Wardak province lies to the south and west of Kabul City. It is a strong Pashtun area and while the men may know both Dari and Pashto, the women generally only know Pashto. There are many small villages scattered around 1-2 major roads through the province. There has been a lot of anti-election activities in this province, and there are a lot of opium fields that have not been eradicated. The government BPHS programme is administered by the Swedish Committee in this province.
Background
In 1985, the IAM started an MCH clinic in Karte Se, Kabul. This clinic remained opened throughout the remaining years of the Russian occupation, the mujihideen retaking of the city, and the subsequent civil war that led to the takeover by the Taleban in 1997. It continued services during the expatriate evacuation in September 2001, and under the interim government that followed. Each government honored the IAM clinic and at times because of expatriate presence of nurses and/or doctors, it was the only clinic opened in the city. The government staff was supplemented by privately hired and trained staff since 1993. In 1999, the project began exploring ways to reach out beyond the clinic, and taught midwives in the community. Basic Health teaching was begun in some neighborhoods in 2002. In 2003, the clinic building was returned to the previously absent landlord and since the government could not provide another structure, the acute care IAM MCH clinic ended. Within months, the expatriate team and some of the private staff began looking at the possibility of working in Kapisa, teaching Community Health Workers. This now restructured project began, but within months, the government requested that the IAM remove its teaching services from Kapisa, so that the government could perform all services. The team connected with Swedish Committee who asked the IAM team to do CHW training in Wardak. Thus the project moved a second time to this highly Pashtun area. The base office remains in Kabul, with national and expatriate staff commuting 45 minutes to villages southwest of Kabul.
Current Activities
During 2005 the project planned to train and use Community Health Workers in 6 villages. This was not achieved owing to security, cultural resistance, and some people having access to health services. Despite this, training was completed in 3 villages and the SCA was pleased with progress made towards promoting the Basic Package of Healthcare Services.
Future Plans
As a result of its strategy to reach the remoter and more underserved areas, in 2005 IAM made the difficult decision to close this well-functioning project. |
