United Nations: The number of confirmed coronavirus cases suggests that Afghanistan could have one of the highest COVID-19 infection rates in the world, a global migration organisation has warned, voicing concern that the expansion of conflict in the war-torn country is exacerbating the disease response.
The International Organization for Migration (IOM) said that with almost 2,900 confirmed cases and 90 deaths as of May 5, Afghan officials have emphasised that in the absence of urgent actions, up to 80 per cent of the country's total population of 35 million could be infected.
The number of confirmed cases suggests that Afghanistan could have one of the highest COVID-19 infection rates in the world.
"Furthermore in recent days, results of a randomised sample of 500 persons in Kabul, a city of between five and seven million people, showed an alarming infection rate of 50 per cent," it said in a statement on Tuesday.
The global agency also warned that Afghanistan is struggling to safely absorb the more than 271,000 people who have returned from Iran and Pakistan since January amidst the fight against the coronavirus pandemic.
The Office of the United Nations High Commissioner for Refugees (UNHCR) said that Afghan refugee returns from Iran and Pakistan are suspended due to COVID-19 precautionary measures.
Further exacerbating the COVID-19 response is the expansion of the conflict over the past three months where security incidents and lack of access to non-government controlled areas means that there is no testing in over 30 per cent of the country.
A key constraint hindering a meaningful response to the pandemic is the low capacity for testing. Eight testing facilities established since January have a daily capacity of 100-150 tests each. However, there is a significant shortage of trained lab technicians and more testing kits are urgently needed.
Another grave concern is that Afghanistan has extremely limited infrastructure to treat severe cases.
Life expectancy is only 50 years for both genders and a high percentage of the population have pre-existing conditions such as TB, HIV-AIDS, malnutrition, cancer and heart and lung diseases, with environmental pollution another major factor in general population health.
"Movement and quarantine restrictions have a limited impact despite being in place countrywide but based on the socio-economic realities in the country - families cannot go for more than a few days without working in order to keep themselves afloat," Emergency Response Officer with IOM Afghanistan Nicholas Bishop said.
"Hence, the out-migration trend back to Iran resumed two weeks where people are desperate to feed their families," Bishop said.
The agency also noted that social distancing is unfeasible in Afghanistan, a country where the average family size is seven and most people live in small, confined, one room homes with poor ventilation.
In rural areas, there is a major gap in awareness. A recent community perception survey carried out by a grouping of NGOs showed 60 per cent of residents were uninformed about COVID-19.
"We may be missing the profound impact of the disease in these areas where the international community is receiving multiple requests for support for health care," Bishop said.
Despite these seemingly insurmountable challenges, IOM said it is actively responding to COVID-19 in close partnership with the Ministry of Public Health and the WHO with over 100 health staff deployed to border level surveillance, health facility-based interventions and mobile health teams.
If temperature checks and symptom screening identify a suspected case, they will be referred by an IOM ambulance to the nearest designated isolation facility. The same is being applied in IOM's migrant transit centres.
"We are also providing training, personal protection equipment and other critical medical supplies for local health workers and supporting risk communication and community engagement (RCCE) in 25 provinces across 10,000 communities through our data collection tool the Displacement Tracking Matrix," IOM Chief of Mission in Afghanistan Stuart Simpson said.
"With such high numbers crossing frontiers, we are also providing coordination support at Points of Entry to the Ministry of Public Health in partnership with WHO and UNHCR."
Each year, IOM Afghanistan provided humanitarian assistance to tens of thousands of undocumented Afghans returning from Iran.
Over 30,000 people have been assisted so far in 2020 through its network of border transit centres. IOM has appealed for an additional USD five million in financial support from donor partners to scale up lifesaving COVID-19 response actions in Afghanistan.
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