COVID-19 : In Afghanistan, Première Urgence Internationale is working hard for public health

In the East of Afghanistan, Première Urgence Internationale has been taking action for four decades to respond the emergency health needs and contribute to the improvement of public services. In response to the COVID-19 pandemic, the NGO is implementing several activities and adapting its usual programs. Dedicated resources and special extra supply have been delivered, through a humanitarian air bridge connecting Europe and Afghanistan.

© Première Urgence Internationale – June 2020

While official data show few confirmed cases of COVID-19 in the country, Afghanistan didn’t escape the ongoing pandemic. Infections continue to spread exponentially against extremely limited availability of tests, across generational households lack space to provide for self-quarantine, and poverty levels have considerably reduced the option of lockdown measures introduced elsewhere.  This deadly virus comes in the country as another scourge targeting the civilians, and increases the humanitarian and sanitarian crisis and the needs for assistance. The revised Humanitarian Response Plan, now estimates the overall number of people in need at the highly worrisome 14 million, or 38% of the total population, up from 9.4 million earlier this year (before the COVID-19 outbreak) and from 6.3 million in 2019.

First aid trauma posts and mobile health teams

In the Eastern regions, at the border with Pakistan, Première Urgence Internationale takes action in 4 provinces: Nangarhar, Kunar, Nuristan, Laghman. The NGO implements an integrated approach, mixing health, nutrition, protection and water and sanitation activities. In the field, Première Urgence Internationale manages for example 29 first aid trauma posts, to provide emergency aid services to traumatic patients (traumas induced by the conflict or by acute diseases).

Première Urgence Internationale also manages 10 mobile health teams, providing weekly emergency health services in remote areas. In these mobile structures, medical doctors, midwifes and nurses perform several services such as medical consultations, antenatal and postnatal care, vaccination, distribution of hygiene kits and nutrition items, psychosocial support…

The NGO also takes action in the rehabilitation of facilities, that including rehabilitation of delivery rooms and walls in provincial clinics as well as OPD ward or vaccination room in health facilities located in remote areas. Then, it also provides the supply of medical and non-medical equipment to these facilities (tables, shelves, chairs, blankets, cables…). When needed, Première Urgence Internationale also provides professional trainings to local staffs, and facilitates the recruitment of specialists (pediatric, nutrition nurses, psychosocial workers…).

Between October 2019 and May 2020, Première Urgence Internationale teams registered more than 136,000 consultations, delivered more than 14,000 hygiene kits, and took in charge more than 6,500 deliveries, 7,000 emergency nutrition supply and 7,000 psychosocial consultations.

Preventive measures to face the COVID-19 pandemic

Despite the global pandemic, Première Urgence Internationale ensured operational continuity of all its programs on the mission, and never stopped to provide these emergency health services.

In order to protect its teams and all the beneficiaries of this programs, the NGO adopted preventive and mitigation measures very early. “From December 2019, when the pandemic stroke China, we were aware that this could arrive in Afghanistan as well”, Dr Muqabel Shah remembers, Project Manager for Première Urgence Internationale. “All our staffs were informed on the symptoms of this new virus, and were trained on preventive measures. Specific material was provided to all our teams and structures: masks, gloves, individual protective equipment, such as infrared thermometer to screen our staffs and our patients.”

Information and visibility material (leaflets, posters…) was also produced urgently, to be displayed in the health structures and distributed by the mobile health teams, for awareness and sensitization. “We also reduced our mobile health teams and implemented rotations between the staffs: from 6 to 3 people. 3 staffs working each week, to reduce potential risks of propagation”¸ Dr Muqabel Shah continues.

Dedicated equipment and drugs were also planned and delivered, in order to cover the extra needs during this particular period. Some products could be found locally, but some had to be bought out of Afghanistan. “In this country, it still remains challenging to find suppliers and do the transportation of medical items”, develops Justyna Bajer, Head of Mission. “We often happen to be in shortage of specific drugs or products, even before the pandemic.”

Humanitarian air bridge: 30 tons of drugs landed in Kabul

Thanks to the cooperation between several European NGOs, and to the support of the European Union, an exceptional humanitarian air bridge has been implemented in the past weeks to connect Europe to around 30 destinations around the globe, and facilitate the worldwide emergency health response to the pandemic. Along with DRC, Haiti, Burkina Faso, and South Sudan among others, Afghanistan is part of the destinations covered by this exceptional aid air bridge.

A first flight to Kabul leaved Maastricht on the 16th June, loaded with a shipment of 1 hundred tons of medical items and drugs. The material was aimed at several INGOs, and around 30 tons were specifically destined to Première Urgence Internationale activities and mobile health teams.

We needed many items and material. During several weeks, at the beginning of the pandemic, all the usual transportation and shipments were cancelled or postponed because there weren’t international flights. We felt that it started to be critical, and this air bridge arrived at the right moment”, develops Sylvain Sanhueza, Logistics coordinator on the mission.

COVID-19 pandemic in Afghanistan - Humanitarian air bridge to deliver medical equipment and drugs
© UNICEF – June 2020

Many drugs are not available on the Afghan market, and for those which are, the quality isn’t always constant”, Sylvain continues. “The origin of drugs and their means of production vary a lot. But when we need specific treatment drugs, for a diabetic patient for instance, the quality needs to be precise and consistent, with the active substances in the same quantities at all times.”

The pandemic increased the difficulties with regard to the importation of products and the availability of items on the market. “The black market has also soared, with prices tripling or more, especially regarding personal protective equipment (gloves, masks, hydro alcoholic gel…). The price for one mask cost 0,10 cents before, and increased until $3! And it happened for almost everything”, Sylvain notes. “As our teams provide medical services and are in direct contact with beneficiaries, we needed huge quantities of these items and verified controlled quality.”

International cooperation

Thanks to this air bridge opportunity, Première Urgence Internationale could work with European suppliers (Nutriset, Medeor and Imres) and command these big quantities of drugs and items. “Our suppliers were very reactive and efficient. They were able to prepare and send our commands in only 10 days, in less time than needed usually”, warmly thanks Sylvain.

At the airport, local authorities also facilitated the customs clearance to speed the supply. “In total, the delivery process took less than a month and a half, while it usually takes 6 to 9 months!” A solution saving time, energy and money, thanks to this international cooperation in the emergency.

Discussions are now ongoing for a potential second flight to Kabul in the upcoming weeks, depending on the needs of all the other partners and NGOs. For Première Urgence Internationale, the needs are still there for medical drugs, items and equipment.

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