NGOs and health officials have expressed concern over what they call the "occupation" of health centres, or former health centers, in parts of Helmand Province, southern Afghanistan, by Afghan and international military forces.
Prominent Afghan NGO Ibn-Sina, which provides health services in the insurgency-stricken province and works closely with the Health Ministry and UN agencies, told IRIN that US forces had turned three Basic Health Centres (BHCs) in Helmand into military bases, though it acknowledged that only one had been fully operational before US forces arrived.
"The Miyanposhta BHC in Garmsir District was operational but it has become dysfunctional since US forces occupied it almost two months ago," Noor Khaled, an Ibn-Sina official, told IRIN, adding that the BHC in Nawa District was now both a health centre and a US base.
Noor said the third clinic, in Khan Nishin District, had been disused for over a year prior to being taken over by US forces.
"One of the two buildings in a health clinic in 52 [name of area] of Nawa has been occupied by US and Afghan forces which has impacted health services because people are scared and do not want to go to this clinic. The clinic in Miyanposhta was functioning when US forces occupied it. It is now closed. And the clinic in Khan Nishin District was closed before US forces occupied it," Enayatullah Ghafari, director of Helmand's health department, told IRIN.
Efforts were under way to persuade the US army to vacate the buildings: "We have conveyed requests to them to evacuate the locations and hope they will do so in the near future," Ghafari said.
Ibn-Sina and the provincial health department expressed concern about the safety of health workers and patients in the "partially occupied" BHC in Nawa District, and warned it could be shut down completely.
"The presence of military forces in a medical compound certainly jeopardizes the safety of civilian health workers there," said one health official who requested anonymity.
US army denial
US forces have categorically denied any wrongdoing and have expressed a willingness to help rebuild and reopen clinics in Helmand.
"None of these buildings have been used as clinics in recent memory as most of them were closed under the Taliban. There were no doctors or medical equipment in the facilities when the marines arrived in the area," Maj Bill Pelletier, a public affairs officer with the US marines in Helmand, told IRIN.
Pelletier said two of the clinics had been used by the Afghan police and army for over a year, and the health centre in Garmsir District had been occupied and destroyed by insurgents prior to coming under US control.
"During a recent visit to the facility, one of our military lawyers said he saw no evidence whatsoever that there are any markings or other indications that the facility is a protected place, or is otherwise identified in any way as a medical facility," said Pelletier, adding that the marines had not contravened any international law by occupying the buildings "because they did not do so with the intent of using the buildings' erstwhile status as medical shelters as protection from enemy attack".
"The Afghan national security forces and the marines are prepared to re-locate their checkpoints once the Ministry of Public Health [MoPH] is ready to support the facilities as clinics," he said.
Under international humanitarian law, civilian health centres must be protected from armed attack and occupation by military forces. However, dilapidated and completely dysfunctional health centres do not have such a status, experts say.
Due to insecurity and an absence of independent actors on the ground, it was difficult for IRIN to verify the accounts of the US military or the health department in Helmand.
Clinics allegedly raided by coalition forces
Meanwhile, the Swedish Committee for Afghanistan (SCA), an NGO working on development issues, has accused the International Military Force (IMF) in Afghanistan of raiding an SCA Hospital in Shaniz, Wardak Province, on 2 September, 2009 in search of insurgents.
The NGO said doors were broken down, rooms vacated and searched, and four employees and two family members of patients tied up. After two hours, IMF soldiers left leaving orders to hospital staff to report any patient that could be a potential insurgent.
"This is simply not acceptable. It is not only a clear violation of globally recognized humanitarian principles about the sanctity of health facilities and staff in areas of conflict but also a clear breach of the civil-military agreement between NGOs and ISAF [International Security Assistance Force]," Anders Fange, SCA country director, said in a statement.
In response to a separate alleged security incident, Lt-Cmdr Christine Sidenstericker, a spokeswoman for the NATO-led international forces in Kabul, told IRIN: "When we are fired upon from a location it losses its protected status."
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Prominent Afghan NGO Ibn-Sina, which provides health services in the insurgency-stricken province and works closely with the Health Ministry and UN agencies, told IRIN that US forces had turned three Basic Health Centres (BHCs) in Helmand into military bases, though it acknowledged that only one had been fully operational before US forces arrived.
"The Miyanposhta BHC in Garmsir District was operational but it has become dysfunctional since US forces occupied it almost two months ago," Noor Khaled, an Ibn-Sina official, told IRIN, adding that the BHC in Nawa District was now both a health centre and a US base.
Noor said the third clinic, in Khan Nishin District, had been disused for over a year prior to being taken over by US forces.
"One of the two buildings in a health clinic in 52 [name of area] of Nawa has been occupied by US and Afghan forces which has impacted health services because people are scared and do not want to go to this clinic. The clinic in Miyanposhta was functioning when US forces occupied it. It is now closed. And the clinic in Khan Nishin District was closed before US forces occupied it," Enayatullah Ghafari, director of Helmand's health department, told IRIN.
Efforts were under way to persuade the US army to vacate the buildings: "We have conveyed requests to them to evacuate the locations and hope they will do so in the near future," Ghafari said.
Ibn-Sina and the provincial health department expressed concern about the safety of health workers and patients in the "partially occupied" BHC in Nawa District, and warned it could be shut down completely.
"The presence of military forces in a medical compound certainly jeopardizes the safety of civilian health workers there," said one health official who requested anonymity.
Photo: Abdullah Shaheen/IRIN  |
| Police and soldiers remove the body of a man who blew himself up a suicide attack in Lashkargah. Insecurity plagues Helmand Province (file photo) |
US forces have categorically denied any wrongdoing and have expressed a willingness to help rebuild and reopen clinics in Helmand.
"None of these buildings have been used as clinics in recent memory as most of them were closed under the Taliban. There were no doctors or medical equipment in the facilities when the marines arrived in the area," Maj Bill Pelletier, a public affairs officer with the US marines in Helmand, told IRIN.
Pelletier said two of the clinics had been used by the Afghan police and army for over a year, and the health centre in Garmsir District had been occupied and destroyed by insurgents prior to coming under US control.
"During a recent visit to the facility, one of our military lawyers said he saw no evidence whatsoever that there are any markings or other indications that the facility is a protected place, or is otherwise identified in any way as a medical facility," said Pelletier, adding that the marines had not contravened any international law by occupying the buildings "because they did not do so with the intent of using the buildings' erstwhile status as medical shelters as protection from enemy attack".
"The Afghan national security forces and the marines are prepared to re-locate their checkpoints once the Ministry of Public Health [MoPH] is ready to support the facilities as clinics," he said.
Under international humanitarian law, civilian health centres must be protected from armed attack and occupation by military forces. However, dilapidated and completely dysfunctional health centres do not have such a status, experts say.
Due to insecurity and an absence of independent actors on the ground, it was difficult for IRIN to verify the accounts of the US military or the health department in Helmand.
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Photo: OCHA/VMU |
| A map of Afghanistan highlighting the restive southern province of Helmand |
Meanwhile, the Swedish Committee for Afghanistan (SCA), an NGO working on development issues, has accused the International Military Force (IMF) in Afghanistan of raiding an SCA Hospital in Shaniz, Wardak Province, on 2 September, 2009 in search of insurgents.
The NGO said doors were broken down, rooms vacated and searched, and four employees and two family members of patients tied up. After two hours, IMF soldiers left leaving orders to hospital staff to report any patient that could be a potential insurgent.
"This is simply not acceptable. It is not only a clear violation of globally recognized humanitarian principles about the sanctity of health facilities and staff in areas of conflict but also a clear breach of the civil-military agreement between NGOs and ISAF [International Security Assistance Force]," Anders Fange, SCA country director, said in a statement.
In response to a separate alleged security incident, Lt-Cmdr Christine Sidenstericker, a spokeswoman for the NATO-led international forces in Kabul, told IRIN: "When we are fired upon from a location it losses its protected status."
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This article was produced by IRIN News while it was part of the United Nations Office for the Coordination of Humanitarian Affairs. Please send queries on copyright or liability to the UN. For more information: https://shop.un.org/rights-permissions
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