INSIDE AFGHANISTAN’S HEALTHCARE SYSTEM

 

Transcript

 

Marco Salustro/ 9 min

 

 

00:00:05:12 - VO:

An urgent ambulance journey to save a newborn’s life.

Baby Zarmina is just 21 days old and struggling to breath.

The hospital in her hometown doesn’t have the resources to save her.

So she is rushed to Medicines sans Frontiers in Helmand capital, Lashkar Gah, more than an hour and half away.

 

00:00:32:17 - Nurse in the ambulance (Pashto):

God willing we will get her there alive.There’s better facilities and she’ll get proper support

 

00:00:46:16 - VO:

Afghanistan health system is on the brink of collapse.

The Taliban takeover meant foreign aid dried up and countless doctors and nurses have left the country.

Now this is the only fully working hospital avalaible for the 1.5 million population of  Helmand province and is completely overwhelmed.

 

00:01:11:06 - Joana Castro, Nurse - Masood Khan, Nurse:

-There is a baby going home.

How many do you have in ER?

-We have, err…the Resus is almost full.

 

00:01:19:03 - VO:

Here it’s one baby in, one baby out.

 

00:01:22:23 - Masood Khan, Nurse:

When they are coming to the hospital… mostly they are coming at the last stages. You know when already the damage it’s already too far gone.

 

00:01:41:06 - VO:

Baby Zarmina has survived the journey, but her oxygen level is still low.

 

00:01:51:23 - VO:

Her parents are scared and confused by how quickly she became unwell.

 

00:01:59:05 - Najiba, baby Zarmina’s mother:

She was fine. I breast fed her and gave her medicine this afternoon, then she slept and then she suddenly turned blue and went completely quiet.

 

00:02:11:22 - VO:

She’s been diagnosed with sepsis and will have to be admitted in the neonatal Intensive care unit for an overnight stay.

 

00:02:23:13 - VO:

Back in Zarmina’s home town Grishk at the local clinic everyday a crowd gathers begging to be seen.

 

00:02:32:23 - Nurse (Pashto):

Listen, don’t allow anyone inside unless there is an emergency. No-one except for urgent cases.

 

00:02:40:13 - VO:

But most have been turned away. Only the most urgent cases are seen and offered the most basic care.

 

00:02:49:20 - VO:

A young burns victim.

 

00:02:53:10 - Burned child’s father:

Her mum was cooking rice, my daughter was sitting next to the boiling water on the stove and she managed to pull it all over herself.

She was so badly burned that her skin and flesh was peeling off.

 

00:03:02:06 - VO:

In unsanitary conditions, with a severe lack of medicines and a desperate shortage of staff there is only so much they can do.

 

00:03:11:08 - VO:

Little Najiya felt from a balcony and suffered a head trauma.

 

00:03:18:20 - VO:

The doctor advices her father to drive her to Kandahar more than 4 hours away for a CT scan as there is no further treatment available here.

 

00:03:32:05 - VO:

But the local Taliban health official insist the situation has improved since they took over.

 

00:03:38:23 - Rahmatullah Ishaq, Responsible for the Public Health Sector in Grishk District.:

⁃      Previously those getting in to higher position in the health sector would only be there because of bribes.

⁃      With the previous government there was no transparency. Now thank God, with the Emirate Regime in place, the hiring of senior positions is done transparently and they pass the process properly.

⁃      These were problems in the past.

⁃       

00:04:07:06 - VO:

Yet many here insist they are not getting the help they need.

We were forbidden from filming female patients. Outside the clinic we heard their complaints.

 

00:04:17:22 - Female patients (Pashto):

They steal the medicine from here for their private pharmacies. We haven’t been helped at all, the international aid is being misused. I swear to God no help has been given to us at all.

 

00:04:34:05 - VO:

With fighting in Afghanistan over and Taliban in charge, the roads are safer for people to travel,

that means 1000 patients everyday turn to the MSF hospital in Lashkar Gah.

Nurses Homeira Nawruzi and Joana Castro are looking after very sick infants.

 

00:04:58:22 - VO:

Joana is Portuguese and usually works for the NHS in the UK.

 

00:05:03:08 - Joana Castro, nurse.:

Every time she gives milk the baby needs to be up otherwise the milk could go in the lungs.

It’s a really tiny baby, he needs to get fat.

 

00:05:20:06 - VO:

Baby Zarmina who has been brought form Ghrisk yesterday shows signs of improvement.

 

00:05:26:17 - Joana Castro, nurse.:

She had a bit of oxygen support but now she doesn’t need it anymore and she was put on antibiotics and now she is breastfeeding and the mother says she’s really improved. She’s more awake, she’s not vomiting anymore , so we are happy.

 

00:05:43:18 - VO:

But all the children here are still critical, the most common in Helmand is malnutrition.

Malnourished baby in this ward are two to a bed.

1.1 million children in Afghanistan are expected to suffer from it this year.

 

00:06:05:15 - Omaira Nawruzi, nurse.:

The malnutrition patients in Helmand is increasing and when we discharge some patients, for many reasons they again come and are re-amitted.

One reason is the local clinics are not working and they can’t get the follow up service and they become worse, they become sick and come here.

 

00:06:29:19 - Omaira Nawruzi, nurse.(Pashto):

Translation: What’s the patients name? Fareida?

 

00:06:35:10 - Omaira Nawruzi, nurse.:

Malnourished patients in the last 24 hours we had 73 patients admitted, It’s a high number.

 

00:06:43:19 - Joana Castro, nurse.:

When I was a child I had a dream that I was going to save the world, I think we all do, but a lot of problems are political.

 

00:06:55:16 - Joana Castro, nurse.:

This is a baby that doesn’t have a mother so the ward sister is giving her breast milk that other mothers donated to the baby.

 

00:07:06:10 - Joana Castro, nurse.:

Ah. That’s so nice!

 

00:07:10:02 - Joana Castro, nurse.:

It’s a daily struggle to manage all these patients.

Some of them they walked or  drove a lot of hours just to come here and get seen by healthcare professionals so , you know, giving answer to all this people it’s a daily struggle.

 

00:07:35:09 - VO:

Baby Samiullah was one of those suffering from malnutrition but is now well enough to be discharged.

His family invited us to join them as they head home to a village in the countryside

 

00:07:55:23 - Qari Mawlawi Saheb Niamatullah Agha, baby Samiullah’s uncle(Pashto):

We eat potatoes from time to time.

Sometimes we eat and other times we go without.

We have a cow, sometimes we have yogurt or buttermilk to eat.

We can’t afford  to eat things like meat, or beans and other things our bodies really need.

 

00:08:21:07 - VO:

The country’s crippled economy and rising prices have left so many struggling to eat. The United Nations now estimates as much as 97% of Afghanistan is believed to be living in poverty.

 

 

 

 

 

CREDITS:

 

Producer/Director/Camera: Marco Salustro.