Violence is so bad in parts of Afghanistan that Red Cross clinics are shutting their doors

 Violence is so bad in parts of Afghanistan that Red Cross clinics are shutting their doors

An Afghan man who lost his leg to a land mine tries out his new prosthetic leg inside a Red Cross orthopedic center in Kabul.KABUL — A smiling physiotherapist beams in a framed photo inside the Red Cross center here, hinting at a radiant personality that charmed her orthopedic patients before a man with polio took out a gun hidden in his wheelchair and killed her.

The slaying of Lorena Enebral Perez at a clinic in the northern city of Mazar-e Sharif followed the roadside killing of six Afghans working for the International Committee of the Red Cross (ICRC) and three abductions earlier in the year, part of an expansion of violence by smaller militias and by the Taliban that during the past week has led to more than 200 deaths.

That violence has prompted the international aid agency to shut down two of its offices in the northern part of the country and to scale down operations in Mazar-e Sharif — a decision that will affect hundreds of thousands of Afghans who receive aid from the organization in seven northern provinces.

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“The places where you have war and insecurity are the places where your help is needed,” said Alberto Cairo, a doctor who during the early 1990s spearheaded the creation of ICRCs orthopedic program, which treats 160,000 people per year across the country. “At the same time, you cannot deliver it. If we cannot guarantee the security of our staff, how can we work?”

So far this year, there have been 107 attacks on health facilities, up from 41 last year, according to the United Nations Office for the Coordination of Humanitarian Affairs. Fifteen aid workers have been killed in attacks, and 43 more have been abducted this year, down from 121 kidnappings the year before.

The orthopedic centers roughly 8,500 patients who have lost legs to war or stray land mines, plus another 17,500 who have problems walking due to cerebral palsy, polio and other ailments, will still be able to receive treatment at the Mazar-e Sharif clinic. But the roughly 675,000 other Afghans who rely on the ICRC for food, water or medical aid in the north will be left without options until the Afghan government or another aid group fills the gap.

With U.S. Secretary of State Rex Tillerson calling on Pakistan to help force the Taliban into peace negotiations amid a surge of 4,000 more U.S. troops, the militant group is fighting for a stronger presence outside its southern strongholds.

In that setting, more aid workers in areas once considered relatively safe have become targets for attacks or abductions. Meanwhile, more people need help.

During the past 12 months, 8,000 civilians had either died or were injured by military operations, down slightly from a peak of 8,500 in the previous year, according to the United Nations.

U.N. officials say humanitarian aid groups are trying to strike a balance by limiting their operations in some areas or prioritizing services to meet only the most urgent demands.

“We have to put the oxygen mask on ourselves before we can help others,” said Toby Lanzer, the U.N.s humanitarian coordinator in Afghanistan. “I think, for the time being, you will see a reduction of aid in some of the areas where aid agencies have been hit.”

The erosion of security in the north is due to a variety of reasons, security analysts say.

In the hostile Kunduz province, fighting between the Taliban and government forces has led to instability all around, making it harder for aid groups to know who is in charge. Elsewhere, smaller renegade groups — some of whom claim affiliation with the Islamic State — have taken hold in areas not under firm control of the government or the Taliban.

Those groups are behind many of the aid worker abductions and the attacks on medical facilities, said Obaid Ali, a director with the Afghan Analysts Network who focuses on security issues in the north.

“They are small groups who work under their own flag and in many cases they refuse to obey Taliban rule and honor local culture,” Ali said. In the case of abductions, “its really hard, and its really dangerous to approach these people and discuss terms with them.”

The increased instability revealed itself to the ICRC in December, when a Spanish member of the staff was abducted by a group of gunmen while traveling from Kunduz to Mazar-e Sharif. Carlos was held for a month before the ICRC negotiated his released.

In February, another group of armed men attacked an ICRC convoy in the northwestern Jowzjan province, killing six Afghan staff members and abducting two others, holding them until September.

Lorena Enebral Perez, a Red Cross physiotherapist, was killed by a patient inside a Red Cross orthopedic center in Mazar-e Sharif.Lanzer said the U.N. humanitarian affairs office is working to figure out how to fill the gap of services left by ICRCs decision to close its offices in the Kunduz and Maimana provinces.

There, the organization assisted wounded fighters on both sides of the conflict, connected prisoners with their families, developed clean water and sanitation programs, and referred patients to the orthopedic center in Mazar-e Sharif, which was temporarily shut down after the shooting but will remain functioning at least through the end of 2018.

Lanzer said replacing the other two offices will be challenging if it is its not clear who is in control.

“I think that with the Taliban, there is a conversation which is manageable,” Lanzer said. Once services cease in those gray areas, “re-engagement becomes very difficult because you dont know who to deal with.”

In Kunduz and Maimana, local officials lamented the closure of the ICRC offices.

“People will suffer a lot,” said Mohammad Hashim, a parliament member in Maimana. “We have discussed the problems people will face in the Parliament and very much hope they will come back.”

Inside the ICRC orthopedic center in Kabul, therapists busily attended to dozens of patients without legs and those who had other walking disabilities.

In the mornings, as many as 500 people walk into the center for treatment and therapy, Cairo said. One was Sayed Rohullah, 16.

He lost his right leg about a year ago after stepping on a land mine in his neighborhood in the eastern Paktia province, near the Pakistan border, while walking to a local shop on an errand. After being fitted for a prosthetic limb four days earlier, he was still wobbly, Rohullah said.

But “it will change my life in a positive way because, without it, I will not be able to work,” he said.

Most patients are grateful for the aid. But Enebrals murder revealed how vulnerable the organization can be while sometimes tending to people who bear grudges against other patients or staff members, Cairo said.

“We trust very much that our visibility, our acceptance, the fact that we are useful has always been our best defense,” he said, adding that the shooter was a 21-year-old man who had been receiving treatment since he was 2.

“Its like if your child suddenly kills you,” Cairo said. “It comes as quite a shock.”

Sayed Sahaluddin contributed to this story.

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By: The Washington Post

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