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British Army Spread Public Health Message

March 1, 2011

British Army medics have been working hand in hand with their Afghan National Army (ANA) counterparts to improve the public health of the local communities in which they work.

A community health project aimed at increasing the reach of Afghanistan’s Ministry of Public Health has seen soldiers and medics from Shropshire-based 1st Battalion The Royal Irish Regiment, and the ANA, support government officials in southern Nad-e Ali.

British Army Spread Public Health Message

The initiative was kicked off earlier this month with a public gathering at Nad-e Ali’s District Centre Clinic, run by the District Health Officer and his staff. Where the troops play a key role is in is encouraging the lessons to be cascaded down to the smaller villages or ‘kalays’. This is particularly important as it is people in these more rural areas who find it most difficult to get to clinics.

Since the initial session, the District Centre Clinic employees, local elders, Afghan National Police officers and British and Afghan troops have worked together to run and support workshops in as many areas as possible, covering training in basic health matters including family planning and malaria prevention.

The key figures throughout have been Major Nicola MacLeod, medical officer for 1st Battalion The Royal Irish Regiment and Dr Noorullah Zyarmal, the ANA’s doctor based at Forward Operating Base Shawqat, who have worked together to ensure the public health messages are pushed as far and wide as possible. Maj MacLeod (32) is from Edinburgh.

The initiative continues to spread: while the involvement of local police was initially to simply provide security for the events, more recently policemen have been attending training so that they can pass on the information, and take back basic equipment, to colleagues and their families.

British Army Spread Public Health Message

And Dr Zyarmal has also been able to meet with and offer guidance to Pashtun doctors in the town of Saidebad, working in a recently-reopened clinic which had been closed due to insurgent activity and fighting.

Dr Noorullah Zyarmal said:

“Teaching about health has been an opportunity to meet locals and get some messages to them to make their lives easier and healthier. A little knowledge can go a long way. Our hope is that those we have trained will share this information in schools, at mosques and with their families.”

Major Nicola MacLeod said:

“The Afghan Ministry of Public Health have some good clinics in Nad-e Ali and recognise the need for community outreach. This project helps them extend to the more rural and poorer areas with the help of the ANA, the ANP and us.

“The local elders understand the benefits of preventative medicine and often put forward teachers, or the Mullah, for training, as they see that cascade of education is an important part of promoting health in their communities.”

Captain Simon Richards, of 16 Medical Regiment, who has also been involved with the project, added:

“Working with the ANA, and in particular with Noorullah, on this project has been a real pleasure. It’s always so much easier for an Afghan to get information across to Afghan people so having a respected figure like him on board has made the initiative significantly more effective.”

One Comment leave one →
  1. Lt Col Ewan Cameron RAMC permalink
    March 1, 2011 11:16

    This is an interesting foray into the civilian health sector. Throughout 2009/ 2010 HQ ISAF and HQ RC(S) avoided the ‘militarisation’ of the civilian health sector as the Ministry of Public Health specifically requested and continues to request that all military elements (including ANSF) do not conduct such activities unless authorised at MoPH Kabul level. (See page 49 to the MoPH Policy This is technically called ‘blurring the lines’ whereby civilian health personnel are targetted as they are now associated with combatants. The MoPH already has a community based training programme to train Community Health workers for which the BPHS NGO is paid and contracted to implement. The military doing this activity introduces free competition, undermines confidence in the local provider and potentially teaches inappropriate clinical skills that cannot be supported by the MoPH once we leave. Guidance on appropriate medical engagements can be found at SHAPE ACO Directive 83-2: Guidance for Military Medical Services Involvement with Humanitarian Assistance and Support to Governance, Reconstruction and Development and HQ ISAF SOP 01154: Guidance on Military Medical Engagement in Health Sector Reconstruction and Development. Finally HQ RC(S) has a very good tactical directive for use by Commanders being HQ RC(S) SOP 9950: Military Responsibilities in Civilian Sector Health Development that provides a ‘determenants of health’ framework against the S/C/H/B construct.

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