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Afghanistan: 2017 Humanitarian Response Plan - Mid-Year Review (January - June 2017)

SITUATION OVERVIEW

In keeping with previous years, humanitarian response has continued to be defined by conflict in the first half of 2017 with equally unacceptably high numbers of civilian casualties (‐1 percent) and a steady rise in armed clashes (+4 percent) if compared to the same period last year, despite an overall reduction in displacement (‐15 percent). 

Between January and June 2017, some 5,243 civilian casualties (1,662 deaths and 3,581 injuries) were recorded by UNAMA Human Rights with Improvised Explosive Devices (IEDs) by Non‐State Armed Groups (NSAGs) the leading cause (40 percent), followed by ground engagements between ANSF and NSAG forces. Notwithstanding the minimal overall reduction in civilian casualties, both child and women casualties rose during the first half of 2017 with a 23 percent increase in women casualties (636) and a nine percent increase in child deaths (436), mainly due to unexploded ordnance, the use of pressure‐plate IEDs and aerial operations in civilian‐populated areas – the latter up by an unprecedented 61 percent in the first six months of the year. 

The contest for territorial control has continued unabated within the same period, with armed clashes now taking place in multiple provinces at the same time – three district administrative centres (Taywara, Janikhel and Kohistan) fell in the same week across different parts of the country in late July while another was (Waygal) temporarily under attack. Overall, conflict incidents are rising year-on-year with a 1,000 percent increase in armed clashes registered between 2007 and 2017. 

The intensification of the conflict has led to unsustainably high numbers of war wounded on both sides of the conflict. Between January and June, almost 25,000 war wounded patients were reported through First Aid Trauma Points (FATPs) and specialised trauma care centres across the country with high combat areas Kandahar, Kunduz and Uruzgan recording the most incidences. Heightened NSAG casualties, combined with limited opportunities for in-country and external patient transfer, have increased the pressure on district-level hospitals for additional stabilisation and casualty management services to be provided, while simultaneously restricting their ability to deliver safe and quality primary health care to local communities. The first half of the year saw an increasing number of health facilities closed by NSAGs with Laghman, Farah and Badghis provinces the most affected. These closures, which constitute a grave violation of international humanitarian law, have rendered more than half a million people without access to essential healthcare, 250,000 of them in Laghman province alone, and may be indicative of a growing trend in which basic services are used as a bargaining chip, primarily by NSAG forces, to extract improved healthcare delivery for their combatants. 

Overall, access to life-saving and basic health services across Afghanistan remains inadequate as a consequence of a defunct and underfunded public health system and a conflict which is both intensifying in nature and expanding in geographic scope. In some 51 districts the Basic Package of Health Services (BPHS) is not available. Health indicators in these areas are particularly bad: women are twice as likely to die giving birth in Uruzgan and Hilmand compared to the national average – already the third highest in the world – and 50 percent less likely to give birth in the presence of a skilled birthing attendant.

Growing insecurity in 2017 has also been punctuated by a doubling in attacks attributable to the Islamic State of Khorasan (from 128 to 237), with the number of provinces and districts affected increasing from 1 to 7 and 8 to 24 respectively compared to the same period in 2016. The rise of ISK activity, which up until 2016 had mostly been confined to Nangarhar province in the Eastern region, has since intensified as fighting has broken out between three entities – ISK, NSAG and government forces – and threatened to expand into neigbouring provinces Kunar and Nuristan. The presence of multiple competing actors across the region, and attendant rise in conflict activity, is one of the main reasons behind the increase in civilian displacement experienced in the East so far this year. 

In this regard, the conflict continues to exact a terrible toll on the people of Afghanistan and fuel the need for large-scale humanitarian assistance to be provided. Over 160,600 individuals (24,240 families) were displaced during the first six months of 2017, roughly 30,000 less than in the same period in 2016. With the insurgency now controlling or exerting influence over areas comprising around a third of the Afghan population, it is likely that the humanitarian community’s ability to identify or assess those impacted by conflict has declined. Some 45 districts are now fully or partially under the control of NSAGs according to the Special Inspector General for Afghanistan Reconstruction (SIGAR), while a further 118 are contested. As general insecurity has spread, populations have been faced with increasingly difficult choices: move to areas which are no safer than those where they currently reside or remain where they are and effectively become isolated and without access to essential supplies. Indeed, with the official IDP petition system largely or completely out of reach for those living in non-government held areas, in addition to the limited coverage of disease and food insecurity early warning systems, the capacity of humanitarian partners to detect or respond to the most acute needs may have been considerably weakened over the past six months, resulting in less IDPs being reported despite intensified conflict.

Insecurity is only likely to increase and further expand over the remainder of the year following the recent announcement of next years’ parliamentary elections. In this context, the eroding military stalemate looks set to continue with no seasonal lull in fighting anticipated as winter arrives later and is expected to be more mild. The recent decision by Trump to surge additional troops to Afghanistan may also result in a more volatile landscape over the coming months, contributing to higher outflows of IDPs. With this in mind, it is likely that the number of new IDPs generated by conflict will reach the 450,000 projected caseload.

While the rate of refugee returns increased significantly between January and June, more than tripling (33,733) compared to the same period last year (7,812), they are significantly lower than the initial annual projection (550,000) and considerably down on the highs seen during the second half of 2016 when 364,765 returned in a six‐month period. Although the number of refugee returns is expected to increase over the second half of the year (to between 200,000‐300,000), additional spikes cannot be ruled out and will depend on the safeguarding of protection space in Pakistan and an extension in the validity of Proof of Registration cards past 31 December 2017. 
In terms of undocumented returnees, a total of 231,193 were recorded across all border points in the first half of the year, less than the 253,074 who returned during the same period in 2016. Undocumented returns from Iran, including forced evictions, account for 70 percent of new arrivals. It is expected that the documentation exercise which began in Pakistan on 20 July 2017, combined with the results of the refugee elder Jirga on 29‐30 July in Kabul and the general deterioration in the security situation in Afghanistan will also impact the decision to return over the course of the coming months. Moving forward, while the provision of post-arrival assistance to returnees at entry points and main areas of settlement will remain a key component of humanitarian response, these populations are ultimately in need of durable solutions. In this regard, the World Bank’s plan to invest USD 172 million – 40 percent of revised HRP requirements – in reintegration projects delivered through government programmes such as the Citizens’ Charter will need to be factored into planning for the 2018 cycle and beyond. 

Protection monitoring and consultations highlight raised levels of vulnerability amongst those displaced. Recent assessment data suggests that more than a third of children have been exposed to psychological distress due to loss of family and community members and the constant risk of death and injury (with this being as high as 68 percent in Kunduz). Populations affected by conflict are also more likely to be exposed to multiple forms of gender based violence (GBV), including early and forced marriage, domestic and psychological and sexual abuse. A community-level protection assessment conducted in the Eastern region in May, for example, identified increased incidences of GBV in Nangarhar, Kunar and Laghman provinces as men reported that the pressures of a loss of income during displacement caused them to resort to negative coping mechanisms such as domestic violence.

Afghanistan’s nutrition situation continues to be negatively impacted by the conflict. Assessment data from the first half of the year shows that global acute malnutrition (GAM) rates in children under 5 across three provinces – Uruzgan (21.6%), Kandahar (16.5%) and Kunar (16.2%) – breach emergency thresholds. The malnutrition rates in a number of other provinces including Kunduz, Nangarhar, Paktika and Zabul are equally concerning. Amidst a backdrop of existing food insecurity, limited livelihood options, poor access to quality water and poor hygiene practices, high rates of diarrhoea persist, negatively influencing the nutrition situation, particularly in areas already impacted by fragmented healthcare and weak service delivery.

Integrated Management of Acute Malnutrition (IMAM) programmes continue to suffer low coverage and frequent high defaulting. Outpatient MAM interventions are only reaching an estimated 31% of those in need of treatment. Critical barriers prevent children with unmet needs from accessing treatment. Amongst many contributing factors is the limited access to community level service delivery, especially nutrition education, counselling, and treatment follow-up, as part of an overall weak capacity at all levels of healthcare.

As of mid-year, the number of individuals affected by natural disaster is 40 percent lower (39,800) than during the same six‐month period in 2016 (65,523) and 64 percent lower than the previous three‐year average (approximately 110,440 people). This is mainly because, as in 2016, no major, large‐scale natural disasters hit between January and June, and of the small to medium scale events that did, only the heavy snowfall, avalanches and localised flooding of February impacted a significant number of people (20,000). Indeed, these three events alone comprise 50 percent of the total natural disaster affected population in the first half of 2017. As in previous years, a significant locust infestation in Ghor and Badghis provinces during the first quarter – which is still ongoing – affected approximately 4,000 households in Dawlatyar district and 24,000 households in Jawand, Mughab and Qadis Districts of Badghis. Almost 10,000 farmers in the Northern region have also been unable to cultivate their crops or experienced crop failure because of delayed rain.  

Despite the decreased incidence in natural disasters, the humanitarian community must maintain a state of readiness to respond to sudden onset crises, of any type and scale, at all times. To support such preparedness efforts, funds have been made available from the 2nd CHF Allocation to decentralise existing stockpiles and preposition them in high-risk weather and conflict areas, including Lashkar Gah, Tirinkot, Kunduz City and Takhar, to ensure sufficient response capacity. 

Humanitarian personnel, assets and facilities continue to be targeted throughout Afghanistan with OCHA reporting 142 incidents affecting NGOs, UN and International Organisations in the first half of 2017, a considerable increase on the 107 recorded in 2016. As a result of these incidents OCHA has recorded 9 killed and 10 injured national and international aid workers, while 20 instances of abduction have been reported in 2017. There has also been a substantial increase in the occupation and closure of health facilities by in the first half of 2017, with 69 incidents reported versus 19 during the same period last year. More pronounced access constraints have also occurred in key military battlegrounds such as Nangarhar, Hilmand and Uruzgan with these three provinces accounting for 50 percent of all access incidents reported.

Webspace(s): 
Organization(s): 
United Nations Office for the Coordination of Humanitarian Affairs
Original Publication Date: 
01 Sep 2017
Document type: 
Periodic Monitoring Report
Location(s): 
Afghanistan
Theme(s): 
Inter-Cluster Coordination
Coordination hub(s): 
National Level Coordination