A Chinese humanitarian health worker coping with COVID-19 in Afghanistan

An Na, a Chinese gynecologist-obstetrician, has been working as a humanitarian worker in many conflict and crisis zones, including Sierra Leone, Somalia and Ethiopia, since 2011. Last August, she embarked on her most recent mission with the International Committee of the Red Cross (ICRC) to support the obstetrics and gynecology department at Mirwais Regional Hospital in Kandahar, Afghanistan.

She recently finished her 11-month mission and returned to Beijing. This trip was her first mission to Kandahar, but it was the fifth time she provided humanitarian aid to the people of Afghanistan.

Coming from a long line of doctors in Beijing, An followed in her parents' footsteps and became a doctor herself. Nine years ago, she quit her job at Beijing Cancer Hospital to participate in humanitarian aid. She has worked with such organizations as the ICRC and Médecins Sans Frontières (MSF).

"I was strongly influenced by my parents, and I'm always striving to be a good doctor who treats patients and saves lives. I think delivering humanitarian aid aligns with my original aspiration as a medical worker and enables me to help those who need it the most," An told China.org.cn.

"In war-torn areas, where diseases rage and medical facilities and medical staff are in shortage, people need medical care. After experiencing it firsthand during my first mission in 2011, I decided that I will continue to devote myself to this line of work."

A Chinese doctor in a "Chinese hospital"

An arrived at the Mirwais Regional Hospital on Aug. 14, 2019. Built by China in the 1970s and supported by the ICRC, the hospital is the largest health center in Afghanistan's southern region. It provides health services to the people of Kandahar and neighboring provinces. 

"When the local Afghan people found that I came from China, they told me that they are very happy to have a Chinese doctor in this 'Chinese hospital'!" An said.

"In Afghanistan, I have seen many diseases that have disappeared or are very rare in China or developed countries. There are people losing their lives because of some very common and preventable diseases," An said. 

"For decades, Afghanistan has been mired in conflict. Insecurity on the roads and having to travel long distances make it hard for some patients to seek care. The shaky health systems also are facing a shortage of health workers and facilities.

"Many pregnant women just give birth at home because they don't understand pregnancy or that they should go to the hospital to give birth. They often only go if something goes wrong – for example, if they start bleeding or lose consciousness. Because of this, the patients I saw at the hospital were often in a critical state."

Even with little more than rudimentary hospital conditions, An said that the Mirwais Regional Hospital still assists about 2,200 births each month, which translates to more than 70 newborns every day. 

Apart from the clinical work at the obstetrics and gynecology department, she also helped train the local staff so that they could develop the capacity to run the medical facility independently if the ICRC one day leaves. 

Coping with the COVID-19

An had been doing her regular job for the first eight months in Kandahar until the coronavirus slipped into Afghanistan in February.

"COVID-19 had a significantly negative impact on our health services," An said.

She recalled a pregnant woman who arrived at the hospital in a coma. The patient was found to have acute fatty liver of pregnancy, a rare and life-threatening pregnancy complication. An asked the patient's family why they had sent her to the hospital so late. 

"Her husband explained that they lived on the border between Afghanistan and Pakistan. Under normal circumstances, it took a short time to cross the border and go to hospitals in Pakistan. But since the border was closed due to the coronavirus, they could only drive over three hours to our hospital," An recounted. 

In addition to the impact on normal medical services, An has also witnessed soaring prices and shortages of medical supplies.

"Fortunately, thanks to the strong support of the governments of all countries, including the Chinese government, and various international organizations, medical supplies were sent to Afghanistan," An said.

After COVID-19 broke out, An was also responsible for guiding the ICRC staff to implement preventive measures.

"Wearing a mask, keeping social distancing, and washing hands … these things sound simple, but they are big asks for the locals who don't have such habits. I have to explain the importance of these habits to them," An said.

Risk and determination of working in conflict zones

COVID-19 is making Afghanistan's shaky health system even more overstretched, but the conflicts and attacks on medical staffs and health facilities have not abated. 

"I was so sad to hear about the loss of 24 people, including women and newborn babies, in a brutal attack on the maternity wing of Dasht-e-Barchi hospital, which is run by the MSF, in Kabul in May," An said. 

A report released by the UN Assistance Mission in Afghanistan documents 15 incidents of violence targeting healthcare workers, including 12 deliberate attacks, between March 11, when COVID-19 was declared a global pandemic, and May 23, when a three-day ceasefire between the Taliban and the Government of Afghanistan began.

Though the ICRC's delegation station, where An lived, is only a five-minute walk from the hospital, she and other medical staff still took a car to the hospital and back every day due to safety concerns.

"I hope there will be no more attacks on medical facilities and humanitarian workers," An said.

Though she also feared for her own safety when working in conflict zones, An said she was always ready to make a difference. 

"The smiling faces of the patients and their families when an illness is cured, my counterparts' perseverance to save lives and the local people's aspiration for a better life … These things motivate me to stay committed to humanitarian work.

"But the pandemic has brought new challenges to international humanitarian relief efforts. We need to adjust and adapt to the 'new normal' of relief work. We need to help local people to the greatest extent possible while still protecting ourselves," An added.