Almost all international support came to a standstill, and it seemed certain that for health workers in life-saving facilities throughout the crisis-stricken nation, and the millions they serve, things would only get worse.
But then, as one midwife * recalled, the support began to come in testimony exclusively to UN News, thanks to a groundbreaking new agreement led by the UN Development Agency.
Lifeline for families
Over the past few weeks, under the agreement with the Global Fund, the United Nations Development Program (UNDP) has quietly extended a lifeline to Afghanistan’s health care system and all the families who depend on it, providing $ 15 million to avoid the collapse of the whole the country. sector.
“We were able to save the lives of most critical patients, and we were able to support inpatient services for more than 500 women and children,” she said.
As the weather changed from autumn heat to a cold winter, she used some of the salary she had finally begun to receive to get some blankets and other materials to keep her family safe.
The midwife is just one of over 23,000 health workers in nearly 2,200 health facilities in 31 provinces who have received pay since the scheme started. UNDP has also paid for medicines and health items.
“UNDP undertook this enormous challenge to help prevent the total collapse of the health care system,” Vice President of Afghanistan Surayo Buzurukova told UN News.
“Of course, it does not solve all the problems; we provide a temporary solution. But it helps. We are sending a message of hope to the Afghan people that not everything is lost, that they have not been forgotten. “
According to the UNDP, this represents a significant financial aid package for the healthcare sector. Before it came, less than 20 percent of these health facilities were fully functional.
Ms. Buzurukova explained that all health workers who have been paid were identified by a group of 16 civil society organizations contributing to a World Bank project known as Sehatmandi.
To overcome the barriers to liquidity in the Afghan banking system, the Agency had to combine several money transfer instruments.
Over 90 percent of workers received their wages directly in their bank accounts; those without bank accounts, often located in remote areas, received the payment in cash.
“The remaining health workers, we are talking about a total of 25,000 people, will receive their salaries by Thursday,” the deputy told UN News.
Continue the work
Millions of vulnerable Afghans remain at risk of losing access to primary health care, and the agency hopes that others providing assistance will also take part in the innovative new approach to keeping health care operational in the crisis-stricken country.
Ms. Buzurukova told us that the agency was in “very close communication” with the World Health Organization (WHO) and the United Nations Children’s Fund (UNICEF).
“They will continue with the payments. We share the best practices, we also share all the experiences we have learned,” she said.
Afghan health workers’ monthly salaries range from $ 150 for technicians, vaccinators, administrative staff or nurses, to around $ 700 for specialist doctors or surgeons.
With about 800,000 civil servants who have been unpaid for months, the project also opens the door to help other groups whose work is the key to keeping the country running, such as judges and teachers.
The abrupt disruption of foreign funding threatens the entire economy, but many international organizations and states providing assistance remain reluctant to cooperate with the Taliban authorities.
Back in October, the UN Secretary-General called on the international community to “find ways to get the economy breathing again”. António Guterres believes that this “can be done without violating international laws or compromising principles.”
“We must look for ways to create the conditions that will allow Afghan professionals and officials to continue working to serve the Afghan people,” he said.
Now the UNDP initiative provides one possible, albeit temporary, solution, Ms Buzurukova said.
We are not involved in the de facto authorities, which are not recognized by the international community
“We are not involved in the de facto authorities, which are not recognized by the international community. We want to provide directly to the doctors, to the nurses, who deal with people, and support them, ”she explained.
A new one tomorrow
The deputy representative recently returned from Mazār-i-Sharīf, Afghanistan’s fourth largest city, where she visited a hospital to see for herself what effect the new initiative has. She was particularly interested in talking to female workers.
“It was really good to see women continuing in their jobs”, she said.
Women’s rights are one of the biggest concerns for the UN since the Taliban took power, but Mrs Buzurukova remains hopeful for the future.
The visit to Mazār-i-Sharīf was part of a series of trips she has taken since 15 August. She described talking to people on the street, going into people’s houses, meeting families, the young and old citizens.
“I was completely impressed with how strong they are,” she recalled. “There is a belief in the future that they will overcome [the challenges]; that tomorrow will come, maybe not soon, but it will come. ”
Forty years of war, recurring natural disasters, chronic poverty, drought and the COVID-19 pandemic have devastated the people of Afghanistan.
The recent escalation of conflicts and consequent upheavals have only exacerbated needs and further complicated an extremely challenging context.
Even before 15 August, the humanitarian situation was one of the worst in the world. By the middle of the year, almost half of the population, about 18.4 million people, were already in need of humanitarian and protection assistance.
One in three Afghans faced crisis or food insecurity, and more than half of all children under the age of five were expected to face acute malnutrition.
Protection and security risks for civilians, especially women, children and people with disabilities, also reached record highs.
The Flash appeal, launched in September by the Secretary-General, is asking for $ 606 million to avoid imminent hunger and disease. So far, it is only 54 percent.
* Names of workers are withheld due to safety concerns.
© UNICEF / Frank Dejongh