As the global fight against COVID-19 continues, Afghanistan is struggling to safely absorb the over 271,000 people who have returned from neighbouring Iran and Pakistan since January at a time when infection rates in the capital are worryingly high.

A key constraint hindering a meaningful response to the pandemic is the low capacity for testing. Eight testing facilities established since January have a daily capacity of 100-150 tests each. However, there is a significant shortage of trained lab technicians and more testing kits are urgently needed.
The grave concern is that Afghanistan has extremely limited infrastructure to treat severe cases. Life expectancy is only 50 years for both genders and a high percentage of the population have pre-existing conditions such as TB, HIV-AIDS, malnutrition, cancer and heart and lung diseases, with environmental pollution another major factor in general population health.

“Movement and quarantine restrictions have a limited impact despite being in place countrywide but based on the socio-economic realities in the country – families cannot go for more than a few days without working in order to keep themselves afloat,” explained Nicholas Bishop, Emergency Response Officer with IOM Afghanistan.
“Hence, the out-migration trend back to Iran resumed two weeks where people are desperate to feed their families,”
Social distancing is unfeasible in a country where the average family size is seven and most people live in small, confined, one room homes with poor ventilation.
“In rural areas, there is a major gap in awareness. A recent community perception survey carried out by a grouping of NGOs showing 60 per cent of residents were uninformed about COVID-19,” Bishop added.
Further exacerbating the COVID-19 response is the expansion of the conflict over the past three months where security incidents and lack of access to non-government controlled areas means that there is no testing in over 30 per cent of the country.

“We may be missing the profound impact of the disease in these areas where the international community is receiving multiple requests for support for health care,” Bishop said.
Despite these seemingly insurmountable challenges, IOM says it is actively responding to COVID-19 in close partnership with the Ministry of Public Health and the WHO with over 100 health staff deployed to border level surveillance, health facility-based interventions and mobile health teams.