21st century health care for children in Afghanistan?

Abstract

* Abbreviations: MCH = : maternal child health clinic • CAI = : Child Advocacy International Primary and secondary health care systems for children in Afghanistan are barely functioning. On average, 4 children die each day in the main children's hospital in Kabul, Afghanistan of preventable/easily treatable illnesses. Strategies to help pediatricians from advantaged countries address this unethical situation include advocacy, twinning (individual or departmental sponsorship of a children's hospital unit, a maternal child health (MCH) clinic or of an Afghan pediatrician), and the acquisition of medical equipment and supplies. Integration of community and hospital health care for children is promoted as the key strategy, with a particular emphasis on continuing medical education and morale building in local medical staff to maintain the practice of pediatrics in the country. Measures to reduce suffering are as important as those designed to save lives. UN Convention on the Rights of the Child (International Law in 1990) Article 38 Point 4 In accordance with their obligations under International Humanitarian law to protect the civilian population in armed conflicts, States Parties shall take all feasible measures to ensure protection and care of children who are affected by an armed conflict. Constant fear and recently witnessing one of their parents being blown apart by a rocket left the two sisters shown in Fig 1 mute. Do we believe that such children are inherently different from those living in advantaged countries such as the United Kingdom or the United States? Do they feel the pain of injury, illness, and loss of a beloved relative any less? Do they have different dreams? We can not know. However, from an ethical standpoint as pediatricians and human beings, how long can we continue to accept the extreme poverty and armed conflict that impacts on so many children in disadvantaged countries such as Afghanistan?1–12 Fig. 1. These sisters are mute after the death of one of their … Address correspondence and reprint requests to David P. Southall, MD, FRCPCH, FRCP, Child Advocacy International, 79 Springfield Rd, Stoke-on-Trent, ST4 6RY, United Kingdom. E-mail:cai_uk{at}compuserve.com.