it’s not possible to find out who the graves belong to, but it’s easy to distinguish the big graves from the small ones.
A tour revealed that at least half of the new graves belong to children. A man who lives in a nearby house also said that most of those who are burying these days are children.
There may be no way to count how many children are dying, but there is evidence everywhere of the scale of the crisis.
Additional reporting by Imogen Anderson and Sanjay Ganguly
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