A Clinic for Sar Assya

Having spent much time with our school construction projects in the region of Ghazni, talking to the population and learning about their main concerns and problems, we decided to broaden our scope and include health initiatives.

While large parts of the world enjoy access to state-of-the-art medical standards and treatment, the conditions in the Nawur district are beyond anything that should still be possible in the 21st century. Many tragedies have occurred from basic and preventable diseases, simply because health care is unattainable. The village of Sar Assya and surrounding hamlets, at an altitude of 3’000 meters, are particularly isolated, devoid of infrastructure (no roads, schools or clinics). The population survives on scarce agricultural produce and remittances sent by relatives living abroad.

The nearest health centre lies 6-8 hours away by car. Most of the time, during an emergency there is no car available and the road conditions are extreme. On foot, it is a 2-day trek to reach Jaghuri, which explains the high mortality rate in and around the village of Sar Assya. Conditions are even more critical during the long and harsh winter months: temperatures drop to -20 degrees, villages are snowed in, and transport possibilities are almost inexistent and unaffordable.

Just one case to illustrate the consequences: During the winter of 2009, a pregnant woman in the area needed urgent medical attention. There was no other way than for forty men from the community to relay themselves in carrying her on a bed, across the unforgiving snow-covered mountaintops to try and reach help. Despite their incredible resolve, they did not make it in time and the baby was lost.

Health in Afghanistan

The health situation in Afghanistan has been very critical for a long time. Even prior to the three decades of war that began in 1978, conditions were very poor owing to the lack of health posts, especially in the traditionally neglected rural areas. Further deterioation was caused by the disruption and decline caused by prolonged armed conflict.

The harsh reality is expressed by the following data obtained from the UN World Health Organization and international NGOs:

• Life expectancy for women in Afghanistan is of 45 years, compared to 82 in Switzerland (Swiss women had a life expectancy of 43 years in 1880).
• The maternal mortality rate (how many women die in child labor) is estimated at 1’700 per 100’000 live births in Afghanistan, compared to 5 per 100’000 in Switzerland.
• The infant mortality rate (children who die before reaching age 1) is estimated between 160 and 180 per 1'000 live births (vs. 5 per 1'000 in Switzerland).
• The under-five mortality rate is estimated at 260 per 1’000 live births (vs. 5 per 1’000 in Switzerland). In other words 25% of children in Afghanistan never reach the age of five.

These figures are simply devastating. It is known that most children die of a variety of infectious and parasitic diseases: acute diarrhea, respiratory infections, tuberculosis, malaria, measles and malnutrition. To this, one must add the diverse disabilities caused or exacerbated by war: amputation, blindness, paralysis, polio, mental health, etc.

Project objectives

Building a clinic in Sar Assya will achieve:

• Improved access to health services for 20’000 people, mainly women and young children
• Immunization for hundreds of young children through annual national and UN vaccination campaigns
• Strong reduction of child and maternal mortality rates
• Basic health and illness prevention education for hundreds of households

The Clinic and its operation

The clinic will have a surface of 300 square meters and ten separate rooms, including: pharmacy and storage rooms, a vaccination room, an examination and mother care room, a delivery room, a sterilization room, waiting and administrative rooms. Staff rooms will ensure that the doctors and nurses have a permanent presence in the community.

The construction of the Sar Assya clinic is carried out by the Atimad Construction & Engineering Company, which also has successfully and efficiently built our three schools. It is a company with long-standing experience, including in projects run by the international community in Afghanistan. The Nai Qala Association and Atimad have signed a project agreement, which includes a detailed technical file, in conformity with the regulations and specifications of the Afghan Ministry of Public Health. A copy of the full technical file is available upon request.

The Nai Qala Association has equally concluded an agreement with the Shuhada Organization regarding the provision of qualified medical, administrative and security staff. Shuhada is one of the most experienced Afghan non-governmental organizations, with a wide range of projects in the health sector (see its website at www.shuhada.org.af). Copies of the full file and item lists are equally available upon request.

The Sar Assya clinic project has been approved by the Ministry of Public Health in Kabul (national level) and in Ghazni (provincial level). Therefore, the clinic will be a formal part of the Afghan public health system. The Nai Qala Association will sign a 5 year-agreement with the Ministry, committing to supervise and provide funds for annual running costs of the clinic.

As a clinic, it will attend basic and primary health concerns of women and young children. For more serious interventions, patients will be referred to a district hospital in Jaghuri, run by Shuhada. Thus the Sar Assya clinic will be connected to a wider network of competencies.

In August 2011, work on the clinic building has been completed to high quality standards. The inauguration is only two months away.

Project budget and progress

The overall 5-year budget is estimated at 800'000 CHF. Of that, about 370'000 CHF are budgeted for the construction.

The construction work commenced in autumn 2010, we will do our best to keep you up-to-date on the project progress. Please check also our photo gallery for related images.

In August 2011, work on the clinic building has been completed to high quality standards. The inauguration is only two months away. 

We are now seeking an annual amount of 86’000 Swiss Francs for the next 5 years to cover the running costs. At the end of that period the clinic will be handed over to the Afghan Ministry of Public Health.