Assessing the Situation Through Conversation
Epidemiologist Says Afghan Refugee Camps are Horrific

The squalid conditions in refugee camps on the Afghanistan-Pakistan border reveal more than a crisis to Dr. Terry Rives, a doctor of public health at The University of Texas Health Science Center at Houston.

Last month, Dr. Rives visited the region for the second time in recent months, conducting a health-needs assessment on behalf of the United Nations’ High Commission on Refugees. What he saw there stunned him – people with no food or water, no hygiene, and no access to what many consider basic essentials.

"The first time I went to Afghanistan, I thought I would go in, determine what medicine they needed, come back to the States, put in an order for it, and that would be it," Dr. Rives said. "What I found, however, were people who literally had nothing to eat or drink – malnourished and starving children, covered in scabies, whose parents were no better off. I realized that people can live for a while without medicine, but they can’t live without food and water."

Dr. Rives completed written evaluations on 200 Afghan refugees, but said he learned far more about the dire conditions just by conversing with people.

"People were interested in two things – peace and learning farming techniques," he said. "These people, for the most part, have never known a time without war. The constant battles within the country have destabilized it so much that people are unable to conduct their lives with any kind of normalcy."

Dr. Rives said life in the camps was horrific last summer, and it has only gotten worse with the arrival of winter and the coalition bombs.

"When I was there in August, about 100 to 125 children died every week from starvation," he said. "Adults often developed heat stroke while attending funerals, and then they would die. Now that the temperature isn’t 120 degrees every day, the risk of heat stroke is gone. But winter is just as harsh and unforgiving. Add that to the increasing number of refugees, and we have a major health disaster brewing."

Dr. Rives, in his everyday job as UT-Houston director of institutional assessment, evaluates the effectiveness of university programs as they relate to students, faculty, staff, patients, and the community. With this project, he hopes to present his public health findings to whatever Afghan government official will give him an audience.

"Pakistan and the United Nations are not equipped to deal with millions of official refugees, as well as the tens of thousands that have not yet been certified as refugees by the United Nations’ High Commission on Refugees," said Dr. Rives. "People in that situation do not qualify for food and other necessities, leaving them to the mercy and limited resources of private charitable organizations. And as long as there is so much unrest in Afghanistan, their situation will just worsen."

John Fredriksson, the U.N. high commissioner for refugees, has reported that each day an estimated 1,000 Afghans flee violence or famine in their home country. Pakistan, which has already received 2 million Afghan refugees, is now attempting to close its borders to prevent the entrance of thousands more.

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©2006 Texas Medical Center

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