Vaccinating amidst insecurity: Ahmed Parsa’s right to health

The UN Convention on the Rights of the Child: Article 24 – the right to the best health care possible

UNICEF Afghanistan
Ahmad Parsa is recieving an oral immunization drop.
UNICEF Afghanistan/UN0340394/Dejongh
25 November 2019

Kabul, Afghanistan – Zuhal, a 27-year-old mother of two, braved the August heat and increasing insecurity of Kabul to bring her daughter and newborn son to the Indira Ghandi Hospital for vaccinations.

“I am in Kabul on holiday to visit my in-laws for Eid, and I’ve realised that it is time to vaccinate my son, Ahmed Parsa,” said Zuhal, an information technology officer in the northern province of Badakhshan.

Fortunately, even amidst the festivities of Eid, Zuhal thought to check 40-day-old Ahmed Parsa’s immunization card. “If it were not for the immunization card, I would have missed my son’s vaccination,” said Zuhal.

Home-based child vaccination records, like Ahmed’s immunization card, play an important role in documenting immunization services received by children. In countries like Afghanistan, where there are significant challenges in collecting this data, they are a crucial tool.


Violence standing in the way of vaccines

Insecurity has been on the rise in both urban and rural areas of Afghanistan – medical facilities, which are protected under international law, haven’t been spared. According to the WHO, in the first six months of 2019, 68 attacks on healthcare facilities were reported, resulting in the closure of 101 health facilities. Only 27 of the facilities were re-opened.

It’s not just clinics that have been under attack, but the people in them too: in the same time period, 18 healthcare workers and patients were killed and 33 others were injured.

The increase in violence has formed a cloud that hangs over daily life. Concerned for their safety, Zuhal’s mother-in-law, Aysheh, went with Zuhal and her two children on their trip to the hospital.

“I accompanied Zuhal to the hospital vaccination centre to protect her and her children in case an explosion happens,” said Aysheh.

“There is no safe place in Kabul. I just want to make sure that Zuhal and the children are safe.”

— Aysheh, Ahmed Parsa's paternal grandmother
A mother, Zuhal, holds a newborn while sitting next to her young daughter who has her hand on the baby's chest.
UNICEF Afghanistan/UN0340387/Dejongh
Zuhal and her daughter, Zeinab, hold Ahmed Parsa in the clinic after his vaccination.

For many children in Afghanistan, violence is another factor compounding the difficulty they face in obtaining vaccines needed to ensure their health. Only one-in-two Afghan children are fully immunised. The other half remain vulnerable, either unimmunised or partially immunised, to diseases that threaten their health and sometimes their lives.

Such a low rate of immunisation has led to a situation where, in 2018, Afghanistan was among the only two countries globally that reported polio cases, in addition to Pakistan. Research suggests that areas in Afghanistan with higher levels of armed conflict carry higher rates of polio incidents.

Dr. Sanjay Bhardwaj, Acting Chief of Health of UNICEF Afghanistan, confirms that violence is a factor in the country’s low immunization rates.

“Violence, poverty, limited education, fear of side effects, lack of awareness to benefits of vaccines, and cultural beliefs are among the many reasons children don’t get vaccinated.”

— Dr. Sanjay Bhardwaj, Acting Chief of Health, UNICEF Afghanistan

Despite these barriers, Zuhal is determined to provide her children with the vaccines they need to grow up healthy and thrive.

“When Zeinab [now four-years-old] was younger, I made sure that she received her vaccines,” Zuhal said with a smile.  “Now, I am making sure that my son is also getting all the needed vaccines on time."

Zeinab, in black hair and a denim dress, smiles at the camera with her finger on her chin.
UNICEF Afghanistan/UN0340383/Dejongh
Four-year-old Zeinab, Ahmed Parsa's older sister, smiles at the camera. Her mother is making sure that both she and her brother are fully immunised.

Nearly 25 years ago, Afghanistan joined the global community in ratifying the UN Convention on the Rights of the Child. Article 24 of the Convention provides that every child has the right to “the enjoyment of the highest attainable standard of health.”

Immunisation is a necessary tool to ensure children realise their right to health, but such tools become less available in situations of conflict. It is time to act for the right to health and security for children like Ahmed Parsa.

In the meantime, UNICEF Afghanistan is working with the Government and donors to realise every child’s right to vaccines. In 2018, with the Ministry of Public Health (MoPH), UNICEF vaccinated more than 1.2 million children less than one-year-old.