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Taliban Pursues Upward Graph Of Attacks On Health Workers In Afghanistan

Sustained insecurity and violence continue to have a tremendous impact on health care in the country.

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On October 11, 2019, a doctor, identified as Mohammad Ali, was assassinated by Taliban terrorists in the Payencha region of Dolina District in Afghanistan’s Ghor Province. Taliban terrorists have been repeatedly targeting health workers, including doctors and nurses, as well as medical facilities across Afghanistan.

Facing constant threat, intimidation and harassment from the Taliban, several healthcare practitioners have resigned and health centres have been shut down, depriving civilians of access to healthcare.

Some of the recent incidents targeting healthcare practitioners include:

September 19, 2019: At least 20 people died after a truck packed with explosives was detonated by the Taliban outside a hospital at Qalat in the Qalat district of Zabul Province. It was the main health facility of the Province.


July 17, 2019: The Swedish Committee for Afghanistan (SCA) stated, “The Taliban forced SCA to close 42 out of 77 health facilities in six out of nine districts of Wardak Province so far, and due to this closure, an estimated number of over 5,700 patients are affected on daily basis.”

May 25, 2019: A bomb exploded outside a clinic in the Jalalabad city, the provincial capital of Nangarhar, wounding six people, including women and children.

April 4, 2019: A bombing at a clinic in Puli Khumri, the provincial capital of Baghlan, killed a doctor and wounded 18 others.



Data compiled from the 2011-2018 Annual Reports of the United Nations Assistance Mission in Afghanistan (UNAMA) and Quarterly Report of October 2019, documents 467 attacks on health facilities and workers.

However, there have also been dozens of unreported incidents of attack, kidnapping, intimidation and assault on healthcare practitioners, and the actual incidence would be much higher. An August 29, 2018, report quoted Dr David Lai, Afghanistan Health Cluster Coordinator, under the OCHA (United Nations Office for the Coordination of Humanitarian Affairs), stating,

There are many incidences of attacks on healthcare that are currently not reported. We need to have good information to address the scope of the problem in this country.”

Attacks on healthcare facilities during armed violence and internal disturbances tend to fall into four main categories.

The first is the deliberate targeting of such places to gain military advantage by depriving opponents and those perceived to support them of medical assistance for injuries sustained.


The second category of attack is also deliberate, but in this case for political, religious or ethnic reasons.

The third type of attack is unintentional bombardment or shelling – “collateral damage” from a missile or mortar aimed at a military target.

The fourth and perhaps most common form of violence committed against healthcare facilities is the looting of drugs and medical equipment.

Interestingly, the Taliban’s reason for attacking health facilities and medical staff is to control the hospitals which fall within their areas of dominance.

As Health Ministry spokesman, Wahidullah Majroh, stated, (as reported on September 27, 2017), the Taliban’s intention is to vet surgeons and other medical staff who treat wounded Taliban fighters. Unsurprisingly, Taliban militants have been demanding control over health facilities in their areas of dominance.

According to the quarterly report released on January 30, 2019, by the Special Inspector General for Afghanistan Reconstruction (SIGAR), as of October 22, 2018, there were a total of 74 Districts under Government control and another 145 under its influence, as against 12 under insurgent control and 38 under their influence. The number of contested Districts was 138. Afghanistan has a total of 407 Districts.

Another reason behind the Taliban’s targeting of health service providers is their (Taliban) requirement to have certificates from doctors for their inmates in jail for their release on grounds of illness. Taliban leaders exert pressure on doctors to sign relatively healthy prisoners (Taliban cadres) out of jail, so they could return to fighting.

In one such incident, on May 5, 2018, Dr Mohammad Haqmal was abducted and tortured by the Taliban for several days because he refused to follow Taliban dictates. Later he was given asylum in the UK, as reported on May 23, 2019.

The Taliban has also regularly attacked polio vaccination staff, accusing them of collecting intelligence to target militant leaders with drones and other airstrikes. In June 2019, Taliban’s military commission alleged that internationally-backed health workers collected information used to find and kill Taliban leaders in Special Forces’ raids and airstrikes. The insurgents want vaccinators to stop delivering polio drops door-to-door, and instead to administer vaccines from a central point, such as a village mosque.

Earlier, in October 2017 the International Committee of the Red Cross (ICRC) announced that it would “drastically” reduce its presence in the country after seven of its employees were killed. On February 8, 2017, six employees were killed at an undisclosed location in Jowzjan Province. And later, on September 11, 2017, another aid worker was killed in Mazar-e-Sharif, the provincial capital of Balkh.


The decision by the charity, which has been working in Afghanistan for over three decades, underlined the growing dangers for aid workers.

The Taliban, in the meantime, accused the ICRC of “suspicious” activities during vaccination campaigns and of failing to monitor conditions in Afghan jails and to provide medical aid to Taliban prisoners.

According to the Afghanistan Crises Situation Reports of the World Health Organization (WHO), between January 2015 and July 2019, at least 241 health facilities were closed due to the ongoing violence in the country. 27 facilities were closed in 2015; 29 in 2016; 42 each in 2017 and 2018 and 101 till July 2019.

The trend indicates a steady increase in the shutting down of medical and health facilities. Further, underlining the dire scenario of health expenditure in the country, the World Bank report, Afghanistan: Public Expenditure Update, dated July 2019, noted that the total budgeted health expenditure in Afghanistan was around 1.5 per cent of GDP (USD 8 per capita), whereas the WHO benchmark is 4-5 per cent of GDP or USD 86 per capita.

Ironically, as reported on May 25, 2019, Abdullah Abdullah, the Chief Executive of Afghanistan in an address to healthcare providers stated, “With what we spend on a single day of the war, we could build a state-of-the-art hospital.”

An October 28, 2019, report notes that, in a country of more than 38.33 million, Afghanistan has just 150 hospitals, including regional, district, and special military hospitals, and a mere three doctors per 10,000 people.

Doctors and medical staff suffer from long working hours, low wages and lack of infrastructural support.

Often, due to lack of governmental assistance, doctors and nurses become de facto engineers, repairing vital solar power systems, fixing plumbing, and performing a vast range of other tasks, outside their job description. The result is a steady stream of doctors and staff quitting their jobs.

Even after the US has spent nearly USD 877 billion (until March 2019) in its fight against terror in Afghanistan over the past 18 years, the Taliban grows more confident of returning to power. Afghanistan, once again, stands at the crossroads of history, and no one knows what is coming.

Sustained insecurity and violence continue to have a tremendous impact on health care in the country.

Decades of insecurity have created a physical and mental health catastrophe, even as health workers are exposed to threats and actual violence.

Disclaimer: The facts and opinions expressed in this article are strictly the personal opinions of the author. League of India does not assume any responsibility or liability for the accuracy, completeness, suitability, or validity of any information in this article.

Published with permission from South Asia Intelligence Review of the South Asia Terrorism Portal.

Dr. Sanchita Bhattacharya

Dr Sanchita is a Research Fellow at Institute for Conflict Management, New Delhi. Assistant Editor: Faultlines Area of Interest: Political Islam in South Asia, Pakistan, Terrorism Education: PhD from JNU, Delhi M.A. in International Relations from Jadavpur University, Kolkata.

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INTERNATIONAL

Japanese Doctor Tetsu Nakamura, Working In Afghanistan Since 80s, Killed

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JALALABAD (Afghanistan): A Japanese doctor whose long career was dedicated to helping some of Afghanistan’s poorest people was among six people killed Wednesday in an attack in the east of the country, officials said.

The armed assault in Jalalabad city, the capital of Nangarhar province, was the second deadly incident involving aid workers in recent days and prompted an appalled reaction in Afghanistan and internationally.

Tetsu Nakamura, 73, was the head of Peace Japan Medical Services — known as Peshawar Kai in Japanese — and had been working in the region since the 1980s, when he began treating patients with leprosy in Peshawar in neighbouring Pakistan.


A spokesman for Afghan President Ashraf Ghani called Nakamura “one of the closest friends of Afghanistan”.

He “dedicated his life to helping and cooperating with our people”, spokesman Sediq Seddiqi said.

Attaullah Khogyani, a spokesman for Nangarhar’s governor, said Nakamura, who had been shot in the chest, was in the process of being transferred to a hospital in Bagram near Kabul when he died.



Five Afghans were also killed: three of Nakamura’s security guards, a driver and another colleague, Khogyani said.

Tetsu Nakamura, 73, who headed Peace Japan Medical Services, died from wounds sustained when gunmen attacked his vehicle in Jalalabad.

Photos from the scene showed a white pickup truck with a large cabin. Its side windows appeared to have been shot out, and at least three bullet holes could be seen in the windscreen.

The Taliban denied responsibility for the attack, saying they have “good relations” with organisations that “contributed to the reconstruction of Afghanistan”.
Nangarhar was once a hotbed of activity for the Islamic State group’s Afghanistan affiliate.

Nakamura was famous in Japan for his aid work, which dates back decades.


Peshawar-kai was founded by associates of Nakamura, who had lived and worked in Afghanistan and Pakistan since 1984.

In 2003 Nakamura, a native of the southwestern Japanese city of Fukuoka, won the Philippines’ Ramon Magsaysay Award for peace and international understanding — often called Asia’s Nobel Prize.

In a statement condemning Wednesday’s incident, the UN Assistance Mission in Afghanistan expressed “revulsion” at Nakamura’s killing.

It was “a senseless act of violence against a man who dedicated much of his life to helping” Afghanistan’s most vulnerable, UNAMA said.

Fond of sporting Pashtun dress, Nakamura was an outspoken opponent of the 2001 US-led war that ousted the Taliban regime, whom he defended as able administrators.

“I am not fooled by the justification that violence is necessary for the sake of democracy and modernisation,” he wrote in an old posting on his website.

“True happiness for mankind should be realised not through violence or money, but in a humane way.”

Nakamura also described a variety of his organisation’s projects to help Afghans, including the construction of wells and irrigation canals, as well as health services.

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INTERNATIONAL

At Least 18 Indians Among 23 People Killed In Sudan

A 24-hour emergency hotline 249-921917471 has been set up at embassy of India in Khartoum. 

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KHARTOUM (Sudan): At least 18 Indians were among the 23 people killed in an LPG tanker blast at a ceramic factory in Sudan. In a release, the Indian mission in Khartoum said, 16 Indians were missing after the incident that occurred at Seela Ceramic Factory in Bahri area in Khartoum.

It added that some of the missing may be in the list of the dead as identification is not possible because of the bodies being burnt.

The embassy today issued a detailed list of Indians who were hospitalised, went missing or survived the tragedy.


As per its data, seven people have been hospitalised, with four in critical condition. Thirty-four Indians who survived have been accommodated at the Saloomi Ceramics Factory residence.

External Affairs Minister S Jaishankar has said that the embassy representative has rushed to the site.

A 24-hour emergency hotline 249-921917471 has been set up at embassy of India in Khartoum.



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INTERNATIONAL

PM Modi Holds Delegation-Level Talks With Swedish Royal Couple

Apart from the official programme in Delhi, the royal couple is scheduled to visit Mumbai and Uttarakhand.

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NEW DELHI: Prime Minister Narendra Modi held delegation-level talks with King Carl XVI Gustaf and Queen Silvia of Sweden in New Delhi this afternoon.

The leaders affirmed the common desire for building greater convergences on bilateral, regional and global matters of mutual interest.

The Prime Minister and the King also chaired the India-Sweden High-Level Policy Dialogue on Innovation Policy.


They emphasised the role of collaborative tech-innovation leadership of the two countries in meeting future challenges.

King Carl XVI Gustaf and Queen Silvia arrived on a state visit to India this morning at the invitation of President Ram Nath Kovind.

They were given a ceremonial welcome at Rashtrapati Bhawan. This is His Majesty’s third visit to India. The King will meet the President this evening.



Earlier, External Affairs Minister S Jaishankar called on the King and the Queen after their arrival and held discussions on ways to deepen bilateral ties.

Apart from the official programme in Delhi, the royal couple is scheduled to visit Mumbai and Uttarakhand.

On the other hand, External Affairs Minister S Jaishankar held a wide-ranging conversation with his Swedish counterpart Ann Linde in New Delhi this evening.

In a series of tweets, Dr Jaishankar said they discussed expanding bilateral cooperation in the fields of environment, manufacturing, health and smart cities. He added that there was a strong identity of views on multilateralism.

Both the ministers agreed on a new consultation mechanism. They also discussed challenges posed by terrorism, especially cross-border terrorism and emphasised that right to life is the most basic human right.


They agreed to work together in international fora to address the key challenge of terrorism.

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