Health, Security Officials Look to Improve Afghan Health System

By Army Sgt. 1st Class Michael J. Carden
American Forces Press Service

May 14, 2009 - Afghanistan's health care system has made "remarkable" advances during the past two years, but clearly defining its capabilities is an important factor for further improvements, a senior Pentagon health affairs official said here yesterday. "One of the most important things that we can provide in the way of support to the Afghan people is to understand what basic health measures exist for that population," Ellen P. Embrey, acting assistant secretary of defense for health affairs, told American Forces Press Service during the Building Health Security in Contemporary Afghanistan conference. "We are working very hard with our interagency partners to construct a plan that might assist them in achieving their near-term and long-term goals."

The two-day conference, which adjourns today, explores the role of health in sustaining security, particularly in Afghanistan and the Middle East. Neither the United States nor any one country or organization can reach the goals alone, Embrey said.

More than 200 health and security policy makers and officials gathered to learn the needs, identify the gaps and organize the existing capabilities of Afghanistan's health care system. Scholars from academia and experts with on-the-ground, first-hand experience made up several panels that discussed the security and health care challenges in Afghanistan. They represented a host of countries, agencies and organizations, and included Afghanistan's public health minister and various European military health providers.

"With the partnerships here with all the agencies and organizations that are represented today, I think that we can all make a real difference in the future and lives of Afghanistan and their people," Embrey said. "Improving health and health care and health care independence in other nations is just as critical to enhancing stability and preventing conflict as our other missions around the world."

With the help of U.S. and NATO militaries and civilian organizations, Afghanistan's government has enjoyed much progress in its ability to provide health services. But under the Taliban's control, women's health care took a nosedive, as did most of Afghanistan's medical infrastructure and programs. For years, child-bearing women were dying at an astonishing rate, and Afghanistan's government couldn't track or prevent even the most basic diseases, Embrey said.

Since the Taliban were ousted from power and despite their recent resurgence, Embrey said, Afghanistan's public health ministry has developed to the point that more than 65 percent of the country's 29 million citizens have access to basic health care. Four years ago, only 9 percent had access, she added.

"[U.S. and coalition governments] spent a lot of time helping the health professionals in Afghanistan gain their capabilities ... and to shape women's health programs that help to address some of the needs that they have," she said. "In the end, we believe that health care has its own rewards, and a population that is capable of supporting itself and its basic health needs is going to begin to see hope for their future.

"Embracing the future with educational opportunities, providing basic public health capabilities -- all of these, we believe, are the basic foundations of a wonderful government that is capable of serving its people."

But before an efficient health care system can be sustained there, security has to be won, and citizens have to have confidence in that system.

Habib Ahmadzai, Afghanistan public health ministry's director of international health, said that without security, the ministry can't invest in medical facilities or commit qualified health professionals to the rural regions where they are needed most.

"[Medical] infrastructure, doctors, nurses and ambulances are critical in the delivery of health care services," Ahmadzai said. "We can't have those things with the insecurity we have now. More than 4 million people still don't have their basic human rights of health care."

Ahmadzai said a long-term commitment from U.S. and NATO partners is the most important aspect in attaining such sustained security.

"If we don't have a commitment for the long term, we're not sure we'll be able to sustain the health care system that we have, because of the terrorist situation in our country," he said.