How Afghanistan Wants Japan to Help
Ahmadyar Akbar / Afghan medical doctor
December 25, 2009
I am an Afghan doctor who has been in Japan for 20 years. Born in Afghanistan, I graduated from Kabul Medical College and worked in the countryside. I came to Japan in 1989 at the time when the Josai Hospital started accepting the Afghan civilians injured in the fighting under the Soviet military occupation and supported their treatment and rehabilitation. At present, I am on the staff of this hospital in Yuki City, Ibaraki Prefecture, and help support the medical activities of the Japan International Friendship and Welfare Foundation (JIFF) attached to the hospital.
This Foundation used to work to help Afghan refugees in Peshawar, Pakistan. It then relocated its clinic to Kabul in 2001, when the refugees began to return home, sent Japanese doctors and nurses there and engaged in medical services in cooperation with the local staff. They are now treating nearly 400 patients every day. As I am going back and forth between Japan and Afghanistan, doing my medical word, I know and want to tell you what the Afghan people are expecting from Japan.
What is most urgently needed in Afghanistan is to restore law and order and for this reason, the top priority should be given to the stabilization of people's lives. If the people find a sure means of making their living, they will be freed from poverty and dissatisfaction, and therefore, have no reason to join terrorist organizations. What then is needed to secure their living? I would say three things: namely, water supply, education and medical care.
First and foremost is the water supply. About 80% of the Afghan people make their living by agriculture and raising cattle. Afghanistan is located in the mountain ranges of Central Asia and the arable land accounts for only 13% of its territory. Although there is enough rainfall and snow to cultivate the crops and produce the feeds for the cattle, many years of war have destroyed the irrigation systems, making it impossible to control the water supply. Rain and melted snow are simply soaked up by the desert, giving rise to a chronic water shortage.
The farmers, therefore, cannot rise out of poverty. This situation makes them dissatisfied with the government, driving them either to help the terrorist organizations or to turn a blind eye to them, which in turn aggravates the security situation. In order for the Afghans to make good use of water, it is necessary to build dams and irrigation channels to collect water and use it wisely. In this way, the life of farmers can be improved greatly. We earnestly look to Japan for technical assistance to this end.
Next comes education assistance. In Afghanistan, about half of the children of school age cannot go to school. Most of them are girls. In addition, 11-million people, about 40% of the population, are illiterate. In recent years, 3500 schools have been founded, but only 25% of them have roofs. The rest are open-air schools. Because many male family breadwinners have been killed or crippled by war, children have to work to earn a living, and cannot go to school. Amidst all these difficulties, there must be created a better environment for education; schools must be built and repaired; teachers must be trained and textbooks provided. For all this, Japan's help is badly needed.
The third priority is medical assistance. The infant mortality rate in Afghanistan is extremely high: 163 out of 1000 births. The death rate of children under 5 years of age is 257 out of 1000. The average life expectancy is 43.7 years. However, 80% of them would have been saved if appropriate medical care had been provided. In concrete terms, more adequate medical facilities and vaccinations are urgently needed. Furthermore, it is hard for women who live in areas of poor hygienic conditions and healthcare to go and see a doctor. To make it easier, I believe that training more female doctors and health workers, as well as the propagation of medical education among the people is indispensable.
I often talk to my elder brother, also a doctor in an Afghan clinic, on the international phone and am concerned more and more about the future after the presidential elections. The abduction of wealthy family members is now a flourishing business so more and more people are fleeing the country. To help secure the stability of life and inspire hope for the Afghan people, I sincerely hope that Japan will extend carefully planned and meticulously executed assistance in compliance with the real wishes of the Afghan people.
The writer is an Afghan medical doctor and Afghanistan Director of Japan International Friendship and Welfare Foundation
This Foundation used to work to help Afghan refugees in Peshawar, Pakistan. It then relocated its clinic to Kabul in 2001, when the refugees began to return home, sent Japanese doctors and nurses there and engaged in medical services in cooperation with the local staff. They are now treating nearly 400 patients every day. As I am going back and forth between Japan and Afghanistan, doing my medical word, I know and want to tell you what the Afghan people are expecting from Japan.
What is most urgently needed in Afghanistan is to restore law and order and for this reason, the top priority should be given to the stabilization of people's lives. If the people find a sure means of making their living, they will be freed from poverty and dissatisfaction, and therefore, have no reason to join terrorist organizations. What then is needed to secure their living? I would say three things: namely, water supply, education and medical care.
First and foremost is the water supply. About 80% of the Afghan people make their living by agriculture and raising cattle. Afghanistan is located in the mountain ranges of Central Asia and the arable land accounts for only 13% of its territory. Although there is enough rainfall and snow to cultivate the crops and produce the feeds for the cattle, many years of war have destroyed the irrigation systems, making it impossible to control the water supply. Rain and melted snow are simply soaked up by the desert, giving rise to a chronic water shortage.
The farmers, therefore, cannot rise out of poverty. This situation makes them dissatisfied with the government, driving them either to help the terrorist organizations or to turn a blind eye to them, which in turn aggravates the security situation. In order for the Afghans to make good use of water, it is necessary to build dams and irrigation channels to collect water and use it wisely. In this way, the life of farmers can be improved greatly. We earnestly look to Japan for technical assistance to this end.
Next comes education assistance. In Afghanistan, about half of the children of school age cannot go to school. Most of them are girls. In addition, 11-million people, about 40% of the population, are illiterate. In recent years, 3500 schools have been founded, but only 25% of them have roofs. The rest are open-air schools. Because many male family breadwinners have been killed or crippled by war, children have to work to earn a living, and cannot go to school. Amidst all these difficulties, there must be created a better environment for education; schools must be built and repaired; teachers must be trained and textbooks provided. For all this, Japan's help is badly needed.
The third priority is medical assistance. The infant mortality rate in Afghanistan is extremely high: 163 out of 1000 births. The death rate of children under 5 years of age is 257 out of 1000. The average life expectancy is 43.7 years. However, 80% of them would have been saved if appropriate medical care had been provided. In concrete terms, more adequate medical facilities and vaccinations are urgently needed. Furthermore, it is hard for women who live in areas of poor hygienic conditions and healthcare to go and see a doctor. To make it easier, I believe that training more female doctors and health workers, as well as the propagation of medical education among the people is indispensable.
I often talk to my elder brother, also a doctor in an Afghan clinic, on the international phone and am concerned more and more about the future after the presidential elections. The abduction of wealthy family members is now a flourishing business so more and more people are fleeing the country. To help secure the stability of life and inspire hope for the Afghan people, I sincerely hope that Japan will extend carefully planned and meticulously executed assistance in compliance with the real wishes of the Afghan people.
The writer is an Afghan medical doctor and Afghanistan Director of Japan International Friendship and Welfare Foundation
The English-Speaking Union of Japan
アフガニスタン支援で日本に望むこと
アマディヤール・アックバール(Ahmadyar Akbar) / 日本在住アフガニスタン医師
2009年 12月 25日
私は日本に20年在住するアフガニスタン人医師です。アフガンに生まれ、カブール医科大卒を卒業後、地方で医療に従事していました。ソ連軍駐留下の戦闘で負傷した人々の治療・リハビリを城西病院が受け入れたのに伴い、そのサポートで89年来日しました。現在、茨城県結城市の城西病院に籍を置き、同病院の日本国際親善厚生財団（ＪＩＦＦ）が行うアフガン国内の医療活動をサポートしています。
同財団は以前はパキスタン・ペシャワールでアフガン難民支援を行っていました。しかし難民が帰国し始めた01年にカブールに診療所を移し、日本人医師と看護婦を送り、現地スタッフと協力して医療活動を行ってきました。毎日４００人近い患者を診療しています。私も医療活動で両国を行き来していましたので、アフガンの人々が何を期待しているかお伝えしたいと思います。
アフガンは治安回復が必須で、そのためには住民の生活を安定させることが最優先課題です。生活が安定すれば貧困や不満からテロ組織に加わる理由もなくなります。では生活安定のためには何が必要か。私は水利、教育、医療の３つを挙げます。
まず水利です。アフガン人の80％は農業と牧畜に従事しています。アフガンは中央アジアの山岳地帯に位置し、耕地面積は国土の13％に過ぎません。農業作物と家畜用の飼料を栽培するために必要な降雨と積雪はあるのですが、長年の戦争で灌漑施設が破壊され用水の管理が出来ないため、雨や雪解け水が無駄に砂漠に染み込み、恒常的に水不足に悩まされています。
このため農民は貧困から抜けられません。またこれが農民の不満を生み、テロ組織に協力したり、活動を見て見ぬふりして、治安の悪化に結びついています。アフガン人が水を有効に利用するには、ダムや用水路を作り、水を貯めることが必要です。これが農民の生活向上につながります。この財政、技術支援を日本にお願いする次第です。
次に教育支援です。アフガンでは就学適齢児童の半数が学校へ行けず、その多くが女子です。また人口の40％に当たる１１００万人が文盲です。ここ数年、約３５００の学校が建てられましたが、学校で建物があるのは全体の25％で、他は青空教室です。
家族の働き手である男は戦争で亡くなったり、身障者になったため、子どもが働かねばならず、学校に行けない実情もあります。ただそうした中でも教育環境の充実を図らねばならず、学校の修復・建設、教員養成、教材の提供などで日本の支援が必要です。
３つ目は医療支援です。アフガンの乳児死亡率は１０００人の出産に対し１６３人と極めて高率です。５歳までの幼児の死亡率は１０００人に対して２５７人。平均寿命は43・７歳です。ただその80％は適切な医療があれば予防・治療出来ます。具体的には医療施設の充実、ワクチンの実施が急がれます。また衛生や健康管理が劣悪な地方の女性が医者に行きやすくするため、女性の医療従事者の養成と、一般住民への保健教育プログラムが必要だと思います。
診療所に医師で務める兄と国際電話で話しますが、大領選挙後「あすはどうなるのか」と不透明感が強まっています。金持ちの家族の誘拐がビジネスになり、国を脱出する人も増えています。人々の生活を安定させ、希望をもてるようにするため、地元の要望をくんだキメ細かな支援をお願いしたいです。
(筆者は日本在住アフガニスタン医師。日本国際親善厚生財団（ＪＩＦＦ）アフガニスタン所長。)
同財団は以前はパキスタン・ペシャワールでアフガン難民支援を行っていました。しかし難民が帰国し始めた01年にカブールに診療所を移し、日本人医師と看護婦を送り、現地スタッフと協力して医療活動を行ってきました。毎日４００人近い患者を診療しています。私も医療活動で両国を行き来していましたので、アフガンの人々が何を期待しているかお伝えしたいと思います。
アフガンは治安回復が必須で、そのためには住民の生活を安定させることが最優先課題です。生活が安定すれば貧困や不満からテロ組織に加わる理由もなくなります。では生活安定のためには何が必要か。私は水利、教育、医療の３つを挙げます。
まず水利です。アフガン人の80％は農業と牧畜に従事しています。アフガンは中央アジアの山岳地帯に位置し、耕地面積は国土の13％に過ぎません。農業作物と家畜用の飼料を栽培するために必要な降雨と積雪はあるのですが、長年の戦争で灌漑施設が破壊され用水の管理が出来ないため、雨や雪解け水が無駄に砂漠に染み込み、恒常的に水不足に悩まされています。
このため農民は貧困から抜けられません。またこれが農民の不満を生み、テロ組織に協力したり、活動を見て見ぬふりして、治安の悪化に結びついています。アフガン人が水を有効に利用するには、ダムや用水路を作り、水を貯めることが必要です。これが農民の生活向上につながります。この財政、技術支援を日本にお願いする次第です。
次に教育支援です。アフガンでは就学適齢児童の半数が学校へ行けず、その多くが女子です。また人口の40％に当たる１１００万人が文盲です。ここ数年、約３５００の学校が建てられましたが、学校で建物があるのは全体の25％で、他は青空教室です。
家族の働き手である男は戦争で亡くなったり、身障者になったため、子どもが働かねばならず、学校に行けない実情もあります。ただそうした中でも教育環境の充実を図らねばならず、学校の修復・建設、教員養成、教材の提供などで日本の支援が必要です。
３つ目は医療支援です。アフガンの乳児死亡率は１０００人の出産に対し１６３人と極めて高率です。５歳までの幼児の死亡率は１０００人に対して２５７人。平均寿命は43・７歳です。ただその80％は適切な医療があれば予防・治療出来ます。具体的には医療施設の充実、ワクチンの実施が急がれます。また衛生や健康管理が劣悪な地方の女性が医者に行きやすくするため、女性の医療従事者の養成と、一般住民への保健教育プログラムが必要だと思います。
診療所に医師で務める兄と国際電話で話しますが、大領選挙後「あすはどうなるのか」と不透明感が強まっています。金持ちの家族の誘拐がビジネスになり、国を脱出する人も増えています。人々の生活を安定させ、希望をもてるようにするため、地元の要望をくんだキメ細かな支援をお願いしたいです。
(筆者は日本在住アフガニスタン医師。日本国際親善厚生財団（ＪＩＦＦ）アフガニスタン所長。)
一般社団法人 日本英語交流連盟