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Afghanistan, One Year On: A Special Report from Kandahar
by Diderik van Halsema
October 7, 2002
Diderik van Halsema has been the coordinator of MSF's relief projects in and around Kandahar, Afghanistan, since May 2002. MSF is currently working in 13 of Afghanistan's 32 provinces with 93 international volunteers and 1273 national staff.
'Sand devils' they call them. Small whirlwinds that sweep across the plain, sucking the sand into twenty-meter-high spirals and blowing it away. Coupled with a strong wind, they are a real source of hardship to Afghans living in Zhare Dasht - which is not just the name of the region but also of a new accommodation for 60,000 Afghans due to be transferred here from the Pakistan-Afghan border by the United Nations High Commission on Refugees (UNHCR).
'Zhare Dasht' is Pashtun for 'Yellow Desert'. The area lies in the Sanzari district, over an hour's drive to the west of Kandahar in the south of Afghanistan. Since mid-August this has been the operational area for the Doctors Without Borders/Médecins Sans Frontières (MSF) team based in Kandahar.
MSF has been active in this region since 1995. Over the years, various immunization programs have been carried out as well as projects to combat malnutrition and prevent outbreaks of cholera, malaria, meningitis, typhoid, measles, dysentery, and other contagious diseases. This is a difficult logistical environment because of its isolation; a difficult cultural environment because of the conservatism; and a difficult political environment because of the years of Taliban domination. Working from Kandahar, the Taliban took control of almost the whole of Afghanistan until they were driven out by US-backed Northern Alliance forces at the end of 2001.
In October 2001 the project in Kandahar came to a standstill when the Taliban commandeered MSF's office. The MSF international staff had already been evacuated but without an office, the national staff was forced to stop their work as well. After the Taliban was ousted and a caretaker government was installed in Afghanistan, the team restarted the project. The office was restored to normal, needed medical supplies were replenished and, in the months that followed MSF assessed the need for new interventions.
During the past two decades of fighting, hundreds of thousands of Afghans had taken to the road; not only internally, but also in neighboring Iran and Pakistan, which had taken in millions of Afghan refugees since the Soviet invasion in the early eighties. Now a new group of Afghans were on the move: fleeing the bombing and the inevitable ethnic tensions, and also the drought in the south. A multi-year drought has led to many health and economic problems that have been consistently under-addressed by the media.
At the start of 2002, Pakistan and Iran exerted increasing pressure on the Afghan refugees to return to their homes in Afghanistan. Many did. The sudden, relative freedom in their country had inspired optimism, but the host countries had also given them a push. As a result, so many people returned that UN organizations such as the World Food Program (WFP) and the UNHCR could barely cope. This year, over 1.5 million Afghans have already returned. No one had anticipated such high figures. All these people need food, shelter, drinking water, and jobs to support themselves. The country is nowhere near capable of handling this. Many have simply exchanged one calamitous situation for another and are desperately searching for any means of survival - also in the south, where the persistent drought creates further complications. Many Afghans have lost their livestock to this drought. The Kutchis, Afghan nomads, have been hit particularly hard because they depend on camels, donkeys, goats, and sheep for their livelihood.
In the south, the harvests have been meagre for several years. Some experts say that the groundwater level falls by two meters a year. Dry riverbeds, encroaching desert, and wells that need to be dug ever deeper -sometimes to a depth of 60 meters- are making life so hard in this part of the country that many Afghans have become dependent on international aid. According to the latest estimates, some 400,000 Afghans are wandering around in the southern parts of the country in search of food and shelter. The UNHCR estimates that next year an additional one million Afghans will return from neighboring countries to face an uncertain future.
Newly displaced persons
Since October 2001, over 60,000 Afghans have been living around the town of Chaman on the southern Pakistan-Afghan border. Half of them fled because of the drought and the warfare in the south. Many of these are Kutchis. The other half comes from the north. These are Pashtuns, trying to escape the ethnic tensions that erupted shortly after the war against terrorism began. Uzbeks and Tajiks took revenge on the local Pashtuns because they suspected them of supporting the Taliban. The Pashtuns fled towards the south, where their tribe is in the majority, and ended up in the border area along with the Kutchis; looking for help and protection.
The first group, a few ten thousand, were lucky. Though Pakistan had officially closed the border it was still allowing a lot of Afghans through. These were taken to various official refugee camps on the Pakistani side of the border, where they received the help they were entitled to. MSF runs health programs in two of these camps: Rhogani and Lande Karez.
Another group of around 25,000 Afghans were less fortunate when they attempted to cross the border at Chaman in February 2002. They were stopped and since then have been stuck in a piece of no man's land, practically on the border but just on the Pakistani side. They have been living in a chaotic camp where it took a long time to organize assistance. MSF was present there from the very start to provide the people with medical support (vaccinations, basic healthcare) and to tackle malnutrition among the children.
Then, there is a third group of some 35,000 Afghans on the Afghan side of the border, dispersed over five camps around Spin Boldak, near Chaman. As they are still inside Afghanistan, they are not official refugees but internally displaced persons. MSF runs a health clinic in Spin Boldak.
Afghans in the official camps are the best off. The 60,000 in the "no man's land" and around Spin Boldak have much more to endure. The Pakistani and Afghan authorities want to get rid of the Afghans and have exerted so much pressure on the UNHCR to move them that there is now a plan to transfer them to Zhare Dasht. New accommodation is gradually being built there in the middle of the desert. There are no facilities for miles, so everything needs to be built from scratch. Though we believe that everyone has the right to cross a border and apply for refugee status if they have good reasons to do so, we have also started setting up medical facilities in Zhare Dasht, in order to assist those who are being relocated. MSF has been working with this group since last October and cannot abandon the people to fate, especially since there are no other organizations or facilities to provide medical support.
The first group - around 500 - arrived on 15 August. By September the numbers had swelled to 5,000. The UNHCR is transporting them in trucks from the border area to Zhare Dasht, where they are registered by ICMC, an aid organization called in by the UNHCR. Registration entitles them to food support, a piece of ground with a tent, and various items such as a tarpaulin, wheelbarrow, spade, jerry can, etc.
After registration, the displaced receive a medical examination from MSF. The children are vaccinated against measles and polio. They are also given vitamin A and screened for malnutrition. The ones who are malnourished are admitted to a special program that devotes extra attention to them, so that they can quickly build up their strength through medically supervised feedings.
Building a new life
In this dry plain the Afghans must try to build a new life. Some may want to return home to the north, but they are still distrustful. They feel it is still dangerous and want to stay in the south for the time being. The Kutchis can do nothing without livestock. Where could they go without the means of subsistence? They could build up a new life in Zhare Dasht. There are various organizations in the area. UNICEF is starting schools, the WFP is distributing food, and MSF has started a large clinic at a central point. In addition to initial medical registration, this clinic will provide medical assistance to the Afghans currently living in Zhare Dasht: basic healthcare, monitoring of the therapeutic feeding programs for the children, support for pregnant women and new mothers, tackling of dehydration and an ambulance to take patients to Kandahar if they cannot be treated in the clinic.
Dry as bone
But the success of Zhare Dasht depends on the availability of water. Many wells have been dug but most of them are useless because they are too shallow. People are really muddling along. The wells are going to be worked on again and efforts will be made to dig deep enough so that they can cope with the demand for water. The earth is dry as a bone, but fertile. But it takes a lot of water to support 60,000 Afghans. Each person needs, on average, 20 liters a day, to cook, drink, and wash with. Average water consumption in most western countries is well over 200 liters per day. Twenty liters is considered the absolute minimum. But it is nowhere near enough to spray the soil and maintain the crops. Much more is needed for that. No one knows how much water is under the ground and how long the water level can meet the demand. The success of Zhare Dasht will depend on the long-term availability of water.
Still much to be done
In the meantime, people are getting by in this vast dry plain. Winter is approaching. This means sub-zero temperatures in the south. But no snow. Just as well, you might say. But, this is exactly what would help the south to pick itself up. Snow or rain, it makes no difference. Snow brings melt water. And water is what the south needs. Apart from national stability and security, water is the only solution for the hundreds of thousands of Afghans who are still dependent on aid. But the prognosis is grim. And the longer the drought continues, the more Afghans will flee the area. This is why MSF continues to work here. To help the people, but also to make sure that this group is not forgotten. A new government and an international military presence do not necessarily mean that the problems are solved. On the contrary.