Estiqlal Hospital: A new CT Scan Department to save afghan lives

On the last 10th of July, IADC Office in Kabul held the inauguration ceremony for the new Computerized Axial Tomography Scan Department at the Estiqlal Hospital in Kabul,  funded under the project "Support for the National Program Health for the Provinces of Kabul and Herat".

Several representatives of the Ministry of Health took part at  the event, including dr. Moyibullah Zeer, Curative Medicine General Director, Dr. Ahamad Bashir Hamid, Preventive Medicine Director General, Dr. Mohamd Salim Rasoli, Director of the "Strenghtening Mechanism", Dr. Wadoodullah Noori, Director of the Estiqlal Hospital, and representing the Italian Agency for Development Cooperation, the Head of Office and technical Advisor.

Due to the precarious security conditions, was not possible organizing the ceremony at the hospital, so at the event was given a symbolic and auspicious aspect for better times in the Country, as well as an important opportunity for exchanging and analysing strategies and activities on IADC funded health program.

IADC  confirmed  its commitments in the health sector, particularly in the provinces of Kabul and Herat, where the Italian Cooperation has built a trust relationship with the Institutions and the Afghan population.

The presentation of dr. Jabarkhail, project coordinator, highlighted the achievements in the following areas of intervention:

- Technical and financial assistance to the Ministry of Health in Kabul and to the Herat Provincial Health Administration;

- Strengthening and improvement of the Estiqlal Hospital in Kabul;

- Establishment of an ambulance service in Herat and in three satellite stations;

- Technical and financial assistance to the Institute for Health Sciences in Herat.

In addition to the analysis of the achievement, new initiatives were discussed, including the hypothesis for further renovations inside the Estiqlal. Extreme satisfaction was expressed for the results of the diagnostic center for breast cancer: since its inauguration, December 2016,  to present, it has performed 1038 mammograms, identifying 386 suspected cases. The establishment of an ambulance service in Herat was also mentioned for its high contribution in saving lives.

If the first victims of a health system in a war-torn country are women and children, today thanks to the support of the international community, were the Italian Cooperation is in the frontline, the Afghan health system has registered visible improvements with a positive impact on population’s health.

Access to primary health services is now affordable to the majority of the afghan people, maternal and child mortality rates have been reduced and life expectancy has increased, and the italian funded health program has largely contributed to these results.

The Estiqlal Hospital, historical partner of the Italian Cooperation, is today equipped with a staff of 524 resources and cares for about 340 people a day between outpatient services and hospital stays, which explains the request for an even more prolific collaboration with the Agency.

On the Italian side, the essential elements for the delivery of a full ownership have been identified: a strategic vision to plan new initiatives, and a functional data collection, to assess the impact of IADC-funded projects and the analysis of sustainability for future ones.

The ceremony ended with the donation to the Afghan counterparts of a commemorative plaque that will be affixed to the entrance of the CT Scan Department of the Estiqlal Hospital.

The Angel of Kabul, Alberto Cairo, received the Afghan Citizenship

Better known as the Angel of Kabul, Alberto Cairo, head of the Orthopaedic Centers of the International Committee of the Red Cross (ICRC) in Afghanistan, received on the 20th of July the Afghan Citizenship from the President Ashraf Ghani.

A reason of satisfaction and proud for Italy and for the Italian Agency for Development Cooperation that started the collaboration with ICRC many years ago, funding the establishing of the Physical Rehabilitation Program.

Alberto Cairo moved to Afghanistan in 1990 and since then has been working for the Afghans made disabled by war. To respond to the high demand for prosthesis, ICRC opened in the nineties new rehabilitation centers, firstly in Mazar e Sharif and then in Herat. Today he manages 7 Centers in the Country. Along the year the Centers expanded its assistance to any others kind of disabilities, such as congenitals conditions, cerebral palsy, hemiplegia, poliomyelitis. To date, the total number of patients registered at the Orthopaedic Centers is over 180.000.

President Ghani expressed his esteem for Cairo saying that in almost 30 years of presence within the Country he did a lot for the Afghan people, especially the war victims.

Is correct. Despite the conflicts, the bombing attacks, the rockets which affected the Country, Alberto Cairo stayed always in the frontline to support the Afghans, the amputees, the disabled,  trying to give them another chance of life, through a prosthesis, through a job opportunity, through a project of social reintegration. He has been the most welcomed and loved foreigner in Afghanistan. Not anymore. Now is an Afghan.

The Italian Development Cooperation in Afghanistan and its forms

What Italy is doing in Afghanistan in terms of development cooperation?

This was the issue presented at the meeting between the three Italian components of cooperation (Italian Agency for Development Cooperation - IADC, Italian military contingent within the Mission Resolute Support, the Italian Embassy) and the Editors in chief of the most important international and local newspapers in Afghanistan, which took place last June 12 at the Italian Embassy in Kabul.

Mr. Mauro Ghirotti, Head of the IADC Afghanistan Office, briefly presented the following activities the infrastructural area:

  • The construction of the Maidanshar – Bamiyan road: a tract of 136 kilometers that has considerably reduced the connecting times between Bamiyan and the Afghan capital from 10 hours to 3 hours.
  • The construction of the Chisti e Sharif highway, a 155 km long road along the Harirud valley, first part of the east-west central corridor that would cut the distance from Herat to Kabul to about 750 km.
  • The upgrade to the International Civil Aviation Organization standards of the Herat airport. Currently the airport the manages 350.000 passengers, even if the estimate passenger volume could be 1 M per year, that could attract interest for Afghanistan and major neighbor and regional Countries.
  • The Harirud bridge, a project to be completed in order to make functional the Herat By-Pass.
  • The Khaf Herat railway: the construction of the fourth segment of the railway connecting Khaf (Iran) to Herat, as part of a much wider plan including connections to Turkmenistan and Tajikistan.

Mr. Ghirotti explained that all these projects are elements of the intermodal transportation strategy implemented by the Agency, which aims at promoting the regional connectivity and the socio-economic development. Italian Cooperation has contributed for around 320 million euros for building roads, bridges and planning new interventions in the infrastructural area. The financial amount invested in the infrastructural sector corresponds to 82% of the volume of IADC initiatives implemented in the Country.

Then has been presented the sector of culture and sustainable development in the Country. In the Bamiyan Valley, known for the destruction by Taliban of the giant stone Buddha, Italy has three projects focused on the creation of an archaeological park, the preservation of the site of Shar e Golgola, an ancient citadel perched on a rock conquered by the ferocity of the Mongol conqueror Genghis Khan, and the development of sustainable tourism in the region and urban planning. Through an integrated approach, IADC wants to promote culture as a tool of affirming national identity and as a development opportunity. And in this context the twinning initiative between the city of Bamiyan and the city of Matera (European Capital of Culture 2019) was born, which IADC is promoting. Both UNESCO World Heritage Sites, they bear an extraordinary resemblance due to their geophysical and anthropological conformation.

Captain Marianna Calò, Gender Advisor of the Deputy Commander of the NATO Resolute Support Mission, illustrated the activities of civil cooperation implemented by the military (CIMIC) and support for gender empowerment in the region of Herat, where Italy is present from start of the mission Born in 2002. Courses for journalists, training for the Afghan female armed forces, construction of hospitals and schools (including the one dedicated to the Italian journalist Maria Grazia Cutuli, who died in Afghanistan in 2001), courses to promote female employment are among the activities implemented by the Italian contingent that actively contribute to gender empowerment.

From the Italian Embassy have been illustrated how the Italian government is promoting female participation within the Afghan forces. Through two specific funds (“Afghan National Army - ANA - Trust Fund” and the “Law and Order Trust Fund for Afghanistan - LOTFA”), Italy in fact contributes to the consolidation of the Afghan defense and security military forces also through the construction of building for military women, such as the city of female police, a pediatric center for assistance to the families of the armed forces and a training center for military nurses.

The session ended with a moment of debate and deepening analysis between journalists, experts and the diplomatic corps: although the political curiosity on the future of Afghanistan and on the role of Italy has accompanied the moment of confrontation, the curiosity and the appreciation for the initiatives were the characterizing elements of the meeting.

Based on the financial volume of the IADC initiatives and the contribution to the reform of the Afghan security system (through the LOTFA), in 2017 Italy was the ninth global donor for the civil sector in Afghanistan (data OECD-DAC and UNDP ) and the third donor in the defense sector (with the ANA Trust Fund).

 A result that rewards the commitment of those who, since 2002, have come to the Afghan Country to contribute to its development.

Italy contributes to three new developmental projects in Afghanistan with 71 million euros

On the last 20th of February, at the Arg, in the presence of the President of the Islamic Republic of Afghanistan Ashraf Ghani (https://president.gov.af/en/), the Ambassador of Italy Roberto Cantone and the Minister of Finance of the Islamic Republic of Afghanistan  (https://mof.gov.af/) Humayon Qayoumi, signed three Agreements between the Government of the Islamic Republic of Afghanistan and the Government of Italy in the field of development cooperation, totalling 71 million Euros.

The projects established by the agreements will be implemented by the Italian Agency for Development Cooperation together with the relevant Afghan Ministries and are expected to start in the coming months.

The first project entails a 65 million Euros loan for the construction of the Khaf-Herat Railway, running in parallel to the Herat by-pass, which was constructed through an Italian grant and inaugurated on the 13th December 2018 by President Ghani. It will increase connectivities with the rest of Afghanistan and the region and will be part of the Silk Road network.

The second project is rural initiative that will provide potable water, sanitation and health education to 250,000 people in the provinces of Herat, Farah, Ghor and Bamiyan, through a grant of 4 million Euros provided by the Italian Government.

The third agreement regards a two million Euros project, to be implemented by the National Statistics and Information Authority, increasing its institutional and human resources capacity. The project will also enhance the coordination capacity of the Afghan Statistical System.

The signing of the agreements confirms Italy’s unwavering commitment toward fostering Afghanistan’s development, as shown by its financing of significant projects in Herat and in Bamiyan. Moreover, in order to continue supporting the democratic process in Afghanistan, Italy has decided to contribute with 3 million Euros to the organisation of the next presidential elections.

Story of Freshta: A Dream Comes True

“I still hear my mother’s cries and moans in pain. I can recall how exhausted she finally was before she surrendered to death”, says Freshta a student of midwifery at the Herat Institute of Health Studies. Freshta and her 4 siblings were orphaned by the painful death of their mother due to obstructed labour, where no help from a skilled birth attendant was available. Freshta was only 11 by then and the youngest sibling, a sister was only 6, Sadaf and Sonita both girls were 19 and 16. Freshta’s mother might have been trying in the hope of having a second son after her only male child, Jalil who was 18 by then.

It was midnight in remote Kamana Village, Kohistaan District of Herat Province of Afghanistan, almost eight years ago, Freshta, was hearing her pregnant mother’s cries for help. The only help available was from an old woman from their neighborhood. “I prayed that my mother would be saved, and that her pain is relieved. I prayed and cried for help”, said Freshta, “I wish an angel would come and save my mother”, she continued in grief. Her mother’s screams and cries faded into groans from exhaustion and pain and then she was silent forever, with the unborn baby still struggling and then was dead in few minutes.

Maternal deaths are mostly caused by complications that are preventable, if a mother seeks antenatal care and institutional delivery in the presence of a skilled birth attendant. However, mothers and babies still die every day, in poor and underserved communities. Afghanistan is one of those places where women face the highest maternal death rates in the Asia and Pacific region. Women have a 1 in 52 chance of dying from pregnancy-related causes, according to the most recent United Nations data and 33% of women do not have access to basic health care.

When her mother passed away, Freshta was a fourth grader at school. Then, she decided to become a health worker, who would help save the lives of women as her mother. Now that family health houses are spread to her village, Freshta got the chance to chase her dream and become a midwife

According, to the most recent state of the world’s Midwifery report, well-trained midwives could help to prevent approximately two thirds of all maternal and neonatal deaths. Also, they could provide around 87 percent of all basic sexual, reproductive, maternal and neonatal health services. Freshta says, “This story is not only of my mother there are many other children who have a painful story such as mine. There are numerous other villages where babies lose their mothers. When I become a midwife I will do all I can to help save the lives of mothers in my village. I encourage other Afghan girls to do the same.”

Despite, huge achievements since 1990 with a 44 per cent decline in maternal mortality ratio, causes related to pregnancy and child birth still take the lives of 830 mothers every day. “The family health houses, led by midwives and providing skilled birth attendance, have been greatly welcomed not only by the Afghan government but by people of each province where they were established. UNFPA Afghanistan is making all efforts to expand the reach of these family health houses, to increase access to maternal health services in remote, unserved areas of Afghanistan where no services exist.”, says Dr. Bannet Ndyanabangi.

Freshta was chosen by the heads of her village to be trained as a midwife and work in the family health house in her village. Her training and the establishment of the family health houses is supported financially by the Italian Cooperation for International Development with technical support from UNFPA.

Family Health Houses (FHHs) are small local clinics which are intended to deliver essential Reproductive, Maternal, Neonatal and Child Health Care services by professionally trained midwives. Currently UNFPA supports 123 FHHs in Daikundi, Bamyan, Frayab and Herat supported by Italian Agency for Development Corporation, Global Affairs Canada and UNFPA. In 2017 around 112,000 people received essential reproductive health care services through these FHHs. With generous funding from the Italian Agency for Development Corporation 35 new FHHs will be built in remote and underserved areas of Ghor and Herat and another 115 FHHs in 5 priority provinces with generous support from Global Affairs Canada. The Afghan Ministry of Public Health with the support of UNFPA is currently assessing provinces.

Freshta is now studying in the Community Midwifery Education Program; in two years she will return back to her village to provide Reproductive and maternal Health services in the Family Health House (FHH) built with contribution of her own community. “I am really thankful to the people of Italy, Ministry of Public Health and UNFPA for providing such an opportunity; I am going to do my best; to get the most out of my studies and to provide healing for pains of girls like me and to be a guardian angel for mothers of my country”, said Freshta.

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Kabul and Bamyan are now closer, thanks to the new road funded by the Italian Cooperation

Kabul -At the presence of President Ashraf Ghani and Ambassador Roberto Cantone, the inauguration ceremony of the road connecting Kabul to Bamyan, with a total length of 136 km, was held on August 28, with a grant from the Italian Cooperation of 99,4 million euros. The section is part of both the east-west crossing corridor of the country, from Kabul to Herat, and of the north-south corridor between Mazar-e Sharif and Kabul, and includes a route in the mountain area with two passes at 3,500 meters of altitude, Onai and Hajigak.

In order to allow a correct maintenance of the road two plants for the production of asphalt and cem

ent have been realized, with relative testing laboratories. Moreover, over the years of construction, three food distributions were carried out for vulnerable groups that are among the populations residing in the area of ​​the road, in addition to the realization of about twenty community projects (irrigation canals, bridges and structures access).

Thanks to this infrastructure work, the Kabul-Bamyan journey time has been reduced from about 13 hours to two and a half.