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A Memorandum of Understanding between Greece and Afghanistan was signed yesterday by Greek Deputy Foreign Minister Miltiadis Varvitsiotis and Afghan Deputy Foreign Minister Meerwais Nab.

The signing ceremony of the Memorandum in Greeces capital was followed by a bilateral meeting, during which the close historical and cultural ties connecting the two countries were confirmed, given the rich Greek cultural heritage in Afghanistan dating back to the time of Alexander the Great over 2,000 years ago.

Varvitsiotis stressed the importance of promoting a positive agenda of cooperation between the two countries, which, however, presupposes addressing issues of mutual distrust, such as illegal immigration.

He raised, in particular, the issue of facilitating voluntary returns for Afghan citizens, who are not entitled to international protection, and welcomed Nabs positive reception of the Greek proposal to conclude a relevant bilateral Memorandum of Cooperation.

He stressed that the issue of returns is a key part of the new Immigration and Asylum Pact presented by the European Commission.

For his part, Nab expressed the desire to cooperate with Greece on the issue of voluntary returns through the Afghan Embassy in Athens, as well as the hope for a Greek Embassy in Kabul, noting that the Afghanistan side can assist about.

After the end of the meeting, Varvitsiotis made the following statement:

Today I had the opportunity to meet and sign a political agreement with the Afghan Deputy Foreign Minister. Mr Nab and I had the opportunity to discuss issues of concern to both countries, and in particular the complex issue of immigration, he said, adding that Greece has always been committed to supporting internal security and, of course, peace in the region of Afghanistan.

That is why it has been participating in the international effort to address the Taliban threat for many years. In this context, Greece has welcomed and is hosting over 40,000 Afghans in our country, the Deputy Foreign Minister continued.

Many of them have refugee status, some of them do not have refugee status and are considered illegal immigrants. That is why we have already started discussions on the immigration agreement with Afghanistan, to send a message to the people, who risk their lives crossing the border illegally to reach our country, that, even if they get here, eventually their path will not be successful, he concluded.

Varvitsiotis also said on Twitter that Greece and Afghanistan are deepening political relations.

?? ??? ?????? ????????? ?????????? Meerwais Nab ?????????? ?????? ???????? ?????????? ????????? ?????????????. ??????? ??? ????? ????????? ???? ??? ??? ???????? ??? ???????? ??????????? ??? ??? ?????? ????????????? ??? ??? ????????? ??? ????????? ??? ???????. ????? pic.twitter.com/4hVvjQlRa3

— Varvitsiotis Miltiadis (@MVarvitsiotis) October 21, 2020

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Greece And Afghanistan Sign Memorandum On Returning Illegal Immigrants - GreekCityTimes.com

After nearly two decades of war, the U.S. government continues to essentially flush billions in taxpayer dollars down the toilet.

The U.S. lost approximately $19 billion to waste, fraud, and abuse in Afghanistan between 2009 and 2018, according to the top government watchdog for the reconstruction effort there.

According to the new audit from the Special Inspector General for Afghanistan Reconstruction (SIGAR) published last week, the U.S. government lost nearly $3 billion in 323 separate instances over the last two years alone.

Waste, defined as the act of using or expending resources carelessly, extravagantly, or to no purpose," accounted for 90 percent of those 323 instances during that time period, according to the SIGAR report.

Fraud namely bribery, theft, and other forms of corruption accounted for about approximately 9 percent of the remaining incidents, while abuse of power by officials accounted forapproximately 1 percent.

The U.S. has appropriated more than $134 billion for Afghanistan reconstruction since 2002, approximately 47 percent of which SIGAR has reviewed through audits over the years, according to the report.

Unfortunately, it's unclear what specific impact this scale of waste, fraud, and abuse. Indeed, the Pentagon for more than a year has either over-classified or outright ceased to gather critical data on whether the United States is actually succeeding or failing to win the war in Afghanistan.

But according toSIGAR, this bodes poorly for the ongoing Afghan peace process:the report concluded that the waste, fraud, and abuse detailed in its audit doesn't just represent a waste of taxpayer dollars, but a potential threat to the long-term prospect of stability in the country.

"Endemic corruption, widespread insecurity, and lack of accountability over on-budget assistance continue to make any investments made in Afghanistan vulnerable to waste, fraud, and abuse and may threaten the peace process as well as the perceived legitimacy and effectiveness of the Afghan government," according to the report.

In a statement to Task & Purpose, the Defense Department blasted the SIGAR report as replete with "factual errors and misrepresentations."

"The report cites instances of 'waste, fraud and abuse' that pertain mainly to projects completed years ago - some more than a decade ago - that SIGAR investigated previously," DoD spokesman Maj.Rob Lodewick said in a statement. "DoD and several other U.S. government departments and agencies are already on record as having challenged these previous reports as inaccurate and misleading. We continue to voice our well-informed disagreement."

"Furthermore, DoD disagrees with some of the reports conclusions, which are subjective, based on previous contentious SIGAR work, and appear to make little distinction between reconstruction efforts that were mismanaged and those efforts that have, to date, simply fallen short of strategic goals," he continued. "Although some projects have yet to accomplish their intended outcomes, the net effect of the overall effort in Afghanistan has clearly improved Afghan society over the last 18 years, despite an ongoing violent insurgency."

Related: How the Afghanistan withdrawal went from home by Christmas to standby to standby

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The US lost $19 billion in Afghanistan to waste, fraud, and abuse over a decade - Task & Purpose

Internally displaced people flee from Nadali district to Lashkar Gah during ongoing clashes between Taliban fighters and Afghan security forces in Helmand province on October 14, 2020. AFP

UNHCR, the UN Refugee Agency, calls for urgent protection and assistance for tens of thousands of civilians displaced by recent escalation of violence in Afghanistans southern Helmand Province.

Men, women and children have been forced from their homes in Nahr-e-Saraj, Nawa-e-Barakzaiy, Nad-e-Ali/Marja and Lashkargah districts by a fresh wave of fighting between the Taliban and government forces. Many ran for their lives with no belongings. Although the exact extent of new displacement is unknown, local authorities estimate more than 5,000 families (nearly 40,000 people) have fled in the last 10 days since clashes erupted.

This latest eruption of violence and displacement reflects the multitude of challenges Afghanistan is facing today. said Caroline Van Buren, UNHCR Representative for Afghanistan. More support is urgently needed as the country grapples with insecurity in some parts, on top of the ongoing COVID-19 pandemic.

UNHCR, as part of the government-led joint humanitarian response, is helping affected people in Helmand. Initial assessments have identified more than 5,000 displaced people in need of immediate assistance. The number is expected to rise as teams continue assessments.

In the last few days, UNHCR has dispatched emergency shelter kits and essential household items such as blankets, plastic sheets, water buckets, cooking utensils and hygiene kits. In addition, UNHCR is providing cash assistance for particularly vulnerable individuals, such as the elderly, children and women at risk, people with disabilities, and those with serious medical conditions. Our initial assessment found that many displaced families urgently need food, water, shelter, hygiene kits, latrines, and cash for rent and other purposes.

Humanitarians are working with limited access to the majority of displaced civilians, said UNHCRs Van Buren. Disruptions in telecommunications, the threat of improvised explosive devices and the continued closure of the highway between Kandahar and Helmand following the destruction of several bridges are adding to the challenges.

Mobile health teams are delivering services to displaced people in Lashkar Gah the capital of Helmand Province, where the majority of displaced Afghans are currently staying. Living conditions are poor with many living in open spaces, in rented accommodation shared with several families, or in shops in the vegetable market.

The Afghanistan National Disaster Management Authority (ANDMA) has allocated 20 million AFN (US$260,000) and is distributing food packages to some 200 families.

More than 220,000 Afghans have been newly displaced by conflict so far this year while another 456,000 people were forced to flee their homes in 2019, adding to an overall figure of around 4.1 million people displaced in Afghanistan since 2012. Conflict and poverty have prevented most of them from returning to their areas of origin.

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UNHCR - UNHCR calls for protection, support for civilians affected by violence in southern Afghanistan - UNHCR

The Sehatmandi Project provides quality health, nutrition, and family planning services across Afghanistan. The delivery of health services is contracted out to nongovernmental organizations (NGOs) and uses a pay-for-performance approach to incentivize a focus on health outcomes, particularly for women and children. The project is helping to improve basic health and essential hospital services, strengthen the overall performance of the health sector, and boost demand for key health services.

Challenge

Afghanistans health system faces a critical shortage of key ingredients qualified healthcare workers, especially female healthcare workers to ensure that women can seek health services; safe and equipped facilities, particularly in areas that are experiencing active conflicts; and supplies of medicines, equipment and vaccines. Insecurity, gender imbalances, and lack of government revenue severely limit the availability of even the most basic healthcare for most Afghans and the situation has become particularly acute during the COVID-19 Pandemic.

Approach

The Sehatmandi program builds on the innovative approach of contracting out the provision of virtually all basic and essential health services to service provider non-governmental organizations (NGOs). The project takes a pay-for-performance (P4P) approach that directly links the payment of service providers to their performance on the delivery of 11 key health-related services such as immunization, skilled birth attendance, family planning visits, and growth monitoring of infants and children. The performance is verified by an independent third-party monitor before payment is made. The expected outcomes are clearly spelled out and quantified and customized for each province of the country through a contract between the MOH and the NGO with set terms for service standards.

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While cooking in the kitchen, I stopped breathing and my vision went dark. When I woke up, I was on a hospital bed. Every time I come here, doctors are so respectful and care about us. My neighbors and I are so pleased. It is five days that I am here in hospital and I have had a very good experience. I appreciate the hospitals management system. There are so many patients, but the doctors are always doing their best.

Gulab Zarin, Kama district, Nangarhar province

The project focuses on improving the value-for-money by enhancing accountability and transparency in the health sector and is a cutting-edge model for service delivery in fragile and conflict-affected settings.

The project has effectively served as a platform to channel the resources of key development partners in a common results framework to finance basic and priority health services across the country with minimal management cost, including in highly insecure and conflict-affected areas which are difficult to serve.

Results

The program made notable achievements despite the rising insecurity and the COVID-19 pandemic.

Since 2002, international development aid, including support from the World Bank and the Afghanistan Reconstruction Trust Fund, has been a critical part of Afghanistan's development.

Overall health outcomes in Afghanistan have improved markedly since the first decade of the 2000s:

Bank Group Contribution

The Sehatmandi Project is supported by grant of $140 million from the International Development Association (IDA), a $425 million grant from the Afghanistan Reconstruction Trust Fund (ARTF). The ARTF is a multi-donor trust fund administered by the World Bank on behalf of 34 donor partners which have contributed almost $12 billion. The ARTF is a vital mechanism to coordinate international aid. Through the ARTF, donors align and coordinate their support around key development programs, reducing aid fragmentation.

Partners

The Afghanistan Sehatmandi Project is implemented by the Ministry of Public Health of Afghanistan in close cooperation with the donors to the Afghanistan Reconstruction Trust Fund (ARTF), WHO and UN agencies. Afghan and international NGOs support the project as service providers.

The Global Financing Facility for Women, Children and Adolescents (GFF) supports the project with a $35 million grant. The GFF supports low- and lower-middle-income countries to accelerate progress on reproductive, maternal, newborn, child and adolescent health and nutrition, and strengthen financing and health systems for universal health coverage (UHC).

Moving Forward

Building on the programs success and to further enhance health service delivery, additional financing for the project is under preparation to make further investments in health facilities and the capacity of the healthcare system and healthcare providers and expand the menu of health services provided.

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Delivering Strong and Sustained Health Gains in Afghanistan: The Sehatmandi Project - Afghanistan - ReliefWeb

SHAHRISTAN, Afghanistan It was midnight on 6 August when there was a loud knocking at my front door. My husband answered. Standing in the dark was a person asking for my help a baby was being born, Shirin described to UNFPA.

It was the start of the greatest challenge she had ever faced as a midwife.

Shirin, 31, manages a family health house in Usho Golaka Village, in Daikundi Province. Family health houses are community-based facilities that provide a host of basic reproductive health services in remote communities, including family planning, antenatal care, safe delivery services, newborn care and immunizations.

She knew the man. He was a relative of Fatima, one of her patients. Tonight her situation was critical, Shirin said.

Fatima, already a mother of six children, was in labour with her seventh. Shirin was immediately alarmed an earlier examination had shown that the delivery would be dangerous.

Fatimas baby was found to be in the wrong position and the delivery was to be a breach birth, Shirin explained. I'd provided information and counselling on her condition, but advised her to refer the case to the provincial hospital in Nili, the center of Daikundi, for further management of her delivery.

But Fatimas family couldnt afford to seek care so far from home. Were a poor family and the economy and unavailability of transport was a big problem for us, Fatima said. We would have had to pay 13,000 afghanis [$170] for transport to reach the provincial hospital in Nili. This was not possible.

Afghanistan has one of the highest maternal mortality rates in the world, according to United Nations data. Some 638 women die per 100,000 live births. Poverty, lack of access to health services and gender inequality all contribute to these tragically high numbers; fewer than 60 per cent of births are overseen by skilled health professionals.

To address these concerns, UNFPA supports Afghanistans community midwifery education programme, a training programme funded by the Canadian Government, which equips midwives to provide essential basic maternal health services and other midwifery care. These midwives then operate from UNFPA-established family health houses, which provide the only medical services available in Afghanistans remotest and most difficult-to-reach areas.

Shirin graduated from the community midwifery education programme in 2015. She has since worked in the family health house in Usho Gholaka, where she has served hundreds of women.

A midwife wears full protective gear to prevent the spread of COVID-19. UNFPA Afghanistan

Her husband is supportive of her work. That night, he took her by motorbike to the village where Fatima and her family live.

The intent was to save a mother and her baby, her husband said. Ive pledged to support my wife in this work, even if its midnight.

Shirin found Fatima suffering in terrible pain, shouting for help. She tried to find a way for the family to urgently transport Fatima to the provincial hospital, but the family felt it was impossible.

Although Shirin is an experienced midwife, she is not equipped to manage serious complications like breach delivery. But in that situation, she was forced to improvise.

I called an expert gynaecologist who was working in the provincial hospital and asked for instructions. This was the only solution I could come up with that might save their lives. I was instructed to use different manoeuvres to shift the position of the baby in the womb. I followed the gynaecologists guidance carefully.

It was a tense labour but in the end, her efforts paid off.

Finally, the uterine contraction began and a baby boy was born after one hour and 45 minutes of labour. He was safe and healthy, Shirin recalled.

Fatimas family was greatly relieved.

When I heard that Fatima and her baby were alive, I cant tell you how happy I was, Fatimas mother-in-law told UNFPA. I am so grateful to Shirin for being there and helping women in need.

Fatima later brought her newborn to the family health house for postnatal services. Im grateful to Shirin, she said. She saved not only my life but also the life of my child.

And Shirin, too, is grateful. Though the experience was harrowing, she feels she has grown as a midwife.

I was very proud of what I did, she said.

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Midwives on the front lines working to reverse Afghanistan's high maternal death rate - UNFPA News