By IPS Correspondents
PESHAWAR, Pakistan, Mar 16 2005 (IPS)

Despite the fall of the Taliban government in Afghanistan three years ago and subsequent international pledges made to help the war-ravaged country get back on its feet, Afghans are still crossing into neighbouring Pakistan to seek basic medical services.

”The hospitals in Afghanistan are rudimentary. They are understaffed, there are not enough drugs and they lack specialist facilities,” said Mamoon Mahmood, a medical doctor in the border city. ”So can you blame the Afghans for wanting to come here?” he asked.

Despite the establishment of aid agency projects, Afghanistan’s health care services barely exist. An estimated 70 percent of medical programmes in the country have been implemented by aid organisations. The state health infrastructure, such as it is, could no longer function without it.

Even Afghanistan’s largest hospitals lack the most basic equipment needed for simple treatment. Hi-tech medical equipment is not available and cleanliness is a luxury that few medical centers can offer.

Peshawar is just 120 kilometers from the Afghan capital Kabul, and Afghan patients overburden the three teaching hospitals in this border city, with 30 percent of the beds occupied by them.

”The Pakistani health professionals tend to disgrace us. They call us parasites for taking advantage of Pakistan’s health system. But what choice do we have?” asked Gul Wali, an Afghan shopkeeper who had travelled from Kabul to Peshawar when his pregnant wife developed complications.

”I took my wife to a hospital in Kabul. There were no ultra-sound facilities, nothing. She was in extreme pain and I was worried about the baby. As her condition became worse, I decided to bring her here,” Wali told IPS.

”Now the Pakistani doctors say she needs an operation. I have called my relatives to come here and donate blood to my wife,” he said with a shaking voice.

Like Wali, Raees Maroof, too, had made the 120-kilometer journey overland from Kabul with his wife and sick five-month-old son.

”My baby son has jaundice and I don’t want him to die. I went to the hospital in Kabul and the nurses said they could not do anything,” Maroof told IPS.

His wife sobbed uncontrollably when he revealed that two of his children died recently in an Afghan hospital. ”I want this son of mine to survive. There have been enough deaths in my family.”

Arguably, it is pregnant women and infants who bare the brunt of Afghanistan’s health crisis.

A recent report by the United Nations Assistance Mission in Afghanistan describes the country’s maternal mortality as ”one of the highest in the world, with two to three women dying every hour”. More than half of all Afghan children grow up stunted and suffering from iodine deficiency, it adds.

The country’s high maternal mortality rate is especially problematic because the average Afghan woman has seven children.

According to the World Health Organisation, of every 100 babies born in Afghanistan, 14 are likely to die before reaching the age of five. Those more fortunate, it added, can look forward to a life lasting an average of 46 years.

WHO indicates that in Afghanistan there are only about two doctors to 10,000 Afghans in a country with 22 million people.

But services are slowly getting better. Kabul’s largest maternity ward, at Malalai hospital, has been refurbished and staff have been trained in emergency obstetrics.

”Lately, there is some improvement in the number of nurses, but they are still way short of the required number,” said Mohammad Nabi, an Afghan doctor.

The fundamentalist Taliban was toppled by U.S. and Afghan forces at the end of 2001 after the regime refused to hand over Osama bin Laden in the wake of the Sept. 11, 2001 attacks on New York and Washington.

Under Taliban rule, women were strictly segregated from men, and men and women were treated at separate hospitals.

In addition, pregnancy and gynecological problems are considered in Afghanistan to be sexual issues, rather than health issues, and the taboos and shame associated with sex impede communication about the topics between male and female family members.

Afghanistan, which held its first ever presidential election last year, is still at risk from drug lords and militants linked to the ousted Islamic rulers and the task of reconstruction is huge.

Excerpt: