Though accounts of successfully implemented humanitarian aid in Afghanistan are rife, the data parsed by medical NGO Médecins Sans Frontières (MSF) tells a starkly different story. A decade of international aid has yielded few tangible results, with ongoing civil conflict resulting in continued preventable deaths and the dissolution of medical neutrality. Between Rhetoric and Reality, a report published by MSF, estimates that roughly one in four Afghan citizens have lost a close friend or relative in the midst of political combat.
Despite ample sums of money from foreign governments being poured into the country's healthcare outfits, hospitals and clinics remain underfunded and ill-equipped. The facilities are typically too costly for civilians to readily afford, and access remains difficult. MSF runs four facilities in Afghanistan, where it's estimated that approximately half of the patients that seek treatment face combat, landmines, and check points en route to their destination. In the Helmand province, that figure jumped to four out of five people experiencing obstacles to securing medical aid.
"Violence not only maims and kills directly, but also indirectly, by impeding access to healthcare," the report reads. "Significant numbers of people, as high as one in four in Khost, knew someone in their family or a close friend who died as a result of lack of access to adequate healthcare. When not a main reason, the conflict was always a major cause of why now-deceased family members had been unable to access adequate healthcare."
The report condemns the apparently futile distribution of funds and the sharp leap in inaccessibility to hospitals, pointing to an almost six-fold increase in the percentage of the populace with medical facilities more than an hour's walking distance of their residence. In 2001, that numbers was at nine percent; at the time of publishing, it sits at a staggering 57.4 percent.
Increasing intolerance and occupation of the healthcare space has also adversely impacted the delivery of medical aid. MSF also reports an upswing in military interference, stating that 80% of such intrusions are conducted at the hands of "pro-government forces using health centers as bases for military operations." Healthcare neutrality is threatened as a result, with impartial spaces marred by politically motivated occupation.
The study also contends with oft-relayed reports of improvement in the country's healthcare facilities. Noting that some improvement had been seen since the Taliban were ousted, MSF nevertheless warns that the information must be taken with a grain of salt, due to misrepresented data from the country's most volatile hubs. "Health statistics from Afghanistan are notoriously unreliable ... data from the most insecure areas are often excluded," says the report. "This introduces a persistent bias that is likely to contribute to overly positive country averages."
MSF has worked in Afghanistan consistently since the 1980s, providing medical assistance as conflict developed in the surrounding regions. The NGO removed all aid workers in 2004 following the senseless murder of five staff members, returning in 2009 in response to heightened medical and humanitarian needs. The organization is supported by private funding and is not affiliated with nor financed by any governments. The study was completed over a six month period, consolidating interviews from more than 800 Afghani residents with health data from medical reports.
