Tragically , Mr . Lowcock ’ s prediction is already playing out in poor and fragile areas of Central Asia . Even the remote , isolated mountain communities where Central Asia Institute ( CAI ) focuses its work are being affected . Our in-country partners report that COVID-19 is taking a toll on almost every aspect of daily life . The region ’ s struggling economies and inadequate , underfunded health care systems are unable to adapt to these new and unprecedented challenges .
But this is just the tip of the iceberg . If Mr . Lowcock is correct and we ’ re months away from a peak in infections , then we ’ re likely to see things get worse before they get better . Countries like Afghanistan , Pakistan , and Tajikistan may have very long and difficult battles ahead of them .
COVID-19 ASSAULTS THE ROOF OF THE WORLD
To reach many of the remote , mountainous communities where CAI works , you ’ ll likely need a four-wheel-drive vehicle , a horse , and your hiking shoes , because you ’ ll be gaining about 10,000 feet of elevation . In these far-flung villages nestled at the foot of soaring peaks , modern health care is almost nonexistent .
Imagine your 32-year-old son returns from a two-day trip to a nearby town and starts coughing . His fever spikes . Then his 30-year-old wife becomes ill . Then your 75-year-old father gets sick . And all of them are sharing a two-room home with you , your husband , and five grandchildren . You ’ re the only one to nurse them . There are no health care facilities or trained medical professionals in your village .
Even if there is a hospital located in the regional capital , you may not have the resources to travel there , stay in overnight lodging , or pay the cost of seeing a doctor , since health insurance is a luxury only for the wealthy . What ’ s more , most clinics and hospitals are understaffed , overwhelmed , and lacking modern equipment , medication , and trained medical personnel . Hospital workers are unlikely to have the appropriate personal protective equipment ( PPE ) to keep them safe from infection . In more conservative areas , your daughter may not be treated at all because the only doctor is a man , and she is not allowed to be treated by a male doctor .
This spring , when COVID-19 swept through Central Asia , this was the reality for many of the families living in the impoverished , marginalized communities we serve . The already insufficient and overburdened medical systems in these regions were quickly overwhelmed . As the infection rate rose , there were not enough hospital beds , PPE , or test kits to meet the growing demand . At one point in Afghanistan , only 13 hospitals nationwide were accepting COVID patients , nowhere near enough to serve a population of 37 million people .
“ Most doctors have closed their infirmaries because health workers are afraid of the virus ,” said Dr . Najmussama Shefajo , who owns a private hospital in Afghanistan . Hospitals like the one that Dr . Shefajo runs must purchase large quantities of PPE , disinfectants , gloves , and masks , and even make alterations to the buildings themselves . “ This is what we have to do for the safety of ourselves and our patients ,” Dr . Shefajo explained . But getting these lifesaving supplies has been difficult .
“ When the coronavirus started to spread , there were no testing kits available ,” said Kamel Farhat , one of CAI ’ s Afghan partners . “ Most kits were reserved for high-level government officials and their families . None was available to ordinary citizens .” Patients were turned away from overcrowded hospitals , and doctors without proper protective gear were asked to continue working despite the risk to their health .
Across the border in northern Pakistan , the situation has been equally dire .
In Afghanistan , the challenges brought about by the coronavirus are exacerbated by existing cultural norms that frequently prohibit women from receiving medical attention . Men sometimes forbid their wives , daughters , and female relatives from seeing a doctor , especially if there is no female doctor available . Men claim it ’ s a breach of modesty for women to be examined or treated by a male physician .
Faced with abysmal , life-threatening work conditions , doctors , nurses , and paramedical staff staged sit-ins and protested in the streets of the normally peaceful regional capital .
In Gilgit-Baltistan , a region in northern Pakistan where CAI has long worked , there are only 126 hospital beds for COVID-19 patients and a meager 21 medical clinics with dedicated isolation units available for the 2 million people who live there . 1 Most health care facilities are in urban centers , far from the remote , mountain communities that CAI serves .
It ’ s difficult to know the true number of cases or the infection rate in Gilgit- Baltistan . According to the Pakistani government , there are only three laboratories processing COVID-19 tests which have a combined capacity of 600 tests per day . 2 A local official in GB clarified , however , that only two of the three labs are available to process civilians ’ tests , the other larger lab is used to process tests for the military . The official also explained that the capacity of the two labs processing civilian tests was only 70 tests per day .
Taking proper preventative measures is also a challenge . In these poor , rural areas , most people do not have running water in their homes , or even soap , so they can ’ t comply with the recommended frequent hand-washing to prevent the spread of the virus .
6 | JOURNEY OF HOPE CENTRAL ASIA INSTITUTE