10 Badakhshan districts without specialist doctors

FAIZABAD (Pajhwok): Ten districts of northeastern Badakhshan province are without proper hospitals and specialist doctors, residents complain.

They are forced to travel long distances to receive essential healthcare. In some cases, patients lose their lives en route to health facilities.

Local sources and health experts told Pajhwok Afghan News of the 28 administrative units in Badakhshan, 10 have operational basic health centres (BHCs).

The 10 districts are Shuhki, Maymi, Kohistan, Tashkan, Tagab, Karan wa Munjan, Yamgan, Zibak, Wakhan and Arghanjkhow.

Except Faizabad, three districts have district-level health centres, while the remaining are served by comprehensive health centres (CHCs).

Basic Health Centres (BHCs) are facilities providing primary health services to the people.

These centres are typically situated in remote rural areas and are responsible for offering primary health services such as examination, treatment and prevention of common diseases like cold, diarrhea, respiratory conditions and vaccinations for children.

CHCs offer more advanced healthcare services than BHCs. Such centres are usually located in district-level areas or places with larger populations and act as intermediary health service hubs.

DHCs provide even more comprehensive health and treatment services. Typically located in larger or more populous areas, these centres serve as the primary healthcare units at the district level, offering facilities like surgery, maternal and newborn care, public health education and laboratory tests.

Lack of specialists, quality healthcare

Mahboob-ur-Rahman Tolat, an influential figure from Kohistan district, said the absence of doctors and the failure to upgrade the BHC to a CHC had caused significant problems for the local population.

He explained: “Our district health centre is basic and does not meet the needs of the people. In many cases, patients transferred from our district to Faizabad, the provincial capital, face serious difficulties on the way. There have even been instances where patients have died before reaching Faizabad.”

In less than a month, two of his relatives, who were en route to hospitals in Faizabad and Kunduz, passed away on the way.

He claimed local residents were concerned and expected the government and international organisations to address the issues and deploy specialist doctors to the district.

Mohammad Adil, a resident of the Qala Panja area of Wakhan district, pointed out there were 108 families living in the area, which had no health centre capable of providing even basic services.

“We are facing numerous health challenges. Our patients must travel more than 100 kilometres to reach the district hospital in Ishkashim, and then another 100 kilometres to Faizabad.

“We urge the Islamic Emirate and international organisations to address our healthcare needs and build a clinic or health post for us.”

Yar Mohammad Niazi, a local leader from Yamgan district, revealed the basic health centre in the town was headed by a nurse.

“Recently, one of our young men, who had suffered a leg injury, needed to be transferred to the Faizabad hospital. However, due to the lack of basic healthcare services and severe bleeding, he died on the way, as we have to travel 120 kilometres to reach Faizabad. Our patients often die during the journey.”

If quality healthcare services and facilities had been available in the district, he opined, the patient might have survived.

He noted there were only two small health centres in Jokhan and Oshengan areas of the district, whose inhabitants had to walk an entire day to reach there.

To reduce mortality rates, he suggested, the centres should be upgraded to comprehensive centres or district hospitals.

He concluded, “These two health centres provide minimal services and are insufficient to meet the needs of the people. Our request to the Islamic Emirate and international organisations is to hire doctors who can diagnose basic diseases like measles and whooping cough, and to upgrade health centres from basic to comprehensive centres and district hospitals.”

Increasing mortality rates

A health expert, who wished to remain anonymous, told Pajhwok in the 10 districts, healthcare services were provided at the level of BHCs.

According to the Ministry of Public Health’s formula, these centres are headed by nurses, who deliver services along with midwives.

The expert added many districts of Badakhshan had complex and difficult geographies, making it hard for residents to access hospitals.

However, in the 10 districts, there are no doctors available to diagnose basic diseases and offer timely treatment. The centres rely on nurses and midwives, as the Ministry of Public Health’s standards do not mandate the presence of doctors at basic and sub-health centres.

The expert stressed due to the difficult terrain, lack of proper roads and transportation challenges, Badakhshan should be exempted from the ministry standards, and the needs of the people taken into account.

In vulnerable areas, where patients cannot be urgently transferred to hospitals, more advanced health centres with doctors, diagnostic services, laboratories and ambulances be established.

According to the expert, the shortage of advanced and properly-equipped health centres in Badakhshan’s districts has led to many patients dying on the way.

If basic health centres were upgraded to comprehensive facilities and district hospitals, services like surgery, laboratory tests and ambulances could be provided, which would significantly reduce mortality, he believed.

Health centres being upgraded

QariAtiqullah Faizi, head of the Badakhshan Public Health Department, acknowledged the lack of doctors and advanced health services in more than 10 districts of Badakhshan.

He explained in these districts, basic health centres existed, but according to MoPH standards, no doctors are present, and services are provided by nurses and midwives.

He commented: “We must accept that the difficult terrain of Badakhshan’s districts has created challenges in all sectors, particularly in healthcare.”

Faizi acknowledged the increasing mortality rates among mothers, newborns and adults in some districts due to the lack of quality healthcare services, difficult terrain and poor telecommunications infrastructure in some areas.

The director admitted the current health centres were insufficient to meet the needs of the people in the province.

He insisted district hospitals be established in all districts. “Fortunately, the establishment of district hospitals in all districts has been approved, but due to lack of funding, the project has been delayed.

“The budget for upgrading several health centres, including in Khwahan and Tagab, as well as for expanding the provincial hospital from 120 to 250 beds, has been allocated for the upcoming year, and work will begin soon.”

Faizi reiterated the Badakhshan Public Health Department’s determination to provide quality health services to the people and address some the challenges faced by the population.

According to a report by Pajhwok, 77% of districts across the country lack adequately equipped hospitals.

sa/mud