The people of Afghanistan have faced enormous hardship. Although humanitarian organisations cannot rebuild states by themselves, they can save lives.
A 40-year-old Afghan has experienced no fewer than six significant dramatic, often violent, regime changes. In dry humour, an Afghan colleague once showed me his collection of identity cards. In the photos, his facial hair perfectly reflected the authority in power in Kabul at each moment in time. Clean shaven in the 1980s, with a full beard in the 1990s, and only neatly trimmed in the first decades of this century. Beards are now once again symbolic of dramatic political change, social redirection, and Afghans’ enduring resilience.
A 40-year-old Afghan has known endless conflict. In 2021 alone, fighting — particularly in Herat, Kandahar, Khost, and Lashkar Gah — has had serious consequences. In just one three-month period, more than 41,000 war-wounded people were treated at health facilities supported by the International Committee of the Red Cross (ICRC), an 80 percent increase compared to the same period in 2020. The Afghan population have borne the brunt of hostilities. Destroyed infrastructure, unexploded munitions, and psychological harm — the less visible scars of war — will continue to impact the Afghans for years to come.
The humanitarian needs in Afghanistan are enormous, and we won’t stop supporting these communities. In the words of Dr Alberto Cairo, who moved to Afghanistan from Italy in the 1990s and heads the ICRC’s orthopaedic program, “If we leave, who stays?”
A 40-year-old Afghan is likely to know the ICRC. It has been present in Pakistan since 1979, and in Afghanistan since 1987. The ICRC has worked with the Afghan Red Crescent Society to support the population through instability and violence. Its unique role in humanitarian action, which requires proximity to people, is only possible with local acceptance. This is why, in September of last year, ICRC President Peter Maurer visited Afghanistan. He met with the authorities to ensure the continued delivery of humanitarian services and to engage their responsibilities.
A 40-year-old-Afghan has seen the immediate consequences of war. Many in Afghanistan have experienced the heartbreaking death of a child, the terror of hostilities, and the pain of injuries. Less visible to the world is the steady decline of services: access to water, communications, even administrative and judicial functions. What good are legal processes when the judge cannot be found and the court and its records are damaged or destroyed? Access to medical assistance and the quality of health services have steadily degraded. This alone can have fatal consequences.
In an icy basement cell of an Afghan prison, I once met a man who had been shot in the stomach. He desperately needed medical attention, but communication services were down, the roads were impassable due to snow, and transport was unavailable. Something as simple as wintry weather had unravelled an already fragile health system, including the ambulance service, putting urgent care impossibly far from those in need. Decades of war have degraded vital services, reaching into all aspects of everyday life — nothing is untouched.
Health-related activities make up a large part of the Red Cross/Red Crescent work in Afghanistan, where the ICRC transports the wounded and sick, and supports and supplies health facilities. The ICRC continues to support hospital and health care centres, which now includes making direct payments to government health workers so they can deliver life-saving medical care. In Kandahar’s Mirwais Hospital, the largest in the southern region, the ICRC provides drugs, medical consumables, and equipment, as well as a team of clinical specialists for the surgical, obstetrics, gynaecology, and paediatric departments.
Humanitarian action cannot substitute for a well-resourced ministry of health and a network of infrastructure, transport, and qualified staff. It can, however, save lives.
Many 40-year-old Afghans know that some wounds don’t heal. Hostilities have left generations of injuries, many of which require long-term care. The Asia Foundation’s 2019 Model Disability Survey of Afghanistan found that almost 80 percent of adults have some form of physical, functional, sensory, or other impairment, with severe disability more prevalent among women. This staggering statistic explains why the ICRC’s physical rehabilitation centres treated over 140,000 people in 2021, including more than 45,000 children in the first six months of the year.
A 40-year-old Afghan is likely to have experienced hunger. Almost 50 percent of Afghans are now facing food insecurity, and there has been a huge increase in malnutrition in children under five. Recurring drought, economic collapse, and COVID-19 exacerbate the effects of conflict. This is one of the reasons why President Maurer cautioned against “conditional humanitarianism.” Withholding support, he warned, would be “a dangerous pathway” for the millions of people in need. UN Security Council Resolution 2615 is an encouraging step in the right direction.
Over 40 years, all Afghans have suffered. One afternoon in 2006, a colleague, Ghulam, told me of his experience of the decades of endless conflict. He told me about his family. During the violence that had wracked Kabul in the 1990s a rocket had landed in his house, killing his close relatives. Even now, I remember this conversation vividly because, while I was shocked and saddened, Ghulam was serene, almost fatalistic. Fifteen years on, and just past my 40th birthday, I think of Ghulam these days as Afghanistan fades from the Australian news cycle.
A 40-year-old Afghan knows that any war shatters bodies and souls. A 40-year-old Afghan knows that four decades of war shatters nations.
David Tuck is the Head of the International Committee of the Red Cross’ (ICRC) Mission in Australia.
This article is part of the “Forgotten Conflicts” series by the International Committee of the Red Cross in partnership with the AIIA, highlighting the serious and often overlooked humanitarian consequences of armed conflicts and other situations of violence. It is published under a Creative Commons License and may be republished with attribution.