A visiting doctorʹs perspective in Afghanistan: poverty, civil war, and private medicine

Starvation, disease, death, war, and migration in many developing countries underscore the need for support from the richer nations of the world. In Afghanistan, for example, resources for hospital medicine are appallingly few, as I witnessed during a visit to the department of internal medicine in the Public Health Hospital, Jalalabad, during 1994–95. Infectious disease accounted for more than half of all admissions (mostly malaria and typhoid), and giving multiple drugs was common. According to a WHO report in 1994, conditions in the wards of the department were “the worst…anywhere in the world”. Doctorsʹ salaries were so low that income was supplemented by work in private clinics, where only the better-off could afford to pay for consultation and laboratory tests. While poverty and political instability remain, there is little hope for Afghanistan.