By: Monitoring Desk
Landmines, wolves and extreme heat: vaccinators in Afghanistan face many dangers to protect kids. UNICEF NZ reports on the challenges of battling preventable diseases in the changing country.
“Where are you headed?” asks a security officer at Auckland airport as he swipes my bag for traces of bomb residue. When I tell him that I am travelling to Afghanistan to see the impact of diseases like measles, polio and TB, his mouth drops open slightly. He waits for the machines to give the all-clear before asking nervously, “Is it voluntary?”
Afghanistan, a little over twice the size of New Zealand, is synonymous with violence, opium and oppression. But there is more to this landlocked country and the 30 million people who live here.
Kabul, designed for one million people, now has a population of more than five million.
As we drive through the dust-swept streets of Kabul, two children cling to a van ahead of us, determined to hold on until an Afghani note is thrust out the window.
Afghanistan is a proud agricultural country. Street sellers stack pyramids of deep red pomegranates, swollen cauliflowers, samosas, biriyani, carrot juice and shornakhad – salted peas.
On Chicken Street the famous Shinwari kebab, named after the largest tribe across Afghanistan and Pakistan is made on a maghary, a coal fired grill. Lamb is thread on to iron rods, hung above hot coals and then softened in the oven. The smell of tomatoes, garlic, peppers and coriander fills the air.
Groups of men huddle over chess sets or play cricket in the park. “Our Afghan cricket team is placed 10th in the world. We now have five players selected for county cricket in England” says our driver.
The elite live in compounds behind barricaded walls with private security. Their kids study abroad. Construction empires have paid millions for land to build a new Afghanistan. Men walk past the Charlie Chaplin restaurant in smart blue suits with tan leather shoes. Women clutch designer leather handbags.
Giant white blimps hover over the skies of Kabul like swollen fish. Inside them, military-owned cameras are recording every move.
We pass a media group supported by Rupert Murdoch. News, entertainment, soap operas and a new talent show are filling Afghan screens. Black, green and red flags blow gently in the wind. A man asks if we want tea.
In an instant, everything changes. A security guard grabs my arm and says we have to move. Now. There has been an attack on the other side of town.
A magnetic improvised explosive device attached to a police vehicle has exploded and killed five people. More than 46,000 Afghanistan National Defence Security Forces have been killed since 2015. There is no financial aid for the families left behind.
I ask our security driver if there are monuments to the dead on the streets of Kabul, thinking of the white crosses that dot New Zealand roads.
“If we did that, everywhere would be marked” he says.
Our security advisor checks under our armoured vehicle. He had heard a click, a tell-tale sign of a magnetised bomb being attached to a car. Click. Click. False alarm. “UN staff are regularly kidnapped” he says. Kabul, designed for one million people, has now surpassed five million. The sewers, roads, electricity are stretched. Concrete walls are pocked with bullet holes from four decades of war. Soviet-built concrete apartments, intended for Afghanistan’s elite, are now frail, caged houses.
Small cries punctuate the air of the Indira Gandhi Children’s Hospital in Kabul. Through thick glass I see an 8-year-old girl, Zol Hayia. Her mother beckons me over. I step under plastic tubes which extend from her small body and reach for her hand. Zol’s eyes are dark chocolate brown and with huge effort, she scans the crowded ward before her eyelids fall closed. “The doctors are working very hard. I would like to thank them for this, but there are not enough resources for every child,” he says.
“My niece isn’t vaccinated and it’s bad. But it is not just my niece. Hundreds of other children are not vaccinated. I call on parents not to be lazy or not see this as unnecessary. Vaccines are very important for the well-being of children so that later in life they do not run into any health issues that can be prevented,” says Daymau.
Fortunately, Daymau has the funds to transfer his niece to a French hospital for further treatment. There is no gurney. No crisp white sheets. But Daymau carefully lies the little girl down in the ambulance and it disappears into the dusty streets.
One in 18 Afghan children die before their first birthday. So many of those deaths could be prevented for the cost of a couple of dollars, and a few vaccinations.
“God has long ago abandoned Afghanistan,” says one of my UNICEF colleagues. “I will be thinking about this all week.” As humanitarian workers, the toll is heavy. No one wants to see children dying of diseases, particularly when they are preventable.
Doctor Aqa Muhammed Shirzad is a specialist at Indira Gandhi Children’s Hospital and knows the challenges of working in one of the most dangerous countries in the world.
“Every morning when I leave my house to come to work, I don’t expect to come home alive. There have been numerous attacks, bomb blasts, suicide attacks on hospitals and clinics. Even doctors are not safe from kidnapping and extortion,” says Shirzad.
Just 50 percent of children in Afghanistan are fully immunised. Measles ranks among the top four childhood killers worldwide. In Afghanistan, it is currently found in 20 of the 34 provinces.
“Vaccination is extremely important. There are killable diseases like chickenpox, measles, TB and polio that can be prevented with vaccination. UNICEF’s support is vital to help save these children,” says Shirzad.
Many young Afghans are hopeful for change. At Wazir Akbar Khan hilltop, we meet five young men dancing, silhouetted by the dipping sun. They pause their music to tell us they are Hazaras – an ethnic minority that has been ruthlessly persecuted for centuries.
They are all students, studying transport and civil engineering, determined to build a stronger Afghanistan. But their hope is not shared by all. As they straddle their polished motorbikes to head down the hill, we’re approached by an Australian woman and her husband from Kabul, who are celebrating their honeymoon.
We leave Kabul on a UN mission flight, headed for Mazar-e-Sharif. Known simply as Mazar, it is North Afghanistan’s biggest city, a place of pilgrimage. Afghans come to the Blue Mosque to find peace and disconnect from the world outside. White doves fly over intricately painted turquoise clay tiles.
At the Marha market, dusty young boys carry yellow jerry cans with brown leather straps. They’ve sliced open the tops to make a lid and peel them back to show us shoe polishes and brushes inside. Thirteen-year-old Mohammed Yousef pushes groceries for a few cents.
“I make $3 a day to feed my family. When I go home my feet hurt every night,” he tells us. “If I had more time I would like to study more and join a boxing club. I like boxing. If you have money you have options to do what you like.”
Freedom here is hard-won, and heavily-defended. The security team escorting us is armed with mounted Russian PKMs, AK47s and American M16s. They lead the way to Dashtchor, a poor side of town, meaning ‘salty desert’. It doesn’t rain here often.
We push open a heavy iron gate and meet 34-year-old Gulsum. She invites us to sit down on thick cushions inside her mud-covered home.
Gulsum’s voice is strong, passionate and quick. We can barely make out the pupils in her eyes beneath the pale blue burqa. She speaks a sad truth – children don’t come with a manual, and parents don’t always get it right.
“Vaccines will save children from pain and any other diseases that threaten their lives but, alas, I didn’t do it,” she says.
Gulsum’s 5-year-old son Osman contracted measles two years ago and has never been the same since. He doesn’t smile like his siblings, she says. “First he developed a fever and then there were red spots all over his body. He became very weak and then slipped into a coma. We lost all hope.”
She is overcome with guilt. “Other women were saying vaccines are no good and I believed them, so only three of my children were vaccinated. My son has been through so much. No one expected him to survive but I am so happy he is here today.”
The ongoing conflict has isolated communities. Parents are misinformed about the dangers of not vaccinating their children and even travelling to clinics can be risky. “If there is peace and security that will be the happiest day in our lives. We would be able to live our lives the way we want to,” Gulsum tells us.
Half of the population of Afghanistan live in conflict-affected areas and UNICEF goes to great lengths to protect the most hardest to reach children.
At first glance the small town of Khulm looks peaceful. We follow tuk tuks decorated with tin peacocks and pass apricot and pomegranate trees shrivelling in the sun.
At the foothills of the Tangi Tashkurgan mountains we meet Zakirullah Saleh, a 25-year-old vaccinator. Although he has never been to New Zealand, he knows about it.
“The literacy rate in New Zealand is quite high. Most people in Afghanistan are illiterate. Some Afghans claim that our ancestors were strong and lived a good life without vaccines. They ask – why should we vaccinate our children?”
Saleh has chosen a dangerous career, riding his motorbike through areas crowded with landmines. He knows if he strays from the path, he may be blown up. According to the UN Mine Action Service, 1,415 Afghan civilians were killed or injured by mines in 2018. Around eighty percent of casualties are children.
Saleh travels to insecure areas where it’s very hard to vaccinate. “We travel to places that are extremely hot in summer. There is always a chance of dying of thirst and in winters there are areas where wolf packs can attack you,” he says. “But I have seen too many children in my family and in my country affected by polio and measles. This can stop if we are committed, and I am committed.”
Vaccines must be carefully stored and transported at specific temperatures – if the vaccine’s temperature drops too low or rises too high, it can become unusable. Saleh opens the carrier to show us the ice packs protecting his vaccines.
We follow Saleh along pot-holed roads, weaving past domed rooves that help balance the bitter winters and scorching summers, before stopping outside the mosque. Through the loudspeakers residents are asked to bring their children to the clinic for free vaccinated. The clinic – more like a mud hut – is where we meet 33-year-old Abdul Jameel with his 2-year-old son Mujeeb ul Rahman.
Jameel works as a daily wage labourer for 300 AFN (NZ$5.7) a day, just enough to cover food. He has no savings. “When you have money, people see you as a human being. Without money, no one even looks at you,” says Jameel.
Jameel could never attend school, and never learned to read or write. “There was fighting all around me. It was difficult to leave the house and go outside. It was a state of despair. Little children could not go out and play with their friends. Planes were dropping bombs. There was shelling. Rockets were landing all around us. No one was able to leave and we were stuck at home for almost five years.”
“There are places in Afghanistan where people are secure. They sit around one another and enjoy life. There is progress. But there are places also where there is only pain and death.”
Jameel heard the announcement calling for children to be immunised. He was first in line, eager to protect his beloved boy.
“I have high hopes for my son. I hope he will finish school and become someone important – a doctor or a teacher. I don’t want my son to be illiterate,” says Jameel.
On the floor of the clinic, the two men sit beside each other. Abdul passes his son’s vaccination card across. Saleh looks it over and realises that, because Jameel can’t read, he doesn’t know the vaccination card is complete.
“You are a good father. You have completed all the vaccinations for your son. Keep your son’s vaccination card safe and tell other parents to follow your example” says Saleh.
Back at Kabul airport, we watch dark green helicopters take off and little red and white striped planes land.
Spotting my passport, the attendant asks where in New Zealand I’m from. When I say Wellington, he smiles. “Me too.” Small world.
Three brothers sprint past us wearing matching Spiderman tracksuits. Kids push their faces up against the kiosk longing for heart shaped candies, crisps and nacho cheese Doritos.
They could be children anywhere in the world. But they’re not. They’re in a country where millions of children contend with conflict, carnage, corruption, illiteracy, poor health and preventable disease every day. Where many won’t make it to their first birthday.
Yes, it’s a small world, but right now, the gulf between the one we live in and the one we just glimpsed couldn’t feel any larger.