Monday, January 6, 2014

More Sad Evidence of Afghanistan's Bad Demographics

A few weeks ago, in a blog post about Yemen, I commented that "It is hard to imagine a country in which women are treated worse than in Afghanistan." Yesterday's New York Times has a story reminding us that the side-effect of the poor treatment of women in Afghanistan is poor health among their children. Although the story is about childhood malnutrition, the issues are much deeper than that.
What is clear is that, despite years of Western involvement and billions of dollars in humanitarian aid to Afghanistan, children’s health is not only still a problem, but also worsening, and the doctors bearing the brunt of the crisis are worried.
Nearly every potential lifeline is strained or broken here. Efforts to educate people about nutrition and health care are often stymied by conservative traditions that cloister women away from anyone outside the family. Agriculture and traditional local sources of social support have been disrupted by war and the widespread flight of refugees to the cities. And therapeutic feeding programs, complex operations even in countries with strong health care systems, have been compromised as the flow of aid and transportation have been derailed by political tensions or violence.
A huge problem is that data collection efforts are stymied in a variety of ways, including politically, leaving us unsure about the actual situation, except to be sure that it isn't good.
In January 2012, for instance, Unicef and the Afghan government’s Central Statistics Organization released a survey of more than 13,000 households showing that some provinces had reached or exceeded emergency levels, with more than 10 percent acute severe child malnutrition.
The survey caused an uproar, but Unicef and the Health Ministry repudiated it, saying it was based on faulty research. Unicef then financed a more thorough child nutrition survey, which was completed in November, but the government has yet to release the data, said Dr. Bashir Ahmed Hamid, head of nutrition for the Health Ministry. “Unfortunately, we faced some challenges with data analysis.”
Estimates of infant mortality from the UN Population Division suggest that Afghanistan has a rate nearly twice the world average and the highest level outside of sub-Saharan African.

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