How Medair Is Helping People in Need in Afghanistan

Medair LogoWorking in some of the world’s most isolated and distressed regions, the international non-governmental organization Medair delivers emergency relief and recovery assistance to help at-risk communities survive crisis situations and secure their future well-being. Since its incorporation in 1989, Medair has undertaken humanitarian efforts in more than 30 countries, with active programs in 12 nations in Asia, Africa, and the Middle East. Medair operates independently, helping all people in need regardless of their ethnicity, national affiliation, or religious belief.

Focused on strengthening local capacity, Medair staff members to implement field programs in close cooperation with beneficiaries and train local professionals in the skills needed to sustain lasting recovery. Community members maintain an ownership stake in Medair projects by contributing their input during the formation of development plans and taking on much of the work to build new infrastructure. In the long-term, the area residents’ direct participation facilitates the eventual handover of projects to the community.

Medair’s Core Activities in Afghanistan

For the past 20 years, Medair has undertaken humanitarian aid work in Afghanistan, concentrating its efforts in the difficult-to-access Central Highlands region, as well as areas in the south of the country, where persistent armed conflict has displaced many families. People living in these regions face challenges ranging from natural disasters, such as landslides, to nutrient-deficient dietary resources and severe undernourishment. To address these issues, Medair coordinates its activities in Afghanistan around the three central concerns: health and nutrition; water, sanitation, and hygiene; and food security.

Mobile Clinics Relieve Child Malnutrition

Afghanistan farmAcross rural southern Afghanistan, hundreds of thousands of people who have sought refuge from violence in unofficial settlements experience inconsistent access to food and water. Continuing conflict both impedes families from leaving their homes to procure food and deters many humanitarian organizations from entering the region. Close to half of all child mortality in Afghanistan is due to malnutrition, and child malnutrition rates are the highest in southern part of the country, where the combined factors of instability, cultural restrictions, and poverty, prevent these children from receiving necessary treatment.

In 2014, Medair began operating mobile nutrition clinics in southern Afghanistan to treat moderate-to-serious malnutrition among children less than 5 years of age and their mothers. The clinics bring healthcare services to the displaced settlers, thus eliminating the burden and danger of traveling through zones of conflict to distant medical facilities.

After diagnosing children as being malnourished, Medair feeds them a calorie-rich, nutrient-dense paste that promotes weight gain and restored vitality. The mobile nutrition program also includes instruction for families in dietary principles and habits conducive to healthy child development. As of mid-March 2015, the mobile clinics had conducted malnutrition screenings for nearly 11,000 children and provided effective treatment for close to 500 children who were severely malnourished.

Bringing Safe Water Supply to the Central Highlands

Waterborne diseases pose a significant public health hazard in the Central Highlands of Afghanistan, where only one in four people has access to a clean, potable water supply. Often, communities and schools in this region lack sufficient restroom facilities and have limited knowledge of hygienic measures essential for containing the spread of infectious illnesses.

Medair deploys water, sanitation, and hygiene (WASH) teams to isolated areas in the Central Highlands to oversee the construction of wells and other water delivery systems, as well as the installation of toilets and handwashing fountains. Comprised of professionals such as hydrologists and engineers, Medair’s WASH teams train local people to maintain water pumps and help villages form committees responsible for supervising their community’s water resources. Medair also teaches beneficiaries about proper water sourcing and storage techniques, as well as safe waste disposal practices.

Shuhada Organization Supports Quality Social Services

shuhada organization logoDr. Sima Samar and Abdul Rauf Naveed formed the Shuhada Organization (SO) in 1989 to address a lack of health services for Afghan refugees in Pakistan. After beginning its operations with the foundation of the Shuhada Clinic in Quetta, Pakistan, SO steadily extended its work to health care and medical training inside of Afghanistan’s borders. Over the course of subsequent years, SO expanded the scope of its activities, first with education programs and then gradually incorporated a wide array of projects in various areas of humanitarian need.

Today, more than 25 years since it began, SO continues to operate as a nonprofit, independent civil society organization with activities in 13 provinces directed at advancing the health, prosperity, and overall welfare of Afghan citizens. Focused on the empowering the most vulnerable Afghans, SO seeks to engender a society in which the principles of democracy, justice, and equality govern the provision of quality social services without discrimination. SO pursues this objective by delivering assistance to Afghans in need through services that span a broad range of areas, including health and education, human rights, sustainable economic development, governance, shelter, and capacity building.

Hospitals and Health Clinics

The pressing need for health care among refugees served as the initial impetus for SO’s inception, and the organization has provided medical services for over 4.8 million individuals since its inception. Over the course of the first 19 years of its existence, SO ran five hospitals and 17 clinics in four provinces. Since 2008, it has maintained the operations of one hospital and six clinics in the provinces of Ghazni and Bamyan. In 2013, nearly 90,000 patients received treatment at these facilities.

Opened in 1993, the Shuhada Jaghoori District Hospital (JDH) in Ghazni includes inpatient and outpatient departments equipped with the capability to perform emergency care, surgical operations, child delivery, and vaccinations, as well as diagnostic scans and lab tests. JDH also offers facilities to train nurses and delivers wellness information sessions for patients through its health education and outreach department.

The staff at SO’s outpatient clinics provide routine examinations and checkups, vaccinations, wound dressings, and reproductive health care. Each of the six clinics also features a free store for patients to obtain essential medical supplies.

Protection and Education for Orphans

afghanistan schoolAmong its human rights activities, SO operates homes for orphans in Ghazni and Bamyan provinces in response to the high number of children who lost parents during the preceding decades of war in Afghanistan. The orphanages function as a means of safeguarding these children from common economic exploitation, which could include using them as free labor or as household servants by adoptive families with inadequate financial resources.

At SO’s orphanages, resident caretakers watch over the children every day. In addition to attending public school, the children receive support from on-site teachers who assist them with school assignments, English lessons, and computer classes. The teaching staff also guides the children toward focused study in specific disciplines ranging from anthropology and literature, to theater and fine arts. Through local radio stations, the children at the orphanages also have the opportunity to produce programs that feature debates and poetry readings. In order to maximize the children’s potential to live independent adult lives, SO ensures that each child attend school and completes the 12th grade. After graduating, each child must take an examination to qualify for university-level studies.

In 2014, a staff of five administrators, four teachers, and 15 support personnel provided care for 161 children living at SO’s four orphanages. In that same year, two students brought up at the orphanages earned bachelor’s degrees, and 23 others completed their first, second, or third year of study at a universities inside and outside of Afghanistan.

Sustainable Economic Opportunities

SO distributes livestock that can be used for the production of marketable agricultural commodities as a method for enabling vulnerable Afghan families to generate sustainable income. In total, SO has provided 2,200 chickens and 1,608 ewes to 512 families with economic difficulties. Distribution beneficiaries also receive basic training in animal husbandry and commercial practices appropriate for maintaining a viable economy in their community. Recent animal distributions have targeted communities in Bamiyan province, including the provision of 64 ewes with their lambs to 16 families in Kholankash village, and the delivery of 300 chickens and 60 ewes with their lambs to 30 families in Ghorab village.

SO also concluded two Sustainable Livelihood Programs in the Bamiyan villages of Sariqol and Golistan in 2014. Implemented over a period of three years, the programs focused on improving the economic situation of farmers in the villages by increasing capacity within the community. Combined with livestock distribution, the programs included educational elements, such as courses in literacy and human rights awareness.

DACAAR Aims to Improve Quality of Life for Afghans in Rural Communities

Since its beginnings in 1984 with the operation of economic opportunity projects at refugee camps in Pakistan, the non-governmental humanitarian and development organization DACAAR (Danish Committee for Aid to Afghan Refugees) has supported the self-reliance of the Afghan people. DACAAR engages in activities targeted at helping the members of rural Afghan communities to acquire the capabilities to direct their own development and achieve sustainable improvements in their quality of life. With a focus on resolving problems related to poverty, DACAAR primarily works with the most vulnerable rural populations in Afghanistan, including youth-led households, internally displaced persons (IDPs), and refugees returning from Pakistan and Iran. From its inception more than 30 years ago, DACAAR has assisted approximately 10 million Afghans and facilitated projects in all but five of Afghanistan’s provinces.

Generally working in locations facing major difficulties, DACAAR emphasizes long-term partnerships with its beneficiaries and normally remains engaged in an area for years after initiating an intervention. Employing a holistic approach to rural development, DACAAR promotes the active involvement of community members in order to strengthen the durability and effectiveness of projects over the long term, build a foundation for civil society, and place ownership of planning each community’s progress in the possession of its residents. The mobilization of a community to carry out development activities occurs in multiple phases to ensure the inclusion of residents from all strata in identifying needs, assigning priorities, and attaining capacity. Along with working in collaboration with village shuras, Community Development Councils, and other existing collective entities, DACAAR enables the formation of practical social and economic community-based organizations, then helps them to connect with civil society institutions and register with the proper government agencies.

Programs Addressed to the Complex Needs of Rural Communities

Seeking to improve the life and health of rural Afghans, DACAAR structures its programming to address interconnected issues of poverty such as income deficiency, food scarcity, and inadequate access to potable water and hygienic waste disposal. Based on the needs and concerns specific to each community, DACAAR undertakes projects categorized within a set of integrated thematic areas that include Water, Sanitation, and Hygiene (WASH), Natural Resources Management (NRM), and Small-Scale Enterprise Development (SSED).

DACAAR maximizes the impact of its interventions by seeking and utilizing synergies between program areas. Projects initiated within NRM and SSED, for instance, both center on skills training in fields where enhanced capacity is vitally needed. While individual beneficiaries only receive instruction and resources in one area, they horizontally disseminate skills across program areas by mutually sharing their acquired knowledge, thereby multiplying a community’s overall capacity.

Water, Sanitation, and Hygiene (WASH)

waterfallIn order to combat the spread of disease in rural communities due to contaminated water supplies and a lack of sanitary sewage facilities, DACAAR engages in WASH projects that secure the provision of clean drinking water. The projects utilize a broad variety of water delivery and treatment systems, ranging from wells and in-home bio-sand filters, to solar-powered conduits and gravity pipeline networks. Over the last 20 years, DACAAR has improved availability of potable water for millions of Afghans by establishing over 45,000 water access points throughout the country.

Complementing the development of infrastructure for clean water supply, DACAAR performs wide-ranging groundwater quality testing through a web of 261 groundwater monitoring wells spread across 22 provinces. This network stands as the only nationwide source for gathering essential scientific data on groundwater quality, volume, and sustainability. The information obtained from monthly groundwater level measurements and twice-annual water quality tests conducted at each well are analyzed, mapped, and reported using an integrated water resources data management system.

The issue of improper hygiene has also led to water-borne illnesses in Afghanistan. Following Afghan government policy for WASH projects, DACAAR provides education relating to human waste disposal and hygiene in the communities that it serves, further reducing the health risks posed by water contamination.

Natural Resources Management (NRM)

Afghanistan countrysideThe productivity of farmland in Afghanistan is generally low, in spite of findings from the 2011-2012 National Risk and Vulnerability Assessment indicating that nearly one-third of Afghan households rely on agriculture as their primary source of income. Large swaths of irrigated and rain-fed land remain uncultivated due to a lack of water and soil infertility. Afghan farmers commonly do not possess knowledge of efficient agricultural techniques nor sufficient access to high-grade input. Together, these factors perpetuate high levels of food insecurity throughout the country.

Through its NRM projects, DACAAR provides farmers with essential inputs and helps them adopt sustainable agriculture and livestock farming practices. Among its recent efforts, DACAAR has assisted farmers with the implementation of bioengineering and affordable soil moisture conservation methods and supported the cultivation of saffron and the planting of fruit and non-fruit orchards. The NRM program has also improved the water supply for farmers by repairing the existing irrigation apparatus and installing new infrastructure, such as canals, dividers, and intakes.

Small-Scale Enterprise Development (SSED)

The creation of strong business ventures in rural Afghan communities has been hindered by insecurity, inadequate resources, a weak business environment, and an absence of institutional assistance. Confronting this dilemma, the Small-Scale Enterprise Development (SSED) program launches initiatives coordinated with the Afghan government’s national strategy for job creation through small- and medium-size enterprise (SME) development.

In this program area, DACAAR focuses on activities such as assisting farmers in the formation of jointly owned Producer Associations (PA). The associations democratically nominate their managing leadership, and members share their assets and ability to produce, process, package, and market agricultural products. In addition to providing PA’s with startup financing, DACAAR delivers training in management and technical skills, and it renders ongoing counsel and support for a minimum of two years. PA’s also receive assistance with building market connections and registering as SME’s with the government.

In addition to supporting PA’s, other SSED projects focus on creating income-earning opportunities for young Afghans without jobs and other at-risk groups. To that end, DACAAR operates vocational training centers where graduating students receive grants and toolkits for establishing their own businesses.