Archive for the ‘Afghanistan’ Category

Tracing every last virus – Reliefweb

Afghanistan steps up surveillance to accelerate polio eradication

A strong surveillance system is the backbone of Afghanistans polio eradication effort. It ensures that every single poliovirus is detected and analysed, enabling a quick and effective response to stop every strain of the debilitating virus.

Afghanistan is closer than ever to stopping polio. The year 2016 ended with only 13 cases, down from 20 in 2015 and 28 in 2014. Most of Afghanistan remains polio-free, with transmission limited to the southern, eastern and southeastern parts of the country. Surveillance is key to ensuring that the virus is tracked and stopped wherever it circulates.

Together with partners of the Global Polio Eradication Initiative, WHO is further strengthening Afghanistans surveillance system to accelerate progress towards a polio-free Afghanistan.

Active volunteers track down the virus

Afghanistan currently has a network of 21 000 acute flaccid paralysis (AFP) reporting volunteers, including health workers in health facilities as well as community volunteers such as traditional healers, mullahs, shrine keepers and pharmacists, supported by over 700 AFP focal points. These volunteers actively find and report children who have symptoms that could be polio: floppy, rapid-onset paralysis with no apparent cause. Stool samples are collected from each child with suspected polio, and sent for further laboratory testing and analysis.

As a doctor I feel it is my responsibility to work for polio eradication in my country. Polio is a devastating disease that can cause permanent paralysis so everyone should play their part in ending this disease, said Dr Saifurrahman, AFP reporting volunteer from Shah Wali Kot district of Kandahar. When a patient with floppiness or paralysis comes to the clinic, I examine the child properly and if the signs point to polio, I immediately inform the Provincial Polio Officer, after which well collect stool samples for further testing.

In 2016, the polio surveillance network reported a total of 2903 AFP cases, of which 13 were confirmed polio cases and 2858 were discarded as non-polio AFP. As of mid-February, 31 cases are pending classification.

An external review conducted in 2016 concluded that Afghanistans polio surveillance surpassed global standards and the circulation of wild poliovirus is unlikely to be missed.

With the support of WHO, Afghanistan continues to step up its surveillance system. In last year alone, 458 new surveillance reporting sites have been introduced and the AFP reporting volunteer network expanded by 18%.

When vaccinators go around communities during immunization campaigns and transit teams vaccinate children on the move, they also conduct active AFP case search to further boost AFP surveillance. Active AFP case search has also been incorporated into trainings led by the Ministry of Public Health and WHO ahead of every national immunization campaign.

Strong polio surveillance relies on Afghans who are close to their communities and trusted by them. Saheeb Jaan, a shrinekeeper in Bamyan province, has been a volunteer AFP reporter for 8 years.

If I see a family come to the shrine with a sick child having weakness or paralysis, I report it to the doctors. WHO has given me a referral notebook so that I can get their information and convince them to call the doctors to make sure their child does not have polio, she said. I became a volunteer because it is a good cause and helps save childrens lives. I am happy and proud to be a part of the polio campaign.

Every single AFP reporting volunteer receives comprehensive training from WHO at least once a year, reviewing key aspects of surveillance such as AFP case definition, clinical signs and symptoms of polio, proper check-up procedures and the protocol for notifying AFP cases to the focal point.

Stepping up environmental surveillance

Environmental surveillance, the collection and laboratory analysis of sewage samples, further increases the sensitivity of surveillance in critical areas.

Afghanistans environmental surveillance was set up in Kandahar City in 2013 and samples are now regularly collected from 17 active surveillance sites. WHO and partners conducted a thorough assessment of existing sites in December 2016, leading to three new additional surveillance sites being selected in Kandahar, Nangarhar and Khost, in addition to existing sites in Kabul, Kunar and Helmand. Environmental samples are collected monthly, but sampling frequency has recently been doubled in the south.

In 2016, two poliovirus isolates were reported from environmental samples, down from 19 in 2015.

The road ahead

Afghanistans strong surveillance system ensures that the programme continues to find every strain of the virus in its hiding places, accelerating the road ahead to a country free of polio.

Vigorous training of AFP reporting volunteers and focal points remains crucial in order to guarantee that no AFP case is missed and that samples are collected, stored and transported properly. WHO continues to support the training and orientation of new and existing AFP focal points and volunteers to ensure each volunteer is trained at least once a year.

The programme is engaging more private health facilities to further strengthen the AFP reporting network. Currently almost 1400 private practitioners are involved as reporting volunteers around the country, making up 6% of the network, and the number is increasing. Engaging more private clinics will further improve the programmes ability to find children with paralysis.

Afghanistans surveillance system exceeds global standards but we must continue to stay vigilant and continuously review and expand the system where necessary, said Dr Hemant Shukla, head of the polio programme at WHO Afghanistan. Constantly improving the quality and sensitivity of the surveillance system is critical for securing a polio-free future for Afghanistan.

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Tracing every last virus - Reliefweb

Caron Butler ‘Extreme Red Alert’ Bomb Scare … During Afghanistan Trip – TMZ.com

EXCLUSIVE

Caron Butler admits he was" extremely scared" during a "red alert" bomb scare while he was visiting troops in Afghanistan ... but praises the Army for keeping him safe and vows to go back.

Butler just returned from a trip to the Middle East with the USO -- and even watched the NBA All-Star game with soldiers in Afghanistan.

But a few days before the game, troops rushed in and moved Caron to a secure area after getting intel about a potential bomb threat.

"You could tell a lot of people was in like a extreme red alert," Butler says ... "I was extremely scared to say the least."

"But at the same time I knew I was in the good hands of the U.S. Army and they took great care of us over there."

Butler says he got a deeper appreciation for our troops while overseas and says he's already making plans to visit them again very soon.

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Caron Butler 'Extreme Red Alert' Bomb Scare ... During Afghanistan Trip - TMZ.com

AAF Conducts Majority Of Air Missions In Afghanistan – Aviation Week (blog)

The Afghan Air Force (AAF) is conducting more air missions and air strikes than the U.S. Air Force in Afghanistan, Brigadier General Charles S. Cleveland, spokesman for NATO's Resolute Support training mission, revealed March 1.

Cleveland said the AAF has grown from zero fixed wing combat aircraft on March 1, 2016, to eight A-29s presently conducting combat operations daily throughout Afghanistan, to be joined by another eight aircraft by the summer/early fall. He added that the AAF has the pilots and maintenance personnel to conduct these operations as well as terminal air controllers calling in air strikes daily.

But he added that "they still do need help," so the U.S. Air Force is providing a bridge "until the Afghans can do it all by themselves."

He put the number of Afghan tactical air controllers, who even have their own acronym, ATAC, at over 100.

Cleveland said the AAF will receive another four A-29s in 2018 if a request made by the Obama administration for more fixed and rotary wing aircraft is approved.

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AAF Conducts Majority Of Air Missions In Afghanistan - Aviation Week (blog)

Shoulder-to-Shoulder No More in Afghanistan? – War on the Rocks

The slogans and pageantry following the rollout of the Trump Doctrine has left U.S. partners and allies in South Asia with much to be anxious about. What does an America First foreign policy look like for them? How will this change the currents of a 15-year state building project in Afghanistan? What does a war on radical Islamic terrorism really mean? While allies are in an anxious wait and see mode as the new administration generates its foreign policy, we wondered what Afghan professionals thought of the challenges ahead. To that end, we conducted phone and email interviews with a dozen current and former officials residing in Afghanistan and working at various levels of military, intelligence, and political affairs in the Afghan government. Not surprisingly, they paint a gloomy picture of security conditions in the country. They also express hope and optimism the United States will remain an all weather partner. At the same time, they are offended by the rhetoric and rumored policy changes coming out of the Trump administration. Like a bull in a china shop, Trump is shattering years of patient diplomacy and costly security assistance as Afghanistan enters yet another year of uncertain outcomes.

Growing distrust between U.S. and Afghan allies could not come at a worse time. Most of those we spoke with represent the new generation of emerging Afghan leaders. This generation was born into conflict, but they are eager to lead their country out of war, repression, and religious fundamentalism. They are modern, ambitious, and open to engaging with the Western world. This is why they are so disheartened to see the sudden shift in U.S. policy from inclusive to exclusive politics. At a time when their own state leadership is in question, our Afghan allies want reassurance of U.S. leaders commitment to the international order and ideals it has long stood for.

Sleepless in Kabul

The two main issues keeping people up at night are the political crises in Kabul under the National Unity Government and the deteriorating security situation around the country. The National Unity Government failed to meet important electoral deadlines and cabinet positions remain unfilled, President Ashraf Ghani and Chief Executive Officer Abdullah Abdullah rarely speak to each other, and the unhinged behavior of Vice President Abdur Rashid Dostum has included threatening violence on his own government and actually torturing political opponents. At the least, the political circus has caused considerable frustration and morale exhaustion among the bureaucratic ranks. One officer was very concerned with weak political leadership that is unable to develop and deliver a coherent national strategy to address the myriad of problems facing the country. Another officer is concerned about the absence of a professional officer corps at the highest levels able to understand the changing nature of warfare. He is frustrated with corruption in the ranks, namely promotion by way of loyalty and political connections. Most worrying is the impression that political squabbles in Kabul have on lower ranks within Afghan security forces. Soldiers and police witness political maneuvering in the Ministries of Defense and Interior, often based on ethnic alliances, seeing senior officials position themselves to undermine each others effectiveness and influence.

Security in the country has deteriorated since last year according to data and impression of those we interviewed. Word on the street is that conditions are bleak, while Commander of U.S. Forces Afghanistan, Gen. John Nicholson describes the situation as a stalemate. U.S. military assessments suggest Taliban control 10 percent of the population, while the Afghan Army maintains control over major population centers or 2/3 of population; 15 percent remains contested. The Special Inspector General for Afghanistan Reconstruction (SIGAR) reports nine districts under Taliban control, 32 under Taliban influence, and 133 as contested out of a total of 407 districts in Afghanistan. Other studies put many more of those contested districts in the Taliban control column. One of those contested areas is Lashkar Gah, the capital of southern Afghanistans Helmand province. One official we spoke with traveled there recently and found the Taliban control nearly the whole province. Lashkar Gah still stands, for now. Approaching the capital, he noted that bridges were blown up, roads destroyed, and cars abandoned. What used to be a two-hour drive from Musa Qala to Lashkar Gah now takes up to seven hours given the number of checkpoints manned by Taliban units and criminal groups, not to mention road damage. Insurgent and criminal predation has led to business decline in the market place, increased school closures, a growing unemployment rate, and a greater resistance role for the madrassanow serving as a safe haven and recruitment center for the insurgency. Coupled with political corruption and state neglect, this is a toxic mixture for a growing statesociety division as extremist narratives resonate.

Three hundred U.S. marines are slated to arrive this spring to help retake lost districts and defend Helmands capital, but Afghan military officials are split on the effectiveness of more troops. On one hand, the increase is welcome, but not enough. During Operation Moshtarak, 15,000 marines (with NATO forces) stormed Marjah and surrounding districts in the largest offensive of the war. No one expects a repeat on a scale of that commitment and sacrifice. However, as one officer noted, a medium surge able to help keep provincial capitals from falling and improve logistical and technical capabilities of the Afghan defense forces is desirable. On the other hand, peace building should take a bottom-up process. Afghans are the only ones who can and should take the country forward. That does not mean training, advising, and equipping are unwelcome, but our Afghan allies realize the deleterious impact that a large contingent of foreign ground forces present politically and culturally. The Sustainable Security Strategy the Afghan Defense Force strategy founded upon a methodology of hold, fight, and disrupt so far exhibits inadequate results. The Afghan Ministry of Defense reported that in the last ten months, Taliban initiated 19,000 attacks while government forces conducted 700 counterinsurgency operations (the U.S. Department of Defense reported effective insurgent attacks at under 800 per month between Dec 2015May 2016). However, the U.N. Assistance Mission Afghanistan recently documented a 3 percent increase in civilian casualties since 2015. Moreover, there is growing concern about the effects Afghan clearing operations are having on the local population, namely expanding the number of internally displaced people, many of whom have fled to Kabul, increasing homeless rates and stretching the capitals very limited social welfare programs. Outside of hard power, one area the US can invest more resources in is ensuring Pakistan is a reliable partner against terrorism. All our interviewees suggested the U.S. put greater pressure on Pakistan, which they view as the source of terrorism in Afghanistan.

Are We Still Friends?

Most expressed confusion over an ill-defined and over-generalized expression Trump used in the campaign and now as president: his vow to eradicate radical Islamic terror. One Afghan official expressed dismay: I dont think he knows what it really means, but he hoped Trump would come to a proper understanding and take the right measures. Another said it should be eliminated, but in a manner that does not provoke further extremism. Another asserted there is no such thing as radical Islamic terror. Instead, he said, the United States should focus on the sources of extremism, which he cited as terror sanctuaries, safe havens, and states that produce, support, or use terrorism as part of their state policy. Another believed the United States must create convergence between Muslim countries fighting terrorism, while also applying pressure on those countries supporting and empowering terrorism. Finally, one official cryptically indicated, terror cannot be eradicated through terror, referencing Americas growing reliance on drone strikes and covert operations (though he might also have meant the growing number of botched airstrikes by the Afghan Air Force). Instead, he thought the United States should focus on cultural-educational strategies and devise strong counter-narratives to defy those who espouse terrorism.

When asked about the America First foreign policy, one officer responded:

It was always America first! We understand the U.S. is not a charity organization. But if Trump really believes in America First, then he has to focus on Afghanistan because this country gave America a problem and will continue to if it is ignored.

One officer understood that some of the presidents policies were populist in nature, meant to rally his base of supporters, and might even help him gain support in America. However, he warned that his statements would increase anger among less educated and radical groups who are less familiar with U.S. politics, making it very hard for moderate forces to convince people through a more inclusive narrative. Another officer noted this policy would feed the extremism and put American nationals in danger everywhere in the world. Instead of providing greater opportunity for terrorists through Trumps rhetoric of exclusion, an officer recommended we strengthen interaction and communication between Muslims and non-Muslims.

Frustration was clearly discernible when discussion arrived at the immigration and refugee bans. One officer advised us, We will no longer be fooled by the slogans of camaraderie referring to Afghans and Americans fighting shoulder to shoulder. He was irked by the idea that the priorities of these two nations have diverged:

Its clear now that we are different. While we fought and shed blood together on the battlefield, now we are denied by America? Its a real shame. Many of us are wondering if we can believe America and its promises. If President Trump is saying America First, he needs to honor America and its values, which doesnt include abandoning the rest of the world.

Another officer was confident the immigration and refugee restrictions (which he viewed clearly as a Muslim ban) was a gift to terrorist groups and would serve as a perfect propaganda tool to increase recruits and terrorist activity. He was sure the ban would increase dramatically recruits for Taliban and Daesh. There are already signs the Executive Order on travel has driven a wedge between U.S. and Iraqi troops. Even though the order did not reference Afghanistan, and has been blocked by the U.S. 9th Circuit Court of Appeals, it seems to have had a strong impact among our allies and the potential for undermining partnerships elsewhere should be considered.

Where Do We Go From Here?

The new administration faces a number of unresolved issues in Afghanistan. The most critical include the legality and viability of the National Unity Government, Taliban and Islamic State territorial gains, and the capability and capacity of the Afghan Defense Forces. In addition, there are concerns about balancing regional powers, lending legitimacy to the Taliban, migration flows in/out Pakistan, external support to the Taliban, and internal resource constraints. All of these will test the resolve of the U.S.Afghan partnership. The current NATO presence in the country 8,400 U.S. troops and 4,900 troops from other NATO member states is a far cry from the state-building ambitions that defined the war under the Bush and Obama administrations. Early indications suggest an increase in U.S. troops is forthcoming. It is unclear whether troop increases will come from a more vigorous foreign policy team that endorses hard power options or in response to degrading security conditions across the country. In either case, the U.S. would be well advised to pay attention to the assessments of Afghan allies and to the lessons of history. Moreover, success in managing unresolved issues in Afghanistan may be partially dependent upon how domestic policy decisions are rolled out in America. We have no doubt U.S. and Afghan professionals can overcome and look beyond strategic missteps in the U.S. administration, but they still require and demand strategic guidance, leadership, and sound policy from their respective governments.

When a state is so dismissive of soft power that it is willing to divide even its allies for insignificant domestic political victories, it cedes critical ideological space to the enemy. In other words, as Leslie Gelb warns, states should not make strategy by giving away power. The boogey man in the closet, radical Islamic terrorism, has been given the gift of free power, which it neither had nor deserved. Equally unfortunate is that this strategic blunder upsets the internal momentum in Afghanistan and South Asia in general. As one officer noted, we look to America to balance differences in the region and be an example as leader of the free world. Where statecraft is formed, leaders in Afghanistan and Pakistan will be forced to make hard choices between their own domestic politics, regime stability, and an exclusive America First doctrine. Where statecraft is carried out, our professional allies in the military and intelligence community will also face hard choices between moral and professional imperatives. Each day America does not lead by virtue of its values it yields power to enemies and weakens allies.

The United States has spent over $70 billion on resourcing, developing, and training Afghanistans national defense forces. The success of that mission shows in the commitment that these dozen professionals exhibit and their faith in ideals that a segment of America seems willing to forsake: the liberal international order, free markets, strong civil society, democratic institutions, a free press, and equality under law. If the United States turns its back on those traditions, not only does it give up on these millennials in Afghanistan that have bled and fought with the United States for a chance to be free, but it also gives up on the generation of Americans that fought with them, shoulder-to-shoulder, over the last 15 years.

Matt Dearing is Assistant Professor and Director of the South and Central Asia Security Studies Program at the College of International Security Affairs, National Defense University. Ahmad Waheed is a Fulbright alumnus and former senior research analyst at the Naval Postgraduate School. All opinions are those of the authors and do not reflect the views of the Department of Defense.

Image: U.S. Army photo byCapt. Charles Emmons

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Shoulder-to-Shoulder No More in Afghanistan? - War on the Rocks

Ex-users try to help Afghanistan’s 3 million drug addicts – CBS News

KABUL, Afghanistan -- Raheem Rejaey was a drug addict for 17 years. He lived under bridges in Kabul or in the ruins of buildings. His clothes reeked. In his misery, he tried suicide several times, he said, once intentionally overdosing and lying unconscious in a street for two days, undiscovered.

So he can feel the pain of other addicts as he searches for them in the streets of the Afghan capital. Clean for six years, the 54-year-old Rejaey volunteers for the Bridge Hope Health Organization, a group made of up of former addicts like himself who help get care and counseling to drug users.

It is an overwhelming challenge: Afghanistan has one of the highest rates of drug use in the world, with an estimated 3 million addicts, around 10 percent of its population of 30 million. The government struggles to provide services, but cant keep up as the numbers of addicts grow in the country, which is the worlds main source of opium and heroin.

Authorities have established treatment centers, and police with health officials often round up addicts from the streets and bring them to the centers. Billions of dollars have been spent on counter-narcotics campaigns in the past decade, including encouraging poppy farmers to switch to other cash crops.

Still, officials say the number of drug users is growing. Most addicts come from the millions of Afghans who work in neighboring Iran and Pakistan, where narcotics are even more of a problem.

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Ninety percent of the world's opium originates in Afghanistan's poppy fields, much of it turned into heroin. Every year more Afghans are getting ...

The 10 volunteers at Bridge tour Kabul districts where addicts are most plentiful and provide basic help to 15-30 a day, such as counseling and referrals to drop-in centers where they can get screened for HIV. They often find old friends.

My health was really bad when I was an addict, I was hoping to die, Rejaey told The Associated Press. When I became healthy and gave up addiction, I decided to devote my life to serving these people, because ... I knew there is no one who will care for them.

The ranks of Afghanistans addicts include more than 1 million women and more than 100,000 children, said Abdul Manan Azadmanish, director of drug demand reduction for the Public Health Ministry.

It is a big disaster, he said, speaking at a Kabul rehabilitation center as police brought in several hundred addicts for treatment.

There are believed to be at least 40,000 intravenous drug users in Afghanistan, making them vulnerable to HIV and other infections. The U.N. estimates that around 7,000 people in the country live with HIV and believes the epidemic is mainly centered among those injecting drugs.

Non-governmental organizations are as overwhelmed as the government.

The Bridge organization has a very small budget. Its volunteers take public buses in their neighborhood tours to cut costs, Rejaey said.

An Afghan drug addict waits to receive first aid for his wounds from Bridge Hope Health Organization (BHHO) during a campaign to help drug users get care and counseling, in Kabul, Afghanistan, Dec. 21, 2016.

AP

Reza Gul Jan, another volunteer, became an addict while living in Iran. He stopped taking drugs six years ago and says his heart breaks when he now sees addicts. But a sense of humanity drives me to come here to help them, he said.

The Taliban, which have been waging war against the Afghan government since 2001, are heavily involved in poppy growing. The militants growing control over the poppy fields in the south meant government eradication efforts almost completely halted, while cultivation of the flower grew by 10 percent.

As a result, Afghanistans potential opium production increased 43 percent to 4,800 tons in 2016, according to Salamat Azimi, Afghanistans counter-narcotics minister.

Atiqullah, a 28-year-old in Kabul, was once a well digger with a decent salary. But over the course of 11 years of addiction, his life and health fell apart. He now lives under a bridge in western Kabul, unable to walk.

If I find money to buy food, I wont be able to buy drugs. If I have money for my drugs, I wont be able to have food, he said, weeping. I am tired of this life and even God is not ending my life so I can at least rest in peace.

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Ex-users try to help Afghanistan's 3 million drug addicts - CBS News