The security situation in Afghanistan has worsened over the last year and a half, and the armed conflict has remained intense in 2008. Regular fighting between armed groups and national and international forces has continued in over half of the country. Even in provinces spared by open combat, roadside bombs and suicide bombings are regular occurrences. The intensity of fighting in western Afghanistan is now comparable to that in the east and south. Hostilities continue to claim the lives of Afghans, international aid workers and foreigners. Remote parts of the country remain difficult to reach.

As in the past the ICRC met the needs of conflict victims in spite of security constraints in many areas. It supported selected hospitals and six physical rehabilitation centres that mainly work with landmine victims. It also renovated water and sanitation services in rural and urban areas and in places of detention. Visits to people detained by the Afghan authorities, the International Security and Assistance Force or the United States-led coalition remain a top priority, along with efforts to restore contact between members of families separated by years of armed conflict.

At the same time, the ICRC continued to remind all those involved in the conflict of their obligations to respect civilian life and property.

The severe drought that has gripped Afghanistan since 2001 has led to a food crisis, made more dire by food shortages in the north. If the next harvest fails, an emergency response will be unavoidable. The ICRC and the Afghan Red Crescent Society have launched a joint appeal to assist four northern provinces in the coming months.

People deprived of their freedom

The ICRC regularly visits people that the Afghan authorities or international forces (US and NATO) are holding in connection with the conflict. It assesses the treatment of prisoners and their conditions of detention, and verifies respect for fundamental judicial guarantees. It also helps family members separated by conflict restore and maintain contact.

In September, following lengthy dialogue with the US authorities, face-to-face visits for relatives of detainees held in Bagram started. Since then, the ICRC has enabled family members of 29 detainees to visit them. ICRC staff:

• made 284 visits to 83 places of detention holding over 12,500 people;
• followed up the cases of 3,100 people arrested in connection with the conflict or the security situation, visiting 1,310 of them for the first time;
• helped 192 released detainees travel home;
• and the Afghan Red Crescent Society collected almost 14,200 Red Cross messages and distributed as many; most of the messages were between detainees and their families;
• set up a video-teleconference call programme, enabling detainees in the US detention facility at Bagram to speak to and see their families for the first time since they were detained. Over 1,700 video calls were made.

Promoting international humanitarian law

In accordance with its mandate, the ICRC verifies that arms bearers are complying with humanitarian law. The organization therefore maintains confidential dialogue with all parties to the conflict: Afghan security forces, international forces and armed opposition groups.

The ICRC discusses allegations of abuse perpetrated against people not, or no longer participating in the hostilities with the relevant authorities in an effort to prevent recurrences and minimize the impact of war on the population.

The ICRC has often acted as a neutral and independent intermediary in prison riots, and has helped to arrange the collection of bodies from the battlefield, allowing families to complete their mourning.

Health care

Mirwais Hospital, in Kandahar, Sheberghan Hospital, in Jawzjan, and Jalalabad Public Health Hospital all benefit from ICRC support and training, which has enabled them to continue treating victims of the conflict and responding to other emergencies. A joint ICRC-health ministry project is also under way to further strengthen Mirwais hospital’s capacity to deliver essential health services. The three hospitals:

• treated around 42,700 inpatients and 200,100 outpatients;
• performed some 17,200 operations.

In Kabul and elsewhere, the ICRC provided medical supplies to the 400-bed Afghan National Army hospital and seven other medical facilities, including the health ministry’s Central Blood Bank and Radiology Department. An emergency kit for the treatment of up to 50 war-wounded is pre-positioned at the ministry. The organization also provided supplies and financial support to nine Afghan Red Crescent clinics which offer general consultations and vaccinations for women and children.

All combatants wounded in war have the right to medical assistance. The ICRC sent over 900 consignments of first-aid and pre-hospital care supplies to remote areas lacking medical facilities.

Rehabilitating disabled people

The ICRC has been providing limb-fitting and rehabilitation services and helping disabled people reintegrate into the community since 1988. This has benefited landmine victims and many people suffering other kinds of motor impairment. The organization has assisted some 86,200 patients, including over 33,600 who had lost a limb.

The ICRC runs six limb-fitting centres, in Kabul, Mazar, Herat, Gulbahar, Faizabad and Jalalabad. They offer a home-care service for patients with spinal cord injuries, providing them and their families with medical, economic and social support. The centres:

• registered around 5,100 new patients
• produced over 11,700 prostheses and orthoses
• conducted around 142,300 physiotherapy sessions
• granted micro-credit loans to over 400 patients to start businesses
• provided over 200 patients with vocational training
• conducted nearly 3,500 home-care visits in Kabul
• assisted over 1,200 patients with spinal cord injuries.

Water and habitat

The ICRC repairs urban and rural water networks, renovates hospitals, detention places and sanitation facilities, promotes hygiene and provides training in environmental health. The organization:

Urban water supply

• completed a project in Jalalabad (10,000 beneficiaries)
• continued three water supply/sanitation projects in Herat and Kandahar (44,000 beneficiaries)

Rural water supply

• completed four projects and worked on three others in Bamyan (about 13,000 beneficiaries)
• completed a project in Mazar (4,800 beneficiaries)
• worked on four projects in Almar, Chemtal, Old Baghlan and Kunar (about 34,200 beneficiaries)

Places of detention

• continued to ensure basic water and sanitation conditions in places of detention in Kabul, Herat and Takhar provinces, for over 3,340 detainees
• completed similar work in Jalalabad, Badakhshan Kapisa, Farah, Baghlan, Samanghan, Sheberghan, Sar-i Pul and Mazar provinces, for over 2,000 detainees

Hygiene promotion

• held 900 hygiene promotion sessions for some 13,400 people
• provided education and practical advice on hygiene to nearly 26,400 people; distributed soap for over 2,500 families
• continued to upgrade and/or maintain the general infrastructure of Kandahar hospital and Jalalabad hospital’s surgical wards.

Emergency aid

The ICRC provides emergency aid to people displaced by the armed conflict who do not have adequate shelter and those hard-hit by natural disasters. With the Afghan Red Crescent Society it distributed 9,700 food kits (rice, beans, ghee, salt, sugar and tea) and 7,700 non-food kits (tarpaulins, blankets, jerrycans, kitchen sets and soap) to:

• nearly 79,000 displaced people in southern, eastern and central Afghanistan. Part of the aid went to some 7,200 Pakistanis and Afghans displaced in eastern Afghanistan by the conflict in Bajaur Agency, Pakistan
• over 13,400 victims of a harsh winter, particularly in the west
• some 132,600 drought victims in northern Afghanistan.

Promoting international humanitarian law

The ICRC's mission is to protect the lives and dignity of victims of war and prevent suffering by promoting compliance with humanitarian law. ICRC staff held 162 dissemination sessions for 4,160 people, including provincial authorities, Afghan Red Crescent Society staff and volunteers, community elders, members of religious circles, journalists and university students.

The ICRC also held 75 sessions for nearly 2,500 Afghan military and police personnel, and 52 meetings with Afghan military authorities, international mentors and legal advisors who train the national army.

Cooperation with the Afghan Red Crescent Society (ARCS)

The ICRC gives the Afghan Red Crescent Society technical and financial support to boost its capacity to deliver programmes and services. The organization:

• supported some 550 trainees and trainers through its vocational training programme;
• supported training sessions for 63 ARCS dissemination staff and 3,800 volunteers;
• supplied over 38,000 first-aid kits to 16,645 ARCS volunteers; trained or retrained 4,140 team leaders and new volunteers;
• held information sessions for some 114,200 people treated at ARCS health clinics;
• completed about 270 food-for-work projects benefiting some 178,800 families.

The ICRC partially supports the Afghan Red Crescent’s mine-risk education programme, which aims to prevent injuries and deaths from mines and explosive remnants of war. Mine action teams held 14,521 mine-risk education sessions for 118,252 adults and over 221,900 children.