Work Plan: Turning Knowledge Into Action

In 2003, Global Watch Group will continue to concentrate where need is greatest, in Afghanistan, with an eye towards replicating its work in other regions of the developing world in the future. GWG will concentrate on three key actions:

1. Documentation of needs and conditions, with accompanying policy prescriptions and recommendations for action;
2. Outreach and advocacy around GWG findings and prescriptions to raise awareness, to increase resources to improve conditions;
3. Piloting service provision projects.

I. Diagnosis and Prescription: Documenting Conditions in Afghanistan

In the late 1990s, Zohra Rasekh, one of the GWG founders, traveled undercover into Afghanistan to document the treatment of women under the Taliban, as well as the effects of the oppressive regime on the physical and mental health of women. In 2001 and 2002, GWG returned to Afghanistan to document access to basic and emergency healthcare in 3 different regions, and to begin plans for service provisioning. In 2003, we will build upon this work, and begin the process of turning our research into policy prescriptions and recommendations for action.

Global Watch Group researchers, in collaboration with on-the-ground colleague organizations already working in Afghanistan, and partner NGOs with expertise in human rights, will return to Afghanistan, beginning in March of 2003, to document conditions in the following areas:

• Access to healthcare. GWG has completed three needs assessments so far:
  • In January of 2001, in the northern part of Afghanistan;
  • In January 2002 in the capital city,
  • and in March of 2002, in the western region of the country.
  GWG’s needs assessments are accompanied by clear recommendations, and plans for action for the organization. Furthermore, GWG plans to expand its focus from basic and emergency healthcare to other immediately urgent forms, including reproductive and mental healthcare for women suffering from trauma and abuse from two decades of war, Taliban policies, and the war waged to bring about the Taliban’s fall.
• Respect for human rights, especially the rights of women. Hand-in-hand with healthcare is the need to document human rights conditions in Afghanistan, particularly that of the majority of the population: women. Women comprise a full seventy percent of Afghanistan’s population. Though the Taliban is no longer in power, it is essential that there be a watchdog presence in Afghanistan to ensure that women are no longer subjected to extreme physical and psychological abuse.
  
  Zohra Rasekh, one of GWG’s founders, has experience working undercover in Afghanistan to document the treatment of women during the Taliban regime. a In 2003, GWG will return to Afghanistan to document the treatment of women under the new regime.. GWG will publish the results of this research, concentrating again on policy prescriptions for the new government and the international community to improve the status of women, along with plans for action for GWG and other organizations returning to the country.

With its research, policy prescriptions and action steps in hand, GWG will be well-positioned to take the next critical steps: raising awareness of the conditions in the country, and building support by governments and multilateral nongovernmental organizations to meet the exigent needs of the Afghan peoples.

II. Prognosis: Outreach and Advocacy to Increase Resources

Too often, today’s crisis becomes tomorrow’s broken commitment. Many are aware that it was in the early 1980s that the United States first became involved in an Afghanistan conflict, with covert military aid to help the country in its war for sovereignty amidst the Soviet incursion.

It is also widely recognized that the United States failed to take the more critical step, after the invasion: to aid Afghanistan in building the structures and systems that help provide for a lasting peace. The failure to do so contributed to the rise to power of the Taliban, with whom the United States went to war. Fewer people recognize an early and severe warning sign that preceded the current crisis: the first group the Taliban declared war on was Afghan women.

To fail to learn from this past is to repeat it. It is critical that Afghanistan receive international assistance to rebuild. In order to receive international assistance, it is necessary to ensure that Afghanistan does not fall out of the public eye, not now, not in the near future, and not once the current crisis abates and the new government is more firmly in place.

GWG has experience documenting the facts and needs; we are also experienced in generating attention, and in making sure that the people who need this information, receive it. Since 2000, GWG founders have appeared in over 100 media pieces, including in-depth interviews on Dateline NBC and CNN, and have given over 100 presentations to diverse forums, from concerned citizens to the governmental and nongovernmental actors who have the power to improve conditions. In 2003, GWG will continue and expand its work to raise awareness on these conditions, and to advance its policy prescriptions and recommendations for action.

III. Treatment: Medical equipment and Services to the Hardest-Hit

In 2001 and 2002, three fact-finding teams from Global Watch Group, led by Dr. Cynthia Johnston, Zohra Rasekh, MPH and Dr. Ali Safayan, visited the northern and western regions and Kabul in order to assess the health condition of internally displaced people (IDPs) and the condition of local hospitals and clinics. Many Afghans, fleeing the war, the totalitarian rule of the Taliban, and years of drought, were forced to live in exile in this region.

Near the northern villages of Khoja Bhawahuddin and Dosht-e-Qala, thousands of families were living in makeshift tent homes in camps without access to basic medical services. In the Panjshir Valley, many displaced persons lived in crudely built shelters with poor sanitation, far from medical facilities. The existing regional government-supported village clinics lacked essential medicine and supplies. Where present, the few NGO-supported medical facilities were sparsely equipped and poorly attended. Many people were ill any dying of potentially curable acute respiratory disease and diarrhea. Other diseases including malaria, TB, typhoid and measles had been reported in the camps. In the western province of Herat, the only public hospital lacks basic medical equipment and supplies.

It is clear that, even before the war, healthcare needs were not being met; access to basic healthcare in Afghanistan reached only 30% of the population. In 2002, the conditions are even grimmer, as the Afghanistan healthcare infrastructure, already fragile prior to the war, is now in ruins.

In phase I, GWG had plans to complete a needs assessment and work with the American Public Health Association (APHA) and the American Hospital Association (AHA) on planning a pilot project for provisioning of medical equipment to the Herat hospital in Afghanistan. The needs assessment and the planning work for the pilot has been completed

Phase II of the GWG efforts will include implementation of a pilot for the collection, transfer, delivery and installation of medical equipment, as well as training of local medical technicians and other staff at Herat public hospital.

In phase III of its work plan, GWG will expand its hospital revitalization project to more hospitals in other hard-hit regions of the country.

In phase IV, GWG plans to continue and expand its previous projects and also expand into other areas of Afghanistan, particularly in the north. In addition, it will begin to meet the basic and emergency healthcare needs of the hardest-to-reach and most needy segment of the population by beginning a pilot project in the western part of Afghanistan. Plans and structure for service provision include:

• Fielding tents and/or mobile health units equipped with basic medical equipment and supplies;
• Establishing a reliable and secure supply route for regular delivery of medicine and supplies;
• Training local medical professionals to staff the tents and mobile units.
• Expanding services to include reproductive, and mental healthcare for women and children.

Time Line

Phase One: 2002 and Ongoing

• Conducting needs assessments for primary, mental and reproductive healthcare;
• Coordinating efforts to fill in the gaps in healthcare system
• Expanding the number of media pieces and presentations, to build support for programs;
• Planning the first phase of the hospital revitalization project.

Phase Two: 2003 and Ongoing

• Continuing documentation and advocacy;
• Implementing the first pilot of the hospital revitalization project in Herat by 4Q 2003. This project is a collaborative effort by GWG, the American Hospital Association (AHA) and the American Public Health Association (APHA).

Phase Three: Early 2004 and Ongoing

• Continuing Phase I-II work;
• Expanding the hospital revitalization project to more hospitals in other parts of Afghanistan.

Phase Four: 2004-2005

• Fielding one pilot mobile healthcare project to reach remote areas;
• Re-assessing the healthcare situation in Afghanistan;
• Expanding coverage to include reproductive healthcare and mental healthcare for women;