The International Committee of the Red Cross issued the following press release on Wednesday. The ICRC also posted a witness account, "A Day in the Children's Ward at Mirwais Hospital"
The main conflict-related challenges faced by Afghans in 2010 will persist in 2011....Those challenges are civilian casualties, internal displacement, and insufficient access to medical care, all of which are occurring against the background of a proliferation of armed groups.
"In a growing number of areas in the country, we are entering a new, rather murky phase in the conflict in which the proliferation of armed groups threatens the ability of humanitarian organizations to reach the people who need their help," said Reto Stocker, head of the ICRC delegation in Afghanistan. "One armed group may demand food and shelter in the evening, then, the next morning, another may demand to know why its enemy was given sanctuary." The emerging groups, which also include criminals, remain difficult to identify.
"Many people see fleeing as their only solution and many end up in camps for the displaced or with relatives in neighbouring districts," said Mr Stocker. Together with its partner organization, the Afghan Red Crescent Society, the ICRC has provided just over 140,000 people throughout the country with food and other items since January 2010. Rural and urban water projects gave 412,000 people access to safe water.
As the conflict has intensified and expanded geographically, civilian casualties have once again increased in comparison with previous years. Mirwais Regional Hospital in Kandahar, serving around four million people, has admitted over 2,650 weapon-wounded patients so far in 2010, compared with just over 2,100 in 2009. The seven ICRC prosthetic/orthotic centres have fitted close to 4,000 new patients with prostheses so far this year. Many of them lost their limbs as a result of fighting.
"The ICRC maintains a constant dialogue with the armed opposition, the Afghan national security forces and the international military forces on concerns relating to detention and the conduct of hostilities. This dialogue is confidential, yet frank and direct when it needs to be," said Mr Stocker. So far this year, the ICRC has followed the individual cases of over 2,630 detainees throughout the country held by international or Afghan authorities to monitor the conditions in which they are being held and the treatment they receive, to ensure that procedural safeguards are met and to enable the detainees to restore or maintain contact with their families. Over 2,000 people took advantage of the opportunity to maintain ties with other family members through video telephone calls, Red Cross messages or ICRC-organized visits to places of detention.
The ICRC frequently receives reports of local medical staff who have been threatened while performing their tasks, and of patients either prevented from or delayed in reaching health-care facilities despite the fact that both are protected under international humanitarian law. "The number of mothers coming in with children dying from easily preventable diseases such as measles or chronic diarrhoea is staggering," said Dr Bart de Poorter, an ICRC health coordinator working in Afghanistan. "But what doctor or vaccinator is brave enough to venture into rural areas given the appalling lack of security and the lack of respect for medical staff?"
Among the essential principles of international humanitarian law is the requirement that persons not taking part in hostilities be treated with humanity in all circumstances.
"The humanitarian principles that we have insisted on constantly in the past decade are as relevant, if not more so, than ever," said Mr Stocker. "In today's Afghanistan, it unfortunately remains urgent and necessary to abstain from attacks against civilians, to spare medical services and to ensure that detainees receive decent treatment."
Afghanistan, where the ICRC has been working since 1979, is the site of the organization's largest operation worldwide with over 1,750 staff based in 15 offices, and a budget for 2011 of 89 million US dollars.