BAGRAM AIR FIELD, Afghanistan (July 20, 2008) — Like most of Afghanistan's provinces, Konar has historically been unable to meet the medical needs of its 381,000 residents, but now Konar’s Provincial Reconstruction Team is working to meet those needs.

As recently as 2002 and shortly after the departure of the Taliban, Afghanistan has faced some of the worst health statistics ever recorded worldwide, including an infant mortality rate of 16.5 percent and 1,600 maternal deaths for every 100,000 live births. More than 25 percent of Afghan children die before their fifth birthday.

There was a great need to provide basic, preventive and life-saving health services to provinces like Konar, where nearly 60 percent of the population was lacking access to any form of health services. PRT Konar is one of 12 U.S.-led partnership organizations working with the government of Afghanistan to rebuild the healthcare system and improve medical services.

Much of the work to rebuild the healthcare infrastructure in the Konar province has been managed by Navy Lt. Gregory Monk, a PRT physician assistant from Naval Hospital Camp Pendleton, Calif. His team of corpsmen includes Petty Officer 2nd Class Alexander Tabayoyon from Naval Air Station Fallon Nev., Petty Officer 2nd Class Ixchel Mattes from Naval Hospital Brementon, Wash., and Seaman Leo Cedeno from Branch Clinic China Lake, Calif. 

Monk and his staff of three corpsmen work closely with the provincial health director, Dr. Fazli, to assist in the implementation of the Basic Package of Health Services.  The BPHS is a strategy developed by the Afghanistan Ministry of Public Health (MoPH) to provide a standardized package of basic health services. The MoPH, Dr. Fazli and Aide Medicale International, with input from the PRT, use the BPHS to identify districts with under-served populations and determine the location for new facilities.

Aide Medicale International is a humanitarian apolitical French organization that implements healthcare networks around the world. The strategy was designed to increase access to MoPH facilities in remote areas (> 2 hours walking distance).  After selecting the locations for the clinics, Monk works with the PRT engineers to solicit contract proposals and oversees the quality of construction for the new buildings.

Once the building is constructed, the staffing, professional medical training and acquisition of supplies needed to run the clinics are provided by AMI.  With the assistance of the PRT, 15 new healthcare facilities are being added to the province.  Dr. Asadullah Fazli reported that six years ago the Konar Health Network consisted of only 12 low-quality clinics.  Now there are 24 healthcare facilities (one provincial hospital, nine comprehensive health clinics, 14 basic health clinics and an additional 242 basic health posts).

Assisted by local Afghan doctors, the PRT medical team conducted village medical outreaches in the remote regions of Konar where local clinics do not exist.  On missions into the local communities they have treated Afghans for a variety of ailments. According to Monk, worms and other intestinal illnesses were predominantly the ailments afflicting most Afghans.

The Konar River, which flows through the province, is used by the community for everything: drinking, cooking, bathing, hygiene and even recreation. Unfortunately, the river is heavily contaminated with pathogenic bacteria, parasites and viruses. According to Monk, almost everyone he sees for evaluation complains of stomach pains.

“The stomach pains are commonly caused by worms or other parasites, but chronic conditions, such as reflux disease, is just as common,” explained Mattes.  “Education on simple acts of washing hands and boiling water before use can prevent a majority of these illnesses.”

Once regularly performed, these engagements became less common because of the growing number of clinics and local doctors in the villages. 

“It makes you feel good to go out and assist Afghan doctors in remote villages that have zero access to medical treatment, we hope that one day every community has it’s own clinic ultimately becoming less reliant on these outreach missions,” said Monk. 

With a continued close partnership between the PRT and the provincial ministry of public health, available health care will soon be a reality to the residents of the Konar province.