Letter from Afghanistan

Editor—After 23 years of war and three years of drought Afghanistan has been driven into sweeping devastation and poverty. Having spent two weeks in Afghanistan on behalf of the US Physicians for Human Rights, as a member of a three person team, I can say that unless the international community moves rapidly to extend a security network outside Kabul and to mobilise funds for short term projects, the military and political investment in the coalition war will have been for naught.

Curfews imposed since the time of the Russians close down the cities at 10 pm, but the United Nations keeps its staff in after nightfall, even in Kabul. At least Kabul can point to the international security force, albeit thinly deployed. Elsewhere, the only restraint is the presence of coalition forces at the airports or in temporary bivouacs, and these troops are poised to leave at any time.

Mazaar-I-Sharif, the main city of the north, is divided into three distinct sections under the direction of three rival warlords. Virtually every male aged 14 to 60 in this city carries a Kalashnikov rifle. To venture out after nightfall is to contend with packs of howling dogs and encounters with wayward armed men, possibly allied with a warlord, possibly simple bandits. Incidents of assault and robbery are increasing daily in every urban area. Checkpoints have sprung up along the roads leading out from every city and town in the north, and it is unclear, as you approach, what will be exacted in order to pass. Everyone we spoke to is afraid of a return to the murderous times of the 1992-6 civil wars.

The relief that people have expressed in watching the Taliban flee is fading quickly into fear of what may happen if the warlords are allowed free rein. In a country where people have seen nothing but conflict they plead first for a neutral and professional external force to help stabilise their early and fragile peace.

They then plead for an urgent infusion of relief aid and the start of practical visible reconstruction projects. Currently in Kabul there is electricity for a few hours every other day. The northern city of Mazaar also occasionally has electricity. Generators are few; fuel expensive. Food is present in the markets, but the prices are high. Cooking and heating rely on thin metal stoves, stoked with diesel burners or gnarled thick wood from the dead grapevines and orchards of the once verdant fields and plains. There is no running water in these cities. There is also no police force, sanitation service, refuse collection, or postal service.

Entire commercial and residential sections of Kabul stand like ancient ruins, the result of murderous cross bombardment in the days of the Mujahadeen. Similar swathes of destruction mar extensive areas of Mazaar, where the Taliban assaulted neighbourhoods, slaughtered civilians, and bulldozed every structure.

In these cities the parks are dust, the remaining trees barely standing with the lack of rain. Very limited access to the villages and hamlets that lie days off the main roads (and these roads themselves are almost impassable because of war damage and neglect) makes it most difficult to generalise about conditions of rural life.

There are few reliable data on the demographic, economic, and social situation of the Afghans. UN surveys suggest that landmines and unexploded ordnance still litter vast areas of arable and grazing land and that $668m will be needed in the next seven years to make that land usable and safe (UN mine action programme, personal communication). Added to this total are the costs of dealing with the cluster bomb contamination and equipment loss from the coalition aerial bombardment.

Unemployment is rampant throughout the country (the demining enterprise is the largest employer, with 5000 local staff). The lack of jobs is said to swell the ranks of the warlord armies, the only game in town. Health conditions are dire; immunisation rates have fallen to 17% of eligible children, serious malnutrition and micronutrient deficiencies have been found in sample surveys,¹ infant mortality is estimated to be 165 per 1000; maternal mortality is thought to be among the highest in the world (1700 per 100 000 live births).²

We met ministers, community leaders, staff from local and international non-governmental organisations, doctors and healthcare workers, and officials with international organisations. All placed high priority on a few key infrastructure tasks—rebuild roads, restore water and sanitation systems, install generators for public buildings, hospitals, and schools. The request to the international community is to bring in the money and expertise to help direct local Afghans in getting this work accomplished.

There are other needs as well—helping to set up an administrative, banking, and legal system; providing training to medical and public health staff; fitting out hospitals and clinics; bringing in basic medical equipment and supplies.

What does not need to be done is instil a sense of hope, energy, and resilience. These core human capacities can be found in abundance in Afghanistan—still, despite all these years. But the window of opportunity will not stay open for long. People cling to the faith that those who drove out the Taliban will now stay and help them rebuild their country. The memory is still fresh, however, of the last time the international community came and then left far too quickly. This memory clouds all current expressions of optimism. If history seems to be repeating itself, there is no telling how much farther Afghanistan might yet fall.