Setting the right priorities Protecting Children Affected by Armed Conflict in Afghanistan -...

7/28/2019 Setting the right priorities Protecting Children Affected by Armed Conflict in Afghanistan - Watchlist 2010

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June 2010

Setting theRight Priorities:

Protecting Children Aectedby Armed Conict in Afghanistan


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Watchlist Mission StatementThe Watchlist on Children and Armed Conict strives to end violations against children in armed conicts

and to guarantee their rights. As a global network, Watchlist builds partnerships among local, national

and international nongovernmental organizations, enhancing mutual capacities and strengths. Working

together, we strategically collect and disseminate information on violations against children in conicts

in order to inuence key decision makers to create and implement programs and policies that eectively

protect children.

Watchlist works within the framework of the provisions adopted in UN Security Council Resolutions 1261,

1314, 1379, 1460, 1539, 1612, 1882, the principles of the Convention on the Rights of the Child and its

protocols and other internationally adopted human rights and humanitarian standards.

General supervision of Watchlist is provided by a Steering Committee of international nongovernmental

organizations known for their work with children and human rights. The views presented in this report

do not represent the views of any one organization in the network or the Steering Committee.

For further information about Watchlist or specic reports, or to share information about children in a

particular conict situation, please contact:

[email protected]

www.watchlist.org

Photo Credits

Cover Photo: Mats Lignell/Save the Children

Please Note: The people represented in the photos in this report are not necessarily themselves victims

or survivors of human rights violations or other abuses.


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June 2010

Setting theRight Priorities:

Protecting Children Aectedby Armed Conict in Afghanistan


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Setting the Right Priorities: Protecting Children Aected by Armed Conict in Afghanistan

ii

Notes on Methodology. InormationcontainedinthisreportiscurrentthroughMarch1,2010.. Thisreportprimarilyrefectsinormationdrawnromsecondarysourcesavailableinthepublic

domain.Inormationiscollectedthroughanextensivenetworkoorganizationsthatworkwith

childrenaroundtheworld.Analysisisprovidedbyamultidisciplinaryteamopeoplewithexpertiseand/orexperienceintheparticularcontext.Somesourcesarecondentialandarenotlistedto

protecttheirsaety.Whencitingthisreport,inormationshouldbeattributedtotheoriginalsource

totheextentpossible.

. Duetoinsecurityandaccessrestrictions,thereislimitedinormationonthehumanrightsandhumanitariansituationintheareasoongoingarmedconfict.

. ThereportdealsmainlywithAghanistanbutmanyotheprotectionconcernsareinactoccurringalongtheAghanistan-Pakistanborderanddemandacross-borderorregionalapproach.Inormation

onthesecross-borderconcernsislimitedduetoaccessrestrictions.

Notes on Terminology

. ThereportollowstheUNdenitionoeightregionsinAghanistan:centralhighlands,eastern,southeastern,southern,western,northern,andnortheastern,andthecapitalregionaroundKabul.

. AghanistanusesthePersiancalendarwhosedatesdonotcorrespondtotheGregoriancalendar,theinternationallyacceptedcivilcalendar.ThisreportusestheGregoriancalendardatesandalso

includesthePersiancalendardatesitheywereprovidedintheoriginalsourcepublication,e.g.1387

(2008-2009).

. AghanSecurityForcescomprisethearmy,thearmyaircorpsandthenationalpolice.Important Updates

. OnMarch22,2010,theUNSecurityCouncil,initsResolution1917,extendedthemandateothe

UnitedNationsAssistanceMissioninAghanistan(UNAMA)oroneyearthroughMarch23,2011.The

newmandaterepeatedtheCouncilscallortheimplementationoSecurityCouncilResolutions(SCR)

1612(2005)andSCR1882(2009)onchildrenandarmedconfictanditsrequesttotheSecretary-

GeneraltourtherstrengthenthechildprotectioncomponentoUNAMA,inparticularthroughthe

appointmentochildprotectionadvisors.

. TheMarjahoensive,ajointAghan-NATOmilitaryoperationthattookplaceinFebruary2010,wasintendedtoserveasatestingcaseorNATOsnewstrategytoocusonprotectingciviliansin

counterinsurgencyeorts.Despitetheseeorts,TheAghanRedCrescentSociety(ARCS)estimated

that35 civilianshaddiedandanadditional37wereinjuredduringthemilitaryoperation.Surveys

among400menromMarjah,LashkarGahandKandaharalsoindicatethattheoensivenegatively

impactedlocalperceptionsoNATOorces,accordingtotheInternationalCouncilonSecurityand

Development(ICOS).

. WatchlistreportnotesthattherehadbeenareductionociviliancasualtiesbyinternationalmilitaryorcesinAghanistanrom2008to2009.OnMay12,2010,theU.S.DepartmentoDeense

announcedthatthenumberocivilianskilledbyU.S.andNATOorceshadincreasedby76percent

(to90reportedciviliandeaths)romJanuarytoApril2010comparedtothesameperiodin2009

(51deaths).TheU.S.governmentattributesthisrisetothestepped-upeortsinthewaragainstthe

Taliban,accordingtoReuters,CiviliansCasualtiesRisinginAghanistan,May12,2010.TheU.S.

DepartmentoDeensedidnotcommentonthepercentageochildrenkilledbyinternational

militaryorces.


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Watchlist on Children and Armed Conict

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Table of ContentsList of Acronyms ............................................................................................. 1

Indicators ........................................................................................................ 3

International Standards ................................................................................. 4

Executive Summary ........................................................................................ 5

Context ............................................................................................................ 8

Major Armed Conicts...................................................................................................8

International Eorts for Peace and Security ............................................................ 8

The Return to Violence................................................................................................... 8

Rebuilding the Country ................................................................................................. 9

Humanitarian Access .................................................................................... 11

Deterioration of Humanitarian Access....................................................................11

Violating Humanitarian Principles ...........................................................................11

Killing and Maiming ..................................................................................... 13

Military and Other Attacks .........................................................................................13

Assistance to Survivors and Impunity for Perpetrators .......................................13

Children Living with Disabilities ...............................................................................14

Refugees and IDPs ........................................................................................ 16

Internally Displaced Persons ......................................................................................16

Refugees ..........................................................................................................................16

Health ............................................................................................................ 19

Access to Services..........................................................................................................19

Maternal Death and Reproductive Health .............................................................20

Infectious Diseases .......................................................................................................20

Malnutrition ...................................................................................................................21

Water and Sanitation ..................................................................................................21

Drug Addiction ..............................................................................................................21

Psycho-Social Disorders ..............................................................................................21

HIV/AIDS ........................................................................................................ 23

The Spread of HIV/AIDS ...............................................................................................23

Treatment and Care .....................................................................................................23

Education ...................................................................................................... 24

School Enrollment and Attendance .........................................................................24

Monitoring and Reporting on Attacks ....................................................................24

Attacks against Schools, School Children and Teachers .....................................24

Protecting Schools from Attacks ...............................................................................25

Conict-Related Barriers to Education ....................................................................25

Abduction ..................................................................................................... 28


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Gender-Based Violence ................................................................................ 29

Prevalence of Gender-Based Violence .....................................................................29

Silence and Impunity ...................................................................................................29

Lack of Services for GBV Survivors ............................................................................29

Child Soldiers ................................................................................................ 32

Recruitment by Afghan Security Forces ..................................................................32

Recruitment by Private and Auxiliary Forces .........................................................32

Recruitment by the Taliban and Other Armed Opposition Groups ..................32

Disarmament, Demobilization and Reintegration for Children .......................33

Detention of Children Formerly Associated with Armed Groups ......................33

Small Arms .................................................................................................... 35

Scope of the Problem ...................................................................................................35

Disarmament Eorts ...................................................................................................35

Landmines and Explosive Remnants of War .............................................. 37

Scale of Contamination and Impacts ......................................................................37

Demining and Mine Risk Education .........................................................................37

Other Violations and Vulnerabilities ........................... .............................. .. 39

Child Labor .....................................................................................................................39

Exploitation and Tracking ......................................................................................39

Illegal and Arbitrary Arrest of Children....................................................................40

UN Security Council Actions ........................................................................ 41

UNSC Resolutions on Children and Armed Conict .............................................41

UNSC Actions on Afghanistan ...................................................................................41

Implementation of UNSC Resolutions on Children

and Armed Conict in Afghanistan .........................................................................41

The UN Security Council Working Group on CAC .................................................42

Endnotes ....................................................................................................... 45

Sources .......................................................................................................... 50

Map of Afghanistan ...................................................................................... 53


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List of AcronymsAI AmnestyInternational

ACBAR AgencyCoordinatingBodyorAghanRelie

AIHRC AghanIndependentHumanRightsCommission

ANDS AghanistanNationalDevelopmentStrategy

ANSO AghanistanNGOSaetyOceAREU AghanistanResearchandEvaluationUnit

ARV AntiretroviralTreatment

BPHS BasicPackagesoHealthServices

CAC ChildrenandArmedConfict

CAAC ChildrenaectedbyArmedConfict

CEDAW UNCommitteeontheEliminationoDiscriminationAgainstWomen

CIVIC CampaignorInnocentVictimsinConfict

CPA ChildProtectionAdvisor

CPAN ChildProtectionActionNetwork

CTFMRM CountryTaskForceontheMonitoringandReportingMechanism

DIAG DisbandmentoIllegalArmedGroup

ERW ExplosiveRemnantsoWar

FATA FederallyAdministeredTribalAreasFRU FamilyResponseUnit

GBV Gender-BasedViolence

GOA GovernmentoAghanistan

HAP HumanitarianActionPlanorAghanistan

HRW HumanRightsWatch

ICG InternationalCrisisGroup

ICRC InternationalCommitteeotheRedCross

IDMC InternalDisplacementMonitoringCentre

IDPs InternallyDisplacedPersons

IEC IndependentElectionCommission

IED ImprovisedExplosiveDevice

ILO InternationalLabourOrganization

INGO InternationalNongovernmentalOrganization

ISAF InternationalSecurityAssistanceForce

MACCA MineActionCoordinationCentreoAghanistan

MoU MemorandumoUnderstanding

MRE MineRiskEducation

MRM MonitoringandReportingMechanism

MSF MdecinsSansFrontires

NATO NorthAtlanticTreatyOrganization

NDS NationalDirectorateorSecurity

NGO NongovernmentalOrganization

NLD NationalLeagueorDemocracy

NSAG Non-StateArmedGroups

NWFP NorthWestFrontierProvince

OCHA UNOceortheCoordinationoHumanitarianAairs

OEF OperationEnduringFreedom

OHCHR OceotheHighCommissionerorHumanRights

PRT ProvincialReconstructionTeams

RI ReugeesInternational

SCR UNSecurityCouncilResolution

SCWG-CAC UNSecurityCouncilWorkingGrouponChildrenandArmedConfict

SOP StandardOperatingProcedure

SRSG SpecialRepresentativeotheSecretary-General

SRSG-CAC SpecialRepresentativeonChildrenandArmedConfict

UN UnitedNations


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UNAMA UNAssistanceMissioninAghanistan

UNDP UNDevelopmentProgramme

UNDSS UNDepartmentoSaetyandSecurity

UNHCR UNHighCommissionerorReugees

UNICEF UNChildrensFund

UNIFEM UNDevelopmentFundorWomen

UNODC UNOceonDrugsandCrime

UNSC UNSecurityCouncil

USDA UnionSolidarityandDevelopmentAssociation

USFOR-A U.S.ForcesAghanistan

USDOS U.S.DepartmentoState

UXO UnexplodedOrdnance

WHO WorldHealthOrganization


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IndicatorsINDICATORS Afghanistan

Population 23.8millionpeoplein2005;1aso2008,46.5%wereyoungerthan142

Gross National Income (GNI)

per Capita

US$466in2008(UNStatisticsDivision)

Refugees and Internally

Displaced Persons (IDPs)

AsotheendoDecember2009,anestimated297,000IDPsinAghanistan,

including161,000children

AsoJanuary2010,approximately1.6millionregisteredreugeesinPakistan,including

about1.18millionchildren,andapproximately1millionregisteredreugeesinIran,

including345,000children 3

Infant Mortality 165/1,000in20084

HIV/AIDS AghanistansNationalAIDSControlProgramregistered559casesasoNovember2009;

UNAIDSandWHOputthenumberoreportedcasesmuchhigherat1,000to2,000.5

Education Estimated74%nationalnetenrollmentrateorboysand46%orgirls6;only11%oboys

and5%ogirlsenrolledinprimaryschoolcontinueontograde12.7

Gender-Based Violence (GBV) Rapeisawidespreadphenomenonthataectswomen,boysandgirls.Actsosexual

violencearecommittedbyarmedgroupsorcriminalgangsaswellasamilymembers,guardiansorcaretakers.Asaresultothetaboosurroundingtheissue,thereareew

publiclyreportedcasesandnocomprehensiveorocialdataavailableonrapeand

gender-basedviolence. 8

Childmarriageisalsocommon,withnearlyhaloallmarriagesinvolvingboysandgirls

undertheageo18.9

Tracking TrackingochildrenwithinthecountryandintoPakistanandIranisaseriousconcern;

somechildrenareexploitedbyarmedgroupsorcriminalgangstocarryoutillegalactivities

suchassmuggling.10

Landmines and Explosive

Remnants of War (ERW)

AsoDecember2009,therewere630km 2omine-aectedland;734recordedinstanceso

childreninjuredorkilledbylandminesandotherexplosivesin2008and2009;626weremales

and105emales.11

Small Arms Estimatesornumbersosmallarmsrangerom1.5millionto10million;

12

nostatisticaldataisavailableonchildreninjuredorkilledbysmallarms.

Child Soldiers AghanSecurityForcesandarmedoppositiongroupshaverecruitedanunknownnumber

ochildrenthroughoutthecountry.

Mostothereportedcasesochildrecruitmentinnationalsecurityorcesweredueto

poorbirthregistrationsystems,weakageverication,andtherisingdemandorpolice

andsoldiers.

Armedgroupshaverecruitedchildrentobeusedasghters,campguardsorsuicide

bombers,particularlyalongtheAghanistan-Pakistanborder.13

Abductions and

Disappearances

Mostcasesoabductionanddisappearancearerelatedtotrackingbycriminalnetworks;

thereissomeconrmedinormationochildrenabductedortranserredtoPakistanwhere

theyhavereceivedmilitarytraining.14

Attacks on Humanitarian and

Human Rights Workers

Aghanistanrepresentsoneothemostviolentenvironmentsoraidworkers,especially

nationalsta,worldwide.15Areported19NGOstaandatleast11UNstawerekilledin2009.16

Please note: DuetoextremelylimitedaccesstocertainareasoAghanistan,especiallywhereactiveghtingistakingplace,there

isaseveregapinreliablenationwidedata.Thegenerallackosocio-economicanddemographicdataisurthercompoundedby

weakinstitutionalandtechnicalcapacitiestoproduceinormation.


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International Treaties Signed (S)/ Ratied (R)/

Acceded (A) (Year)

International Treaties Not Signed

ConventionontheRightsotheChild(R,1994)

OptionalProtocoltotheConventionontheRightso

theChildontheinvolvementochildreninarmed

confict(A,2003)

OptionalProtocoltotheConventionontheRightsothe

Childonthesaleochildren,childprostitutionandchild

pornography(A,2002)

TheGenevaConventionsI,II,IIIandIVo1949(R,1956)

ProtocolIotheGenevaConventions,Relatingtothe

ProtectionoVictimsoInternationalConficts(A,2009)

ProtocolIIotheGenevaConventions,relatingtothe

ProtectionoVictimsoNon-InternationalArmedConficts(A,2009).

ConventiononthePreventionandPunishmentotheCrime

oGenocide(A,1956)

ConventionontheEliminationoAllFormsoDiscrimination

againstWomen(R,2003)

InternationalCovenantonEconomic,SocialandCultural

Rights(A,1983)

ConventionagainstTortureandOtherCruel,Inhumanor

DegradingTreatmentorPunishment(R,1987)

InternationalCovenantonCivilandPoliticalRights(A,1983)

ConventionRelatingtotheStatusoReugees(A,2005)

ProtocolRelatingtotheStatusoReugees(A,2005)

ConventionontheProhibitionotheUse,Stockpiling,

ProductionandTranseroAnti-PersonnelMinesandon

theirDestruction(A2002)

ConventiononClusterMunitions(S,2008)

RomeStatuteotheInternationalCriminalCourt(A,2003)

ProtocolIIIotheGenevaConventions,relatingtothe

AdoptionoanAdditionalDistinctiveEmblem

ILOConvention182ontheWorstFormsoChildLabor

ProtocolagainsttheIllicitManuacturingoandTracking

inFirearms,TheirPartsandComponentsandAmmunition,

supplementingtheUnitedNationsConventionagainst

TransnationalOrganizedCrime

OptionalProtocoltotheConventionagainstTorture

andOtherCruel,InhumanorDegradingTreatment

orPunishment

InternationalLabourOrganization(ILO)Convention29on

ForcedLabor

ILOConvention87onFreedomoAssociationandRight

toOrganize

ProtocoltoPrevent,SuppressandPunishTrackingin

Persons,EspeciallyWomenandChildren,supplementing

theUnitedNationsConventionagainstTransnational

OrganizedCrime

UN Security Council Actions Relating to Children and Armed Conict in Afghanistan

UNSecurityCouncilResolutionsonAghanistan TheUNSecurityCouncilpassed27resolutionsonAghanistan

between2001andMarch1,2010owhichsixspecicallyreerredtochildren.Theseare1419(2002),1833(2008),

1806(2008),1868(2009),1890(2009)

UNSecurityCouncilResolutionsonChildrenandArmed

Confict(CAC)

1882(August2009);1612(July2005),1539(April2004),

1460(January2003),1379(November2001),

1314(August2000),1261(August1999)

UNSecurityCouncilWorkingGroupConclusionson

CACinAghanistan

S/AC.51/2009/1(July2009)

International Standards17


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Executive Summary

Children bear the brunt of the ongoingarmed conict in Afghanistan.In2009,atleast346childrenwerekilledinaerialstrikes

andsearch-and-raidoperationsbyinternationalspecial

orcesaswellasbyassassinationsandsuicidebombings

byanti-governmentelements.Inaddition,landmines,

explosiveremnantsowarandotherexplosiveshavekilled

orseverelyinjuredhundredsochildren,particularlyboys

whoplayoutside,tendanimals,orcollectood,wateror

wood.Armedgroupshavealsodamagedanddestroyed

schools,targetingstudents(especiallygirls),teachers

andotherswhoareseenassupportiveoAghanistans

educationsystem.

ThousandsoAghanamilieshavebeenorcedtofee

theirhomesduetoarmedconfictandeconomichard-

ships.Morethanhalothecountrysinternallydisplaced

approximately161,000peoplearechildren;anaddi-tional1.5millionchildrenarereugeesinPakistanandIran.

Despitesomeprogressinexpandingbasichealthservices

toawidepopulation,inantandmaternalmortalityis

alarminglyhigh.Aghanistanremainstheworstplace

intheworldoranewbornchild,accordingtochild

protectionagencies.

Current strategies of the Afghan governmentand its international supporters thoughaimed at protecting civilians - have largely

neglected the specic needs of childrenaected by armed conict.Thisreluctancetocommittotheprotectionochildren

isrefectedinpolicyandundingdecisions.TheLondon

Conerence18communiquoJanuary2010whichserved

astheroadmaptoaddresssecurity,governanceand

economicconcernsinAghanistanoverthenextveyears,

didnotreertochildrensneedsdespitethesevereimpact

thatitsdecisions,suchasplannedoersoamnestyto

Talibansoldiers,willhaveontheirsecurity.Onlyonechild

protectionadvisorhasbeenstationedattheUnited Nations

AssistanceMissioninAghanistan(UNAMA),despite

repeatedcallsbytheUNSecurityCounciltoallocatemore

resourcestobolsterUNAMAschildprotectioncapacity.

Keydecisionmakershavealsoneglectedtheadviceochildprotectionagencies.Duringthe2009presidential

electionorinstance,AghanistansIndependentElection

CommissionignoredrepeatedwarningsoUNagencies,

nongovernmentalorganizationsandsomegovernmental

agenciesnottousehealthacilitiesandschoolbuildings

aspollingstations.Thisdisregardultimatelyresultedin

multipleattacksonschoolsandhospitals.

The protection of childrens rights shouldnot be limited to safe areas, or stop atAfghanistans borders.In2009,approximately43percentothecountrywas

cutoromhumanitarianassistance,particularlyinthe

confict-aectedsouth,southeastandpartsothewest.

Limitedaccessresultedinthousandsochildrenmissing

outonurgentlyrequiredservicesoeredvianational

healthandeducationcampaigns.

Thelackoaccessduetoinsecurityhasalsoseverely

hamperedtheworkotheUN-ledMonitoringandReporting

Mechanism(MRM)inAghanistanwhichwassetupto

addressthesixgraveviolationsagainstChildrenand

ArmedConfict(CAC)inaccordancewithUNSecurity

CouncilResolutions1612and1882,whichincludekillingormaimingochildren,abductions,recruitmentoruseo

childsoldiers,attacksagainstschoolsandhospitals,rape

orothergravesexualviolenceagainstchildren,andthe

denialohumanitarianaccesstochildren.

Inaddition,thereisinsucientinormationavailableon

theextentoviolationsthatarecross-borderinnature,

includingchildrecruitmentortrackingandtheexploita-

tionochildrentosmuggledrugsorillegalgoods.Inorder

toholdperpetratorsotheseviolationsaccountableandto


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providemoresystematicresponsestochildren,

protectionactorsshouldmakeaconcertedeortto

engagewithallpartiestoconfict,concerned

governmentsandlocalcommunities.

Theprotectionowar-aectedchildrenmeritsspecial

attentionandmustbemadeastrategicpriorityasthe

Aghangovernment,withsupportromtheinternationalcommunity,laysoutplanstobringlastingpeaceand

stabilitytothecountry.

Theollowingarekeyrecommendationsrom

Watchlistsreport:

1. Ensure that the protection of children from

conict-related violence becomes a top priority

in policy and funding decisions on Afghanistan

The Government of Afghanistan (GoA) and its

international supportersshouldsetspecic

benchmarksonchildprotectionagainstwhich

progresscanbemeasured.ThiscouldincludedevelopinganAgendaorChildrenAectedby

ArmedConfictalongthelinesotheAghanistan

Compact,whichsetsoutspecicgoalsorthe

nextveyearsandestablishesacoordination

mechanismtoensureimplementationand

monitoringothisplan.

The UN Security Council Working Group on

Children and Armed Conict (SCWG-CAC)

shouldensurethatcoreconcernsrelatingtochildren

aectedbyarmedconfictarerefectedintheterms

oreerenceotheupcomingSecurityCouncileld

visitplannedormid-2010.ThisincludesollowinguponthecommitmentsmadebytheGoAand

internationalmilitaryorcestotheSpecial

RepresentativeonChildrenandArmedConfict

(SRSG-CAC)duringherrecentvisit.

The UN Secretary-Generalshouldensurethe

immediatedeploymentoadditionalchildprotection

advisersthroughoutthecountryinaneortto

strengthenthechildprotectioncomponento

UNAMA,asrecommendedbytheUNSecurityCouncil.

The SCWG-CAC and relevant donorsshouldrequest

aninormationalbriengwithchildprotectionactorsandcivilsocietyrepresentativesinordertobetter

understandtheroleocommunity-basedmecha-

nismsinAghanistantopreventattacksagainst

schools,andhowtobettersupporttheseinitiatives.

The SCWG-CACshouldrequestanindependent

assessmentotheimpactoprojectsthatareunded

oroperatedbyProvincialReconstructionTeams

(PRTs)onthesecurityandwell-beingochildren

inAghanistan.Theassessmentshouldexplore

alternativewaystoassistchildrenlivinginareasthat

arenotaccessiblebyUNagenciesorNGOs. DonorsshouldollowtheGoodHumanitarian

DonorshipPrinciplessothatundingisallocatedin

proportiontotheneedsothemostvulnerable

populations,includingchildren,andnottourther

politicalgoals.

2. Take eective measures to prevent violations

against children in armed conict and end

impunity for perpetrators

Non-state armed groupsshouldimmediatelyhalt

allviolationsperpetratedagainstthesecurityand

rightsoAghanchildren. Haltallsuicideandimprovisedexplosivedevice

(IED)attacksonciviliantargets.

Rerainromattacksandthreatsoattacksagainst

schools,teachers,educationsta,studentsand

parentsatthelocalandnationallevel.

Stopoperatingoutoschoolsandothercivilian

acilities,andendtheuseohumansasshields.

The GoA and international military forcesshould

ensurethatsystemsorinvestigatingalleged

violationsagainstciviliansaretransparent,timely

andindependentlymonitored.Theresultsotheseinvestigationsshouldbepubliclysharedandinclude

datadisaggregatedbyageoncombatantand

civiliancasualties.

All parties to the conictshouldullycooperate

withtheCountryTaskForceontheMonitoringand

ReportingMechanism(CTFMRM)toprepareand

implementactionplanstoendtherecruitmentand

useochildsoldiers,rapeandothergraveactso

sexualviolenceandkillingandmaimingochildren

inlinewithUNSecurityCouncilResolutions1540,

1612and1882.Commandersshouldequallywork

towardshaltingallviolationsagainstchildren.


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The GoAshouldrepealthereconciliationand

generalamnestylawandholdallperpetratorso

violationsagainstcivilians,includingchildren,

accountableinaccordancewithnationaland

internationallaw.

The GoAshouldunderallcircumstancesavoid

theuseoeducationandhealthacilitiesintheupcomingelectionsandorotherpoliticalpurposes.

The GoAshouldadapttheEliminationoViolence

againstWomenActtoincludeadenitionorape

thatcomplieswithinternationalstandardsand

bringsperpetratorstojusticeinaccordancewith

UNSecurityCouncilResolutions1820and1888.

The GoAshouldcriminalizechildrecruitmentand

theuseochildsoldiers,andactivelyprosecute

thosewhoexploitchildrenassoldiers.TheGoA

shouldworkcloselywithUNagenciestoreneage

determinationproceduresandgrantullaccesstoalltraininganddetentionacilities,includingthose

otheNationalDirectorateoSecurity(NDS),or

monitoringpurposes.

3. Strengthen monitoring, reporting and response on

all violations committed against children, including

those committed in Afghanistans conict zones and

across its borders

The UN Country Team in Afghanistan,underthe

dedicatedleadershipotheSpecialRepresentative

otheSecretary-GeneralorAghanistan(SRSG),

shouldcommitstaandresourcestoprioritize

childprotectionwithintheirrespectiveagencies,includingtheullimplementationoSecurityCouncil

Resolutions1612and1882throughoutthecountry.

The Country Task Force on the Monitoring and

Reporting Mechanism (CTFMRM)shouldworkwith

allpartiestotheconficttocapturecriticalinorma-

tionthatcouldpreventviolationsagainstchildren

andmoreeectivelyassistsurvivors,including

monitoringearlywarningsignsaswellasthe

circumstancessurroundingtheattacksandtheir

impact.Quarterlyreportsromtheirevaluations

shouldbeusedtotracktrendsandinorm

evidence-basedadvocacy.

Donorsshouldsupportstrengtheningthecapacity

oChildProtectionActionNetworks(CPAN),which

consistogovernmentalandnongovernmental

organizationsinAghanistan,torespondmore

eectivelytoviolationsagainstchildren.

The SCWG-CACshouldrequesttheUNHigh

CommissionerorReugees(UNHCR)and/ortheRepresentativeotheSecretary-Generalonthe

humanrightsointernallydisplacedpersons(IDPs)

toleadastudytodeterminevulnerabilitiesandrisks

ordisplacedandreugeechildrenromAghanistan.

Thestudysndingswouldbetherststeptowards

enactingacomprehensiveactionplantonddurable

solutionsordisplacedchildrenromAghanistan.

The Government of Pakistanshouldinvitethe

SpecialRepresentativeonChildrenandArmed

Confict(SRSG-CAC)toconductamissioninPakistan

toidentiypotentialwaystoimprovecoordinationin

endingcross-borderviolationsthatimpactchildren

aectedbyarmedconfictsuchasthedrugtrade,

trackingandsmallarmstrade.

The Secretary-GeneralshouldrequesttheUN

CountryTeamsinAghanistanandPakistan,under

theleadershipotheSRSG-CAC,toestablisha

UNregionalstrategytocontributeactivelytothe

protectionochildrenaectedbycross-border

violations.

The UN Country Team in Pakistanshouldestablish

aWorkingGrouponChildrenaectedbyArmed

ConficttomoreeectivelyaddresstheconcernsoAghanreugeechildren,andcooperatewiththe

CTFMRMandotherchildprotectionagenciesin

Aghanistantoaddressissuesocommonconcern,

includingcross-borderrecruitmentochildsoldiers

andtracking.

The Afghan Independent Human Rights

Commission (AIHRC)shouldcoordinateclosely

withtheindependentHumanRightsCommission

oPakistan(HRCP)toconductjointmonitoringand

reportingalongtheircommonborderareas.

Executive Summary


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Context

Major Armed ConictsIn1979attheheightotheColdWar,Sovietorcesinvaded

Aghanistantoghtaproxywar.Aterthewithdrawalo

theSovietorcesin1989,actionalghtingamongvarious

armedgroupscontinueduntil1996,whenthecapital,

Kabul,wastakenbytheTaliban,aundamentalistIslamic

group.By2001,theTalibancontrolled90percentothe

countryandimposedanewregimebasedonthestrictest

versionoSharia,orIslamiclaw,denyingbasicrightsto

womenandchildren,includingaccesstoeducation,and

subjectingthemtocruelpunishments.

FollowingtheterroristattacksoSeptember11,2001,a

U.S.-ledcoalitionintervenedinAghanistanandwiththe

NorthernAlliance,anAghanoppositionarmedgroup,

soonremovedtheTaliban,whichhadharboredAlQaeda,a

terroristnetwork,rompower.Thisinterventioninitiateda

processopolitical,securityandsocialreormsaimedat

establishingademocraticallyelectedAghangovernment

andrebuildingpeaceinthesocietyaternearlythree

decadesowar.

International Eorts for Peace and SecurityTheBonnAgreementoDecember2001laidtheoundation

orAghanistansuturegovernment,whichledtothe

establishmentoatransitionalauthorityin2001,the

adoptionoanewconstitutionin2004,andpresidential

andparliamentaryelectionsin2005.Inordertosupport

theAghanSecurityForcestomaintainsecurity,theUN

SecurityCouncilauthorizedmemberstatestoormthe

InternationalSecurityAssistanceForce(ISAF),which

operatesunderChapterVIIotheUNCharter.Since2003,

ISAFhasbeenledbyNATOandasoMarch5,2010,is

comprisedoapproximately89,480troopsrom44dierent

countries.Moretroopsareanticipatedtoarriveintherst

halo2010,bringingthetotalnumberoISAFtroopsto

about100,000.InadditiontoISAF,atleast12,000mostly

U.S.orcesaredeployedalongtheAghanistan-Pakistan

borderunderthemandateoOperationEnduringFreedom

(OEF),ajointU.S.,UKandAghanoperation.Allinterna-

tionalmilitaryorcesoperatinginAghanistanwhether

underISAForOEFareplacedundertheoperational

controlotheU.S.ForcesAghanistan(USFOR-A).Linked

tothesemilitaryeorts,ISAFmemberstateshavealso

deployed26ProvincialReconstructionTeams(PRTs)in

Aghanistan,whichincludemilitaryandciviliancompo-

nentstoacilitatedevelopment,reconstructionand

governanceeortsinvariouspartsoAghanistan.

Since2002,theUNAssistanceMissioninAghanistan

(UNAMA)hasbeenmandatedbytheSecurityCouncil

tosupportthegovernmenttobuildpeacethroughthe

promotionohumanrights,reconstructionanddevelop-

ment.UNAMAworksasanintegratedmission,meaning

thatitaimstoaddressdevelopmentandhumanitarian

issues,aswellaspoliticalaairs.UNAMAhasalsoassisted

thegovernmentinimplementingkeyrameworksorcooperationwiththeUnitedNationsandtheinternational

community,includingtheAghanistanCompacto2006

andtheAghanistanNationalDevelopmentStrategy(ANDS).

Withastao1,500militaryandcivilianemployees,mosto

whicharenationalsta,UNAMAisoneothesmallerUN

operationsworldwide.Inthebeginningo2009,UNAMA

addedachildprotectionadvisor,whoworksclosely

withthemissionsvarioussections,particularlythe

HumanRightsUnit.

The Return to Violence

Thenewgovernmentandinternationalsupportorthepeace-buildingprocesssparkedhopeamongmany

Aghans,instigatingthevoluntaryrepatriationomillions

oreugeesromIranandPakistantoAghanistanimmedi-

atelyaterthedeeatotheTaliban.However,thesecurity

situationdeterioratedsignicantlyater2004.19From2004

to2010,theareasexperiencingongoingattackshave

extendedromthesouthandsoutheasttotheareasthat

wereearlierdeemedsecure,includingthenorthernand


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9

easternregions.Violenceagainstcivilianshasnotonly

spreadthroughoutthecountrybuthasalsointensiedin

thelastewyears,asdemonstratedbytheriseincivilian

casualtiesromabout1,500civilianskilledin2007,toover

2,100killedin2008andmorethan2,400civilianskilledin

2009,accordingtoUNAMAsannualreportsonthe

protectionociviliansinarmedconfict.20

ManyTalibanorcesandotherarmedgroupsneverlet

theirstrongholdsinAghanistan.Othersregroupedinto

areasalongtheAghanistan-Pakistanborderandgained

strength,largelyoperatingromthesemi-autonomous

tribal-dominatedareaowesternPakistan,includingthe

FederallyAdministeredTribalAreas(FATA),Baluchistan

andtheNorthWestFrontierProvince(NWFP).Giventhe

Talibansrequentcross-borderattacks,Aghanauthorities

andtheinternationalcommunityhaveincreasedpressure

onthePakistanigovernmenttotakestrongeraction

againsttheinsurgentsinnorthwestPakistan,including

throughmilitaryoperations.21

Thesearmedoppositiongroupshaveusedinsurgency

tacticstounderminethegovernmentandpushout

internationalorces.Theyhavealsospecicallytargeted

thoseseenassupportinggovernmenteortssuchas

teachers,healthproessionalsandstudents.Common

tacticsincludeattacksonschoolsandhospitals,theuse

oindiscriminateimprovisedexplosivedevices(IEDs)and

employingsuicideattacksinhighlypopulatedareas.The

authorityothecentralgovernmentisurtherlimitedby

theexistenceoshadowgovernmentsestablishedbythe

Talibaninmanyprovinces,warlordsclaimingownership

ocertainareasandtheexpansionocriminalnetworks.Insomeareas,localmilitiasallegedlywithclandestine

supportromtheAghanandAmericangovernmentsalso

conductmilitaryoperationsagainstinsurgentswhichrisk

underminingtheruleolawduetotheirlackoormal

trainingandaccountabilitystructures.22

Intensiedaerialattacksbyinternationalmilitaryorces

havealsokilledcivilians.Inseveralinstances,theAghan

governmentandinternationalandnationalhumanrights

organizationshavequestionedwhetheraerialbombard-

mentswereproportionalandnecessary.23Inresponse,the

commanderoU.S.andNATOorcesinAghanistan,General

StanleyMcChrystal,revisedthestrategyointernational

militaryoperationsandissuedtacticaldirectivestotroops

underhiscommandwiththespecicgoaloavoiding

civiliancasualtiesandincreasingtransparencyand

accountabilityomilitaryoperations.24Thisstrategyhas

resultedinareductionorecordedciviliancasualtiesby

internationalorcesin2009andintherstewmonthso

2010.25Yet,thecontinuingdeteriorationothesecurity

situationandthelackobasichealthandsocialservicesin

manyareashavemadeitdicultorinternationalmilitary

orcestogaintheAghanpeoplessupportorcounterin-

surgencyandreconstructioneorts.

Rebuilding the CountryAterdecadesoconfictandcorruptgovernance,

Aghanistancurrentlydependsalmostentirelyoninterna-tionalsupportormaintainingsaety,rebuildingits

economic,politicalandlegalstructuresandpayingor

suchbasicservicesaspolicing,healthcareandeducation.

Despiteprogressachievedinthehealthandeducation

sectorinrecentyears,Aghanistanhasbeenconsistently

rankednearthebottomotheHumanDevelopmentIndex

withthemajorityoAghanslivinginextremepoverty.26

Incontrast,economicactivityintheblackmarketoten

coupledwithcriminalactivityhasbeengrowing,partly

duetothegovernmentsinabilitytoenorcetheruleolaw,

particularlyintheborderareas.Forinstance,asignicant

shareotheestimatedUS$4billionnetprotodrugtrackinggoestoarmedgroupsthroughdirectinvolve-

ment,briberyandtaxation,accordingtotheUNOceor

DrugsandCrime(UNODC).27Extortionandmisbehavioras

wellasimpunitybythepoliceandseniorgovernment

ocialshaveletlocalpeopleinsomepartsothecountry

resentultowardstheirowngovernment.28

Moreover,institutionalizedcorruptionpreventsthe

governmentromestablishingtheruleolawandinstilling

trustamongcitizensintheirstateinstitutions.Local

powerbrokershavebeenaccusedobribinggovernment

ocialsandlawenorcementagencies,orusingpatronage

linkagestoevadeprosecution,accordingtothe2009reportotheUNOceotheHighCommissionerorHuman

RightsonthesituationohumanrightsinAghanistan.29In

the2009elections,HamidKarzaiwasarmedasPresident

oAghanistanatertherstroundwasdeclaredraudulent

byaUN-backedcommissionandthesubsequentsecond

roundwithdrawaloKarzaismainrivalwhocitedalacko

transparencyintheproceedings.Suchreportsocorruption

byhigh-levelstateocialsriskunderminingnotonlythe

credibilityotheAghangovernmentbutalsootheUN

andthewiderinternationalcommunitybackingit.

AttheLondonConerenceinJanuary2010,theAghan

leadershipanditsinternationalpartnersagreedtoa

roadmapsettingoutave-yearmilitaryandcivilian

strategytoaddressthesecurity,governanceandeconomic

concernsothecountry.Conerenceparticipantsagreed

thatinternationalmilitaryorceswouldgraduallytranser

responsibilityorAghansecuritytothenationalgovern-

mentandbytheendo2011,theAghanarmywould

expandtrooplevelsrom97,000to171,600,andthe

nationalpoliceorcesrom94,000to134,000.30Further,


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10

donornationspromisedtosupportthegovernments

plansoranAghan-ledNationalPeaceandReintegration

Programmetolurelow-andmid-levelinsurgentsaway

romviolencebyoeringeconomicincentives.Theyalso

welcomedthegovernmentsplanstoholdaloyajirgathat

wouldbringgovernmentocials,triballeadersandsome

moderateTalibanleaderstogethertodiscussstepstowardsresolvingthecurrentconfict.TheLondonConerence

participantsannouncedUS$1.6billionindebtrelie,and

appealedtodonorsorUS$870millioninhumanitarianaid.

Thespecicsotheve-yearplanareexpectedtobe

determinedataconerenceinKabulinmid-2010.


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11

Humanitarian Access

Deterioration of Humanitarian AccessTherewereapproximately1,300nationalNGOs,300

internationalNGOsand16UNorganizationsengagedin

humanitariananddevelopmentassistanceinAghanistan

asoJanuary2010,accordingtotheAgencyCoordinating

BodyorAghanRelie(ACBAR).Intenseghting,landmines

andtargetedattacksorthreatsagainststamembersoten

preventtheseaidorganizationsromassistingchildren

andtheircommunitiesintheareasmostaectedbythe

confict.31Aghanistanrepresentsoneothemostviolent

environmentsoraidworkersworldwide,accordingtothe

HumanitarianPolicyGroup,anindependentthinktank.32

In2009,approximately43percentothecountrywas

consideredhigh-riskbytheUNDepartmentoSaety

andSecurity(UNDSS)andwascutoromhumanitarian

assistance,particularlytheconfict-aectedsouth,south-

eastandpartsothewest.33Asaresultolimitedaccess,

nationalhealthandeducationcampaignsmissthousandsochildreninneed,andthecampaignseectivenessis

undermined.Forexample,130,000childrendidnotbenet

romtheUN-ledvaccinationcampaignagainstpolioin

2009(seebelow:Health).

Despitelarge-scaleinternaldisplacement,ongoing

confictandnaturaldisasters,mostdonorstateshave

largelyneglectedgrowinghumanitarianneeds.34The2010

UNHumanitarianActionPlanorAghanistan(HAP),the

mainmechanismorcoordinatinghumanitarianresponse,

requestsatotaloUS$870millionrominternationaldonors,

a30percentincreaseinrequestedundingcomparedto

the2009HAP.However,thedesireotroop-contributingnationstoreinorcedevelopmentintheprovinceswhere

theyareactivemeansthataidisnotnecessarilychanneled

totheareaswiththehighestneedsorhumanitarianor

developmentaid.

Inadditiontodeprivingchildrenotheirbasicrights,the

lackoaccesstosomeotheareasmostaectedbythe

confictmakesitdicultoraidorganizationstodene

theneedsochildrenandothervulnerablegroups.For

example,thecampaignotheAghangovernment,with

supportromtheUnitedNationsChildrensFund(UNICEF),

toregisterallnewbornchildrenby2009hadtoleaveout

allchildrenlivinginremoteorinsecureareas.35Withonly

1 percentoAghansholdingabirthcerticateaso2008,

inormationromthisregistrationexercisewouldhave

allowedthegovernmenttoobtainaccurateandcompre-

hensivenumbersochildrentoinormitsplanningor

buildingschoolsandhealthacilities,aswellasvaccination

initiatives.Moreover,thepossessionoabirthcerticate

endowschildrenwiththerighttobenetromthespecial

legalprotectionramework,includingthespeciclawson

juvenilejustice,andontherecruitmentanduseochildren

byarmedgroupsororces.

Violating Humanitarian PrinciplesThemilitaryinvolvementindevelopmentactivitieshas

endangeredAghanciviliansandaidworkersastheseprojectsotenbecomethetargetsoarmedopposition

groups,leadingtotheblurringolinesbetweenthe

militaryandhumanitarianmission.36TheUNOceor

theCoordinationoHumanitarianAssistance(OCHA)

re-establisheditspresenceinAghanistaninOctober2008

toadvocateormoreprincipledhumanitarianactionand

tostrengthenindependenthumanitariancoordination

bytheUN.37Despitethispositivedevelopment,ona

structurallevelOCHAremainsconnectedtoUNAMA

andtherebyitspoliticalmandateasitisledbythe

HumanitarianCoordinatorwhoalsounctionsasDeputy

SpecialRepresentativeotheSecretary-Generaland

ResidentCoordinator.

ThedeteriorationoaiddeliveryinAghanistanistoa

signicantextentduetothenatureoPRTsandtheway

theyhavebeenimplemented.PRTs,whichusuallyconsist

oamilitaryandasubstantiallysmallerciviliancontingent,

carryoutrelieworkbutaredirectlymanagedbyISAF

memberstates.PRTstendtooperateinsomeothemost

insecureareasthatareolimitstotheUN,theAghan


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12

governmentandmanyNGOs.However,theirunderlying

politicalagendatogainsupportorthegovernment

andtheinternationalpresenceundercutshumanitarian

principlesoneutralityandimpartialityandmakesiteven

harderoraidagenciestoretaintheirspaceinother

areas,accordingtoastudybyTutsUniversitysFeinstein

Institute.38

Moreover,NGOshavecriticizedPRTsortheirlackotechnicalexpertiseandtheabsenceoacoherent

nationwidestrategyamongthevariousPRTs,whichare

currentlyonlyaccountabletotheirhomegovernments.39

InstanceswherePRT-ledprojectshaveprovenunsustain-

abletendtonegativelyaecthowcommunitiesviewand

acceptinternationalaidworkers.

Inordertoclariythespecicrolesandresponsibilitieso

civilandmilitaryactors,UNagencies,ISAFandNGOsagreed

tonon-bindingCivil-MilitaryGuidelinesinMay2008.40

TheGuidelinesarmthatinprinciple,governmentand

humanitarianactorsareresponsibleorprovidinghumani-

tarianassistance.Incontrast,theroleothemilitaryisonlytoassistcivilianactorstoprovidebasicinrastructureand

urgentreconstructionassistanceinexceptionalcasesand

asaproviderolastresort.Thisusuallyreerstocases

wheretheprotectionothepersonsphysicalsecurity

requiresamilitarypresence.Inaddition,theGuidelines

callortheclearlyvisibledistinctionbetweenhumanitarian

andotheractors.However,somemilitaryactorshave

violatedtheGuidelinesandinternationalhumanitarian

principlesbyengaginginrelieactivitiesororceprotection

purposes.41Humanitarianactorshavealsonotedalacko

awarenessotheGuidelinesamongPRTstaorlacko

commitmentamongtroop-contributingcountriesto

implementthemduetotheirvoluntarynature.Inaddition,theimpactotheGuidelinesislimitedastheUS-ledOEF

hasnotagreedtoitsprovisionsandtheTalibanandother

armedoppositiongroupsremainlargelyunawareoit.42

Intherecentpresidentialelections,Aghanistans

IndependentElectionCommission(IEC)usedhealth

acilitiesandschoolbuildingsaspollingstations,citing

thelackoalternativepublicbuildingsorthisuse.UNICEF,

theWorldHealthOrganization(WHO),OCHA,theUN

Educational,ScienticandCulturalOrganization(UNESCO),

NGOsandseveralgovernmentocialsrepeatedlywarned

othesevereriskstothesecurityostudentsandpatients

giventheTalibansoppositiontotheelections.43InAugust2009,themonthotheelections,therewere249reported

incidentsagainsteducationcomparedto48reported

incidentsinthemonthoJuly,accordingtotheUN-led

CountryTaskorceontheMonitoringandReporting

Mechanism(CTFMRM).Inmanyothesecases,insurgents

hadattackedpollingstationslocatedinschools.

Recommendations on Humanitarian Access UN agencies, ISAF and NGOsshouldintegratechildprotectionbestpracticesandrelevantprovisionso

SecurityCouncilResolutions1612and1882intotheCivil-MilitaryGuidelines,includingprohibitionsagainst

theuseoschoolsandstudentsorpoliticalpurposes.AdherencetotheGuidelinesshouldbereportedto

theExpertCommitteeonProtectionoCivilianstoinormitsrecommendationsregardingUNAMAs

mandaterenewal.

International military forcesshouldensurethattheirstandardoperatingprocedures(SOPs)areinlinewith

theCivil-MilitaryGuidelines.ThisincludesprovidingregulartrainingsontheGuidelinesorallsta,including

civiliansandPRTsandhighlightingtherelevantprovisionsrelatedtotheprotectionochildren.

The SCWG-CACshouldrequestanindependentassessmentotheimpactoprojectsthatareundedor

operatedbyProvincialReconstructionTeams(PRTs)onthesecurityandwell-beingochildreninAghanistan.

TheassessmentshouldexplorealternativewaystoassistchildrenlivinginareasthatarenotaccessiblebyUN

agenciesorNGOs.

The GoAshouldunderallcircumstancesavoidtheuseoeducationandhealthacilitiesintheupcoming

electionsandorotherpoliticalpurposes.

Humanitarian organizationsshouldinvolvelocalcommunitymembersintheplanning,executionand

evaluationodevelopmentassistanceprojectstoincreasetheirapplicabilityandlong-termimpact.

DonorsshouldollowtheGoodHumanitarianDonorshipPrinciplessothatundingisallocatedinproportion

totheneedsothemostvulnerablepopulations,includingchildren,andnottourtherpoliticalgoals.


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Killing and Maiming

Military and Other AttacksThenumberocivilianskilledandinjuredsince2006asa

resultothearmedconficthasrisenatanunprecedented

rate.Nearly6,000civilianswereinjuredorkilleddueto

confict-relatedviolencein2009,andothisnumber

2,412 werekilled,accordingtoUNAMAsannualreport,

Protection of Civilians in Armed Conict in Afghanistan,

2009.44Thismarksa14percentincreaseinciviliandeathsas

comparedtothesametimeperiodthepreviousyear.Most

otheincidentswererecordedinthesouth,southeast

andeasternregionswhereaidorganizationshavelimited

accessandhostilitieshaveescalated.In2009,346 children

werereportedlykilledduetoconfict-relatedviolence,

including131throughairstrikesand22innightraidsby

SpecialForces,and128werekilledthroughassassinations,

suicidebombingsandotherattacksbyarmedopposition

groups,accordingtoUNAMA.45Thisnumberdoesnot

includeincidenceswherechildrenwerekilledbylandminesandexplosiveremnantsowar(ERW),andmightonlybea

ractionotheactualcasesashumanrightsmonitorshave

limitedaccesstoconfictzonesduetoinsecurity.The

AghanIndependentHumanRightsCommission(AIHRC)

reported520childrenkilledbywarringpartiesbetween

March2009andMarch2010,whichalsoincludesmine-

relatedvictims.TheAghanistanRightsMonitor(ARM),a

localhumanrightsgroup,reportedatleast1,050children

killedbysuicideattacks,airstrikes,improvisedexplosive

devices(IEDs),ERWsandincross-rebetweenwarring

partiesin2009.46

WhiletheTalibansCodeoConductinstructseverymemberotheMujahideen[to]dotheirbesttoavoid

civiliandeaths,civilianinjuriesanddamagetocivilian

property,armedoppositiongroupshaveattimesdirected

theirviolenceatcivilianstointimidatethemandunder-

minethegovernment,stagingsuicidebombingsinhighly

populatedareas,detonatingIEDsonbusycivilianroads,

andattackingschoolsandhospitals(seebelow:Education

andHealth).Childrenhavealsobeentargetedbythese

armedgroupsandexecutedonallegationsospyingor

governmentorinternationalmilitaryorces,according

toUNsources.Therearealsoreportsoarmedgroups

deliberatelyusingchildrenashumanshields.47

Mostotheciviliandeathsattributedtopro-government

orceswereasaresultoairstrikesand,toalesserextent,

nightraidsoteninvolvingexcessiveuseoorce.Forexample,inMay2009,theU.S.claimedthatitresponded

tocallsbyAghanArmedForcesorprotectionagainst

insurgentattackbyusingaerialbombardments,which

killedatleast65childrenand21womeninavillagein

theBalaBulokdistrictoFarahProvince,southwestern

Aghanistan,accordingtoAIHRC.Independenthuman

rightsorganizationshavestruggledtoveriysuchclaims

duetothelackotransparencyininvestigationsconducted

byinternationalmilitaryorces.48Inmanyothesecases,

theuseounreliablesourcesoraultyintelligencehave

contributedtoincreasedciviliancasualties.49

OneothemostproblematicaspectsorchildprotectionactorsisthatcontrarytotheConventionontheRightso

theChildsdenition,ISAFsCivilianCasualtiesTrackingCell

denesachildasapersonundertheageo15.Thismakes

itextremelydiculttoaccuratelyassesstheimpacto

militaryattacksonchildrenandmayleadtounderestimates

othenumberochildrenassociatedwitharmedgroups.

Childrenhavealsobeencaughtinthecross-reasghting

betweentheAghanorcesandinternationalmilitary

orcesagainstarmedoppositiongroupscontinues.

Similarly,landmines,ERWandotherexplosivesplaced

byarmedorcesandothergroupshavekilledhundreds

ochildrenandinfictedpermanentinjuriesonothersthroughouttheconfict(seebelow:LandminesandERW).

Assistance to Survivors and Impunityfor PerpetratorsFollowinganattack,childrenandtheiramiliesusuallydo

notevenreceivebasicinormationastowhohascommitted

thecrime,thecircumstancesotheincidentorthestatus

andollow-upoinvestigations,includingpotential


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prosecutions.50Todate,therehasneverbeenanindictment

orconvictionoTalibancombatantsorcrimesagainst

humanityorwarcrimes,whichcanbepunishedunder

internationalanddomesticcriminallaw.Moreover,in

February2010,theAghangovernmentputintoorce

thereconciliationandgeneralamnestylawwhichgives

immunitytoprosecutionorthoseengagedinthecurrenthostilitiesitheyagreetoengagewiththegovernmenton

reconciliation.HumanRightsWatch(HRW),theTransitional

JusticeCoordinationGroup,whichconsistso24Aghan

civilsocietyorganizationsandotherhumanrights

organizationshaveraisedseriousconcernsregarding

theamnestylaw,arguingthatitwouldultimatelyunder-

minethereconciliationandpeaceprocessandviolate

internationallaw.51

Theresponsesointernationalmilitaryorcestoattacks

involvingtheinjuryordeathocivilianshasvaried

dependingonthetroopsinvolved.However,thelacko

publicacknowledgement,prosecutionandcompensationhaveincreasinglycausedAghancivilianstoloseaithin

internationaltroops,accordingtoAIHRC.52InAugust2009,

GeneralStanleyMcChrystal,thecommanderoNATOISAF

andU.S.Forces,puttheprotectionociviliansromattacks,

thereductionociviliancasualtiesandtransparencyand

accountabilityormilitaryoperationsatthecenterohis

counter-insurgencystrategy.53Aspartothisstrategy,

GeneralMcChrystalissuedaseriesoTacticalDirectivesto

ISAFandU.S.ForcesinAghanistanthatprovidespecic

instructionstotroopsregardingorceprotection,air

strikesandnight-timeraids.54ISAFsCivilianCasualties

TrackingCellsandaparallelunitwithinUSFOR-A,thecommandandcontrolheadquartersorU.S.orces

operatinginAghanistan,wereestablishedtoensurea

moresystematicmonitoringandresponsetoreported

incidents,includinginvestigationsandcompensation.

Asaresultotheseinitiatives,ewercivilianswerereportedly

killedinairstrikesin2009thanin2008,accordingto

UNAMAsgures.Theocusonciviliansisalsorefectedin

someothedrasticresponsesthatsometroopshavetaken

ininstanceswherecivilianshavebecomethevictimso

militaryoperations:TheorderoGermanNATOorcesto

carryoutanairstrikeinKunduzonSeptember3,2009,

whichappearedtocontraveneMcChrystalsdirectivesandISAFstandardoperatingprocedures,ledtotheresignation

othreeGermanseniorocials.ANATOinvestigation

conrmedthatthemilitaryhadwithheldinormation

thatcivilianshadbeenkilledintheincident.55

However,thereisstillnotransparent,comprehensiveand

independentlymonitoredsystemtoinvestigateviolations

committedbymilitaryorcesandtoholdperpetrators

accountableorauniormstrategyorcompensating

civilians.Compensationalsolargelydependsonthetroops

perpetratingtheattackandisprovidedonacase-by-case

basis,accordingtotheCampaignorInnocentVictimsin

Confict(CIVIC).56Whilemosttroopsoeranex gratia

paymenttocivilianssueringlossesincombatoperations,

survivorsaceseriousobstaclesinobtainingthisassistance

inatimelymannerduetothedicultyinidentiyingthemilitaryunitresponsible,thelengthybureaucratic

processinvolvedandthelackoaccesstooces

receivingcomplaints.57

AnumberoNGOshavethuscalledoramorepro-active

andsystematicapproachincontactingvictimsandtheir

amiliestooerocialapologies,inormthemaboutthe

circumstancesotheincidentandtoexplaintothemhow

theycanraisecomplaintsandhavethemheardbyISAF.

Theyalsourgedalltroop-contributingcountriestodevelop

asystematic,transparentwayocompensatingamilies

andvictimsthatisstandardizedbyalltroop-contributing

countries.58

Children Living with DisabilitiesMorethan200,000childreninAghanistanlivewith

permanentinjuriesanddisabilitiessueredduringhostilities

orasaresultoinadequatemedicalsupport,accordingto

themostrecentsurveybyHandicapInternationalin2005.

ThegovernmentpaysamonthlypensionoUS$6toUS$10

topersonswithdisabilities,whichbarelycoversthecosto

medicaltreatment,accordingtoHandicapInternational.59

Schoolacilitiesandteachersarenotequippedtoaddress

thespecialneedsostudentswithdisabilities,which

urthercaststhechildrenintodisadvantageandisolation,accordingtoocialsattheMinistryoEducation.60Only

22.4percentothe196,000childrenwithdisabilitiesin

Aghanistanwhowouldhavequaliedorschoolwere

abletoattendschool,accordingtotheInternational

OrganizationoPersonswithDisabilities.61

AghanistanhasnotsignedtheUNConventiononthe

RightsoPersonswithDisabilities,whichaskssignatory

statestoensurethatchildrenwithdisabilitiesarenot

excludedromreeandcompulsoryprimaryeducation,or

romsecondaryeducation.Nationallegislationrelatedto

personswithdisabilitiesiscurrentlyintheprocessobeing

approved.Inordertoacilitateintegrationochildrenwith

disabilities,theMinistryoEducationhasintroduced

awareness-raisingcomponentsintheschoolcurriculum

andisworkingonstrategiestoprovidespecializedand

inclusiveeducation.62


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Recommendations on Killing and Maiming All parties to the conictmusttakeallpossiblemeasurestoavoidciviliancasualties.Allallegedperpetrators

shouldbeheldaccountableinaccordancewithnationalandinternationallaw.

The GoA and international military forcesshouldensurethattheirinvestigationsintoallegedviolations

againstciviliansaretransparent,timelyandindependentlymonitored.Theresultsotheseinvestigations

shouldbepubliclysharedandincludedatadisaggregatedbyageoncombatantandciviliancasualties.

The GoAshouldrepealthereconciliationandgeneralamnestylawandholdperpetratorsoviolations

againstcivilians,includingchildren,accountableinaccordancewithnationalandinternationallaw.

International military forces,incoordinationwiththerelatednationalmechanism(PresidentialFundand

theMinistryoLabor,SocialAairs,Martyrs&Disabledcompensationmechanism),shoulddeviseauniorm

strategyorcompensatingciviliansurvivorsoattacksandensurethatthesecompensationsystemsaremade

easilyaccessibletovictims,includingchildren.

The GoAshouldimmediatelysignandimplementtheUNConventionontheRightsoPersonswith

Disabilitiesand,withinternationalsupport,moreeectivelyassistchildrenwithdisabilities.

Killing and Maiming


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Refugees and IDPs

Internally Displaced PersonsThousandsoAghanchildrenandtheiramilieshave

beenorcedtofeetheirhomesduetoarmedconfictand

economichardship.Inaddition,moreandmoreAghan

reugeesarereturningromothercountriesonlytoall

againintodisplacementintheirowncountrydueto

insecurityintheirplacesooriginorlackoaccesstotheir

previouslyownedland.Largeandmountingnumbers

otheinternallydisplacedremaininvisibletothe

governmentandinternationalorganizationsdueto

ongoinghostilitiesandseriousaccessconstraints.

Asotheendo2009,anestimated297,000internally

displacedpersons(IDPs)werelivinginmakeshitcamps,

inormalsettlements,orbeinghostedbyAghanamilies

towhichtheyhavecloseties,accordingtotheUNHigh

CommissionerorReugees(UNHCR),whichco-chairsthe

NationalIDPTaskForcetogetherwiththeAghanMinistry

oReugeesandRepatriationAairs.Morethanhalo

theseIDPsapproximately161,000arechildren,according

toUNHCRestimates.Despitetheirlargenumberand

specialneeds,humanitarianagenciesontheground

conrmedthattherewasadearthocomprehensive,

disaggregateddataontheirsituationtoinormpolicy

andprogrammaticresponses.

AssistancetoIDPswhetherresidingincamps,settlements

oroutsidethecamps,includinginurbanareasomajor

Aghancitiesremainsminimal,uncoordinatedand

partiallyad-hoc.Healthworkersrequentlydescribe

childrensueringrompreventablediseaseslikemeasles,

dysenteryanddiarrheaasaresultothelackovaccina-

tions,unhygienicconditionsinIDPsettlementsandthe

lackoaccesstosaedrinkingwater.63Manyothese

childrenaredeprivedoaccesstoeducationalopportunities

inthesettlementsasone-thirdoallsiteslackeducation

acilitiesandvirtuallynoneoeraccesstohighereduca-

tion.64DisplacedparentsresidinginKabulsmakeshit

campshavereportedlyevensoldtheirchildrento

criminalandtrackingcirclestosurviveorprovide

ortheirotherchildren.65

Moreover,thestateodisplacementotendepriveschildren

oprotectivecommunityoramilystructuresandexposes

themtoagreaterriskorecruitmentintoarmedorcesorgroups.Whilemoreevidenceisneeded,availabledata

seemstoindicateacorrelationbetweenchildrecruitment

andhighlevelsodisplacement,accordingtothe2008

Secretary-GeneralreportonCACinAghanistan(seebelow:

ChildSoldiers).Inact,thethreatochildrecruitmenthas

causedsomeamiliestofeetheirhomes,accordingtothe

samereport.

Inparticular,ndingdurablesolutionsorchildrenatrisk,

includingunaccompaniedandorphanedchildren,remains

achallenge,accordingtoUNHCR.WhiletheGovernment

oAghanistans2006NationalStrategyorChildrenat

Riskocusedondevelopingcommunityandamilybasedsupportorvulnerablechildrenandreducingtheemphasis

oninstitutionalcare,theorphanagesrunbythegovernment

andtheAghanRedCrescentSocietyprovidemostly

temporaryshelteranddonotalwaysadmitboyso

15 yearsandolder.66Childprotectionagencieshave

alsowarnedothepoorlivingconditionsinsomeorphan-

ages.Forexample,asurveyconductedbyAIHRCwith

43 childreninAlahuddinOrphanageinKabuloundmost

childrentobedissatisedwiththeacilities,citingpoor

oodquality,lackosanitationacilitiesandphysicaland

verbalviolence.

RefugeesInthemid-1990s,atthepeakothedisplacementcrisis,an

estimated8millionAghanreugeeslivedinneighboring

countries,mainlyinPakistanandIran,representingone

othelargestreugeepopulationsworldwide.67Withthe

arrivaloanewgovernment,internationalorcesand

unding,morethan5.6millionpeopledecidedtoreturn


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totheirhomecountrybetween2002and2009.68Othe

4.4 millionassistedreturneesromPakistanandIran,over

2 millionwereundertheageo18,accordingtoUNHCR;

theagencyurtherreportsapproximately1.6million

registeredreugeeslivinginPakistanandabout1million

inIranasoJanuary2010.69WhileupdateddataonAghan

reugeechildreninPakistanandIranisnotavailable,UNHCRestimatesabout1.18millionchildrenamongAghan

reugeesinPakistanand345,000childrenamongAghan

reugeesinIranbasedonstatisticsromregistration

exercisesconductedin2007.70

Pakistanisnotasignatorytothe1951ReugeeConvention

andits1967Protocol,whichestablishtheinternationallegal

standardsorreugeeprotection.WhileIranisasignatory

toboththeConventionandtheProtocol,regimesater

1979havereusedtoabidebytheprovisionsothe1951

Convention.Theprolongedreugeepresenceandsecurity

issuesduetocross-bordermigrationandcrimehaveled

toconcernsthatthecountrieswouldclosetheirbordersandputpressureonAghanreugeestoreturnhome,according

totheInternationalCrisisGroup.71Since2004/2005,both

PakistanandIranhavetightenedtheirasylumpoliciesand

increasedpressureonAghanstoleavethecountryby

closingreugeecamps,cuttingoassistanceandinsome

instancesarrestinganddeportingreugees.

MostotheregisteredreugeesinPakistan(around

85 percent)arelivinginthetwoprovincesadjacentto

AghanistanNorthWestFrontierandBaluchistantwoo

themostdestituteprovinces.Thereareseriousprotection

concernsorreugeeslivingintheseareasassomearmed

groupshavereportedlyusedthecampsasbasesortheirmilitaryoperationsinAghanistan.72

Citingsecurityconcerns,theGovernmentoPakistanhas

limitedtheaccessoaidorganizationsandonlyallowsaid

tobeprovidedtoreugeesthroughitsownprograms

despiteitslimitedexpertiseonprotectionissuesandits

directpoliticalinvolvementintheconfict.73

InMarch2010,anewTripartiteAgreementbetweenthe

governmentsoPakistanandAghanistan,andUNHCR

onvoluntaryrepatriationwassigned,whichextendsthe

stayoregisteredreugeesthroughDecember31,2012.

Between2005andthebeginningo2010,about25Aghanunaccompaniedminorslargelyundocumentedlabor

migrantsweredeportedromPakistan,according

UNHCRsstatisticsrombordermonitoring.

ThesituationorreugeesinIranalsoremainsprecarious.

Since2002,about5,818Aghanunaccompaniedminors

havebeendeportedromIran,accordingtoUNHCR.While

themajorityothesechilddeporteesareundocumented

labormigrants,humanrightsorganizationswarnthatchild

deporteesmaybeataheightenedriskosexualexploitation,

physicalabuse,humantrackingandvariousexploitations

andabusesupontheirreturn,accordingtoAIHRC.74Some

deporteeshaveaccusedtheIranianpoliceobeatings,

illegalandarbitrarydetention,andtheIraniansecurity

orcesoinsultsbeoretheirexpulsion.75TheIranian

governmenthasalsomadeitmoredicultorAghanreugeestostayinthecountrybybanningthemrom

22 provincesaspartoitsno-goareapolicyandgradually

cuttingotheiraccesstosubsidizededucation,health

careandood.76In2009,thegovernmenttooksomesteps

toeasetheserestrictivepoliciesbybeginningtogivework

permitstoregisteredAghanreugeesandallowingall

school-agechildren,includingregisteredandunregistered

reugees,toenrollingrades1-12inthesamemanner.77

However,gapsintheimplementationothesepolicies

remain,accordingtoUNHCR.

MostregisteredAghanreugeesdonotwanttoreturn

totheirhomecountryduetothedeterioratingsecuritysituation,thelimitedabsorptioncapacityocommunities

inAghanistanandthelackosocio-economicopportuni-

ties.Withoutland,jobs,accesstobasicservicesandwith

ongoingsecurityrisks,returneesareatahighrisko

reneweddisplacementwithinAghanistanororced

re-migrationtoneighboringcountries.78UNHCRalluded

tothespecicprotectionconcernsoreturneechildren,

includingchildlabor,smugglingandhumantracking,

andearlyororcedmarriage.79Moreover,abouthaloall

reugeesgrewupinanothercountryand80percenthave

livedthereormorethantwodecades,makingitdicult

orthemtoreintegrateupontheirreturntoAghanistan.80


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Recommendations on Refugees and IDP Children The UN Security Council Working Group on Children and Armed Conict (SCWG-CAC)shouldrequest

UNHCRand/ortheRepresentativeotheSecretary-GeneralonthehumanrightsoIDPstoleadastudyto

determinevulnerabilitiesandrisksordisplacedandreugeechildrenromAghanistan.Thestudysndings

wouldbetherststeptowardsenactingacomprehensiveactionplantonddurablesolutionsordisplacedchildrenromAghanistan.

The GoAshouldensurethatunaccompaniedandseparatedchildrenreceiveadequateinterimcareuntilthey

arereunitedwiththeiramilies,placedwithosterparentsorotherlong-termarrangementsorcarearemade,

inaccordancewiththeInter-agencyGuidingPrinciplesonUnaccompaniedandSeparatedChildren.The

governmentshouldmonitorthatthestandardsoprotectionandcareprovidedbyprivateandpublic

orphanagesaremet.

The Government of Iranshouldcomplywiththe1951ReugeeConventionandits1967Protocol;the

Government of Pakistanshouldsignandcomplywiththe1951ReugeeConventionandits1967Protocol.

Inparticular,theyshouldprovidereugeechildrenromAghanistanwithaccesstoeducation,healthand

documentationtoacilitateopportunitiesorlocalintegrationorrepatriationandensurethattheirprotection

againstharassmentordeportationisinlinewithinternationalstandards.

The Governments of Afghanistan, Pakistan and IranshouldworkwithUNHCRtoensurethatchildren

cancontinuetheireducationorvocationaltrainingupontheirreturn.

AIHRCshouldcoordinatecloselywiththeindependentHumanRightsCommissionoPakistan(HRCP)to

conductjointmonitoringandreportingonhumanrightsandchildrightsviolationsalongtheircommon

borderareasandtotakespecicmeasurestopreventthem.


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Health

Access to ServicesThedestructionromthewarandensuingpoliticaland

economicinstabilityhaveletAghanistanshealthcare

systeminshambles,andnearlyullydependenton

externalundingandassistance.Since2002thegovern-

menthastakensomeimportantstepsinimprovinghealth

care,whichhaveresultedintheincreaseohealthacilities

rom400in2002to1,788in2009andasubstantial

increaseintrainedhealthpersonnel,accordingtothe

MinistryoPublicHealth.81Withtheexpansionobasic

healthservices,preventableatalitiesamonginantsand

youngmothershavemarginallydecreased.However,

intensiedconfict,attacksandintimidationagainsthealth

workers,andlowqualityservices,havecontinuedtokeep

inantandmaternalmortalityratesalarminglyhigh.

Aghanistanisstilltheworstplaceoranewborninterms

oaccesstohealthcareandsurvivalopportunities,

accordingtoUNICEFandSavetheChildren.82Oneinour

Aghanchildrendonotreachtheirthbirthday,partly

duetolackoaccesstoadequatehealthcare.83Savethe

Childrenreportsthat15percentovulnerablepeople,

includingchildren,inurbansettingsand30percento

thoseinruralareasdonothaveaccesstoanygovernment,

nongovernmentalorganizationorprivatelyrunhealth

acilitiesinAghanistan.84Newlydevelopednationalhealth

carepoliciestoprovidepeoplewithbasichealthservices

(BasicPackagesoHealthServicesBPHS)generallydo

notreachpeoplelivinginthesouthernandwesternparts

othecountry,partlyduetoinsecurity.85Asaresult,

childrenhavecontractedordiedodiseasesthatareeasilypreventableorcontrolledinmostcountriesaround

theworld,includingrespiratoryinections,diarrhea

andvaccinepreventabledeaths,especiallymeasles,

accordingtoWHO.86

Atleast1millionAghans(15percentothepopulation)

weredeprivedobasichealthcareservicesduetoattacks

onhealthcareacilitiesandhealthworkersin2008,and

insucientcoveragebytheBPHSsystem.Thisnumberhas

doubledsince2007,accordingtotheMinistryoPublic

HealthandWHO(seeabove:HumanitarianAccess).87

Thesituationintheconfict-aectedsouthernregion

(Helmand,Kandahar,ZabulandNimroz)isparticularly

severeandcontinuestodegrade.Somehealthacilities

havebeenclosed,damagedordestroyedbythearmed

oppositionandthedeliberatetargetingohealthacilities

andworkerslimitsaccesstohealthservicesormuchothe

populationlivingininsecureareas.Manysecurityincidents

involvingtheharassment,intimidationandkidnapping

ohealthworkersremainunreportedbecauseoearo

retaliation.AsoNovember2008,13southerndistrictshad

nounctionalpublichealthacilities,potentiallyaecting

hundredsothousandsopeople,includingchildren,

accordingtotheUN.

Armedgroupshavelargelybeenresponsibleorattacking

healthacilities,stamembersandpatients.Forexample,

armedoppositiongroupsdestroyedseveralNGO-runclinicsintheeastandabductedstabetweenJuly1st

andSeptember30,2009.88AghanSecurityForcesand

internationalmilitaryorceshavealsonotalwaysrespected

thespecialprotectionaordedtomedicalpersonneland

acilitiesunderinternationallaw.Forexample,inAugust

2009,Aghanmilitaryorcesreportedlyoccupiedtwo

BasicHealthCentersinHelmandprovince.89TheSwedish

CommitteeorAghanistanalsoaccusedISAFoinvading

itshospitalonSeptember6,2009.90Inordertoprevent

urtherincidentsinvolvingtheoccupationohealth

acilitiesbymilitaryorces,theHealthClustermembers,

whocoordinatethehealthresponseamongUN,govern-

ment,NGO,academicandprivateactors,havedeveloped

acodeoconductorallmilitaryactorsregardingentry

intohealthacilities(seeabove:HumanitarianAccess).

Inaddition,theHealthClusterincoordinationwith

theUN-ledCountryTaskForceontheMonitoringand

ReportingMechanism(CTFMRM)establishedamecha-

nismormemberstoreportattacksagainsthealthsta

andacilities(seebelow:UNSecurityCouncilActions).


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Thereisalsoacriticalshortageohealthcareworkersin

confict-aectedorremoteareas.91Onaverage,onedoctor

isresponsibleortreatingmorethan5,500patients,and

80 percentohealthclinicslackadequateequipment.92In

particular,thelackoemalemedicalstaposesaserious

obstacletoprovidingessentialservicestowomenand

children.InPaktikaprovince,orexample,thereisnotasingleemaledoctorandonlyaewemalenursesand

midwivesintheentireprovince,wheremorethan

180,000 womenlive,accordingtoAghanistansCentral

StatisticsOce.93

Withoutaccesstomedicalsuppliesandproessionalsta,

someAghanshavereliedoninormalmedicaladvicerom

amilyeldersorboughtmedicineromlocaldrugsellers

suchasopium,withharmulconsequences.94Inparticular,

thesmallnumberoemalehealthworkersdiscourages

girlsandwomenromseekingmedicalassistance,espe-

ciallyorreproductivehealthconcerns,accordingtothe

samereport.Currently,lessthanone-thirdohealthacilitieshaveatleastoneemalehealthworker,according

totheSecretary-GeneralsreportonWomen,Peaceand

Security,September16,2009(S/2009/465,para.16).

Maternal Death and Reproductive HealthInspiteoimprovements,Aghanistancontinuestohave

oneothehighestmaternalmortalityratesworldwide

with1,800/100,000livebirths.95Onemotherdiesevery

halhourinAghanistanbecauseobirth-relatedproblems,

accordingtoUNICEF.96Theinantmortalityratestandsat

165orevery1,000livebirths.97Theprevalenceoearly

marriagehasresultedingirlsgivingbirthatayoungagewhentheyarenotyetphysicallymature,whichcarries

serioushealthrisksorthemotherandinant.Forexample,

anadolescentgirlistwotovetimesmorelikelytodie

rompregnancy-relatedcomplicationsthana20-year-old

woman,accordingtoSavetheChildren.98

Inaddition,traditionalgendernormspreventwomenand

girlsromlearningaboutreproductivehealth,visitingmale

doctorsoraccessinghealthacilitieswithoutamaleperson

accompanyingthem,accordingtoUNICEF.Theagency

urtherreportsthatthehighmaternalmortalityrateis

duetoverylimitedaccesstocomprehensiveemergency

obstetriccareorwomenlivinginruralareas,pooraware-

nessaboutsaedeliverypracticesandthescarcityo

proessionalhealthworkers,particularlyemales.99More

than70percentobirthstakeplaceathomewithoutany

medicalsupportandanyemergencyplaninplace.100While

thenumberomidwiveshasincreasedsubstantiallyrom

400in2001toapproximately2,500in2008,morethan4,500

moremidwivesarerequiredtomeetcurrentneeds.101

Theenrollmentostudentsorcommunitymidwiery

schoolsishamperedbythelowliteracyratesamong

emalesintheruralandremoteareasandevenmore

bythethreatsandintimidationotheiramiliesbythe

armedoppositiongroups,accordingtoWHO.Someo

itsimplementingpartnersoperatinginsecuritychal-

lengingdistrictsreporteddropoutratesobetween30 40percent.Progressinimprovingtheaccessto

skilledbirthattendantsislikelytobeslow,especiallyin

areaswherethiswouldbemostneeded,namelyinrural,

remoteandinsecurelocations.

Infectious DiseasesUntreatedcommunicablediseasesthreatenindividuals

andcommunitiesinAghanistan.Othecasesreported

totheDiseaseEarlyWarningSystemadministeredbythe

MinistryoPublicHealth,morethan60percentposedthe

threatodevelopingintoamajorepidemic,accordingto

WHO.Thissituationisespeciallydireininsecureareaswheregovernmentandhumanitarianagencyoperations

arerestrictedduetoconfict. SourcesatWHOreportthat

50percentooutbreaksaretakingplaceininsecureareas,

whereevenaccesstoemergencyhealthcareisimpossible.

Forexample,duringthecholeraoutbreako2009,aatality

rateo13percentwasrecordedinunstablepartsothe

southernregion.Theseuntreated,otenseriousdiseases

contributetoAghanistansunder-vemortalityrateo

25 percent,whichisoneothehighestintheworld.102

NationwidecampaignsbytheAghangovernmentwith

UNsupporttoeradicatepoliohaveresultedinthenear-

eradicationothepandemicinthelasttwotothreeyearswithinthecountry,accordingtoWHO.However,insecurity

haspreventedagenciesromaccessing110,000childrenin

theconfict-aectedsouthernprovinces,where20othe

23caseswereregisteredin2009,accordingtoaWHO2009

reportonthepolioeradicationcampaign.Healthagencies

considertheAghanistan-Pakistanregionasaprimaryrisk

areaorpolioasitinvolvestwootheourremaining

countrieswherepoliostillremainsendemicduetoinsecu-

rityanddisplacement,accordingtoWHO.103Whileinsecurity

haspreventedaccesstocertainareas,partiestoconfict

havenotdirectlyobstructedvaccinationeortsinareas

undertheirinfuenceorcontrol,andtheTalibanpubliclydeclaredthatitwouldnotopposeimmunizationcam-

paigns.104Thesuccessulengagementohumanitarian

agencieswithnon-statearmedgroupsinnegotiatingaccess

orimmunizationcampaignshasallowedWHOandits

partnerstoinclude30,000childrenromdicult-to-reach

areas,andtoestablishadditionalDiseasesEarlyWarning

Systemsortheidenticationandresponsetooutbreaks.105


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MalnutritionTheHumanitarianActionAppealwarnedosevere

malnutritionamongunder-vechildren,andinpregnant

andlactatingwomenin2008duetodrought,risingood

pricesandinsecurity.Inact,40percentochildrenunder

veinAghanistanareunderweightand54percentdisplay

severesignsostuntingaccordingtoUNICEF,State of the

Worlds Children 2008.Accordingtothesamesurvey,

24 percentolactatingwomenaremalnourishedand

over19 percentopregnantwomenhavepoornutritional

status.Therearestrongindicationsthatyoungmothers

andchildrenregularlydieomalnutrition-relateddiseases,

accordingtoUNICEFandtheAghanMinistryoPublic

Health.106UNinitiativesocusoneedingchildrenunder

veandpregnantandbreasteedingwomenthrough

eedingcentersandoerdailylunchestostudentsto

encourageparentstosendtheirchildrentoschool.107

Water and SanitationInadequateaccesstocleanwaterandsanitationurther

exacerbatesthehealthsituationorchildreninAghanistan.

Lessthanone-quarteroallAghanscurrentlyhaveaccess

tosaewatersources,andlessthanone-thirdothe

populationisabletouseadequatesanitationacilities.108

Threeoutoourpublicschoolsdonothavesaesanitation

acilitiesorstudentsandapproximately2millionstudents

attendingtheseschoolsdonothaveaccesstosae

drinkingwater,accordingtoUNICEF.109

Basichygienicmeasuressuchaswashinghandswithsoap

atervisitingthetoiletorbeoreeatingcanreducetheriskoachilddyingodiarrhealdiseasesbyhal,accordingto

UNICEF.UNICEFurtherarmsthatespeciallyoldergirls

areextremelyunlikelytoattendschoolsthatlackgender-

separatedlatrines.Improvingaccesstowaterandsanitation

atschoolscanthuscontributetobothincreasingschool

attendanceandreducingchildmortalityinAghanistan.

Drug AddictionThelargesupplyoopiumtogetherwithpoverty,

unemployment,mentalillness,lackoawarenessand

widespreaddespairhascreatedanincreasingdemandor

drugsinAghanistanswar-tornsociety.ThemostrecentUNOceonDrugsandCrimeDrug Use Survey 2005

estimatedthatnearly1millionAghans,including

60,000 childrenundertheageo15,wereaddictedto

drugs.Childrenweremostlyreportedasusinginhalant

tranquilizers.Figuresondrugabuseamongyouthare

believedtobemuchhighertodayandencompassawider

rangeosubstancesduetoavailabilityandcontinuing

stresses,accordingtoUNODC.Mostothewomenusing

opiumareoreproductiveage,makingbabiestheymay

havemoresusceptibletowithdrawalsyndromes,prematu-

rity,accidentalpoisoningandotherhealthissues.110

Morerecently,aewhealthagencieshavereportedentire

amiliesinAghanistanbecomingaddictedtodrugs.111An

AIHRCstudyoundthat15percentodruguserssurveyed

gavetheirchildrendrugstokeepthemquietwhiletheywork.112Theuseodrugshasparticularlyharmulconse-

quencesorchildrenbecausetheyaremoreeasilyaddicted

andsuerpermanentmentalandphysicaldamage.113

Intheirdrivetoacquiremoredrugs,somechildrenjoin

criminalnetworksorarmedgroups,accordingtoUNAMAs

2007report.Healthexpertsalsowarnotheimpending

risksrelatingtodiseasesthatcanbetransmittedby

sharingneedlessuchasHIV/AIDSandhepatitisC(see

below:HIV/AIDS).

OnlyoneoutoourreporteddrugaddictsinAghanistan

receivesthenecessarytreatmentandrehabilitation

services,accordingtoUNODC.Patientsexpectingtreatment

otenhavetowaitmonthsoroneothe100bedsreserved

ortreatment.114Theearobeingstigmatizedalsokeeps

manywomenandchildrenromseekinginormation

andservices.

Psycho-Social DisordersTraumaticeventsexperiencedorwitnessedduringthe

confictcontinuetohauntmanychildren,makingit

dicultorthemtoreadjusttonormallie.Arecentsurvey

oundthat22percento1,011childrenbetweentheages

o11and16yearsattendinggovernment-operated

schoolsinKabul,BamiyanandMazar-i-Shariexhibited

signsopsychiatricdisorder;girlsweretwo-and-a-hal

timesmorelikelytohavedisordersthanboys.115

However,thereislimitedpsycho-socialtraumasupport

providedinthecountry,accordingtoHandicap

International.Standardhealthresponsesorvictimso

violenceevenrapevictimsocusonphysicalcarewith

littleattentionpaidtothepatientsmentalwell-being.

Theproessionocounselingdoesnotevenexistinpublic

healthservices.Somechildprotectioninitiativesengage

confict-aectedchildreninactivitiestopromotecreativity

andplayasanalternativetomoretraditional

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