Category Archives: Blog

Nawur health center as a confirmed base for vaccination

Nawur health center is used as a platform for vaccination campaigns in the region

Afghanistan is one of the last three countries in the world where poliomyelitis is still endemic [1]. 14 polio cases were reported in 2017, and by the end of April 2018 there were 7 new cases reported in the country [2]. Polio mainly affects children under 5 years of age and one in 200 infections leads to irreversible paralysis.

Polio is one of only a limited number of diseases that can be eradicated and it can be eradicated because it affects only humans, because a cheap, safe and easy oral vaccine exists and immunity lasts a lifetime.

In March, the Afghanistan polio eradication initiative conducted its first national immunization campaign for eradication of the disease in 2018. In just a week, around 70,000 workers knocked on doors and stopped families in health centers, city streets and border crossings to vaccinate almost ten million children [3]. Monitoring data reflected more than 94% coverage in each vaccination campaign during 2017. The number of children missed due to inaccessibility went down since 2017 but an estimated 138 000 children were still missing in the national vaccination campaign of March 2018.

Without a clinic, a region like Nawur would have remained unknown to the health authorities; at its opening, the ministry of public health informed organizations such as UNICEF which registered the clinic as a vaccination center. The ministry and its partners have long been trying to reach isolated areas with vaccination campaigns and the health clinic gives them a base for this in the region. Before the establishment of Sar Assya clinic in the district of Nawur in 2011 [4], various illnesses remained untreated, the mortality rate among mothers and children was high, and children did not receive the requisite vaccinations. The Nawur clinic’s services have brought about significant improvements in the health situation of the population.

Since it registration in the national health care system, the Nawur clinic’s staff vaccinated thousands of children not only for polio, but other infectious diseases such as tuberculosis, diphtheria, tetanus, pertussis, etc. In 2017, 1,022 children and several hundreds of women were vaccinated in Nawur. During the March 2018 vaccination campaign, 142 young children received the polio vaccine.

Through its implementation in a remote region of central Afghanistan Nawur health center contributes to the reduction of mortality and serves as a base for vaccination and other prevention campaigns.

[1] http://moph.gov.af/en/page/polio-eradication/polio-situation-updates

[2] Note: No cases have been reported since 2016 in the central region of Afghanistan where Nai Qala operates.

[3] http://www.emro.who.int/afg/photo-essays/ten-million-children-70000-workers-five-days.html; http://www.emro.who.int/afg/programmes/polio-eradication-initiative.html

2011 – Sar Assya

Girls’ education, a change of mindset

Promoting girls’ education and cultural changes through a capacity building program

Improving the quality of education provided in the schools Nai Qala has built. 

Overall, the quality of education in Afghanistan in particular in the rural areas is very low. To remedy this, the Nai Qala Association is not only providing school buildings in those isolated regions but also several tutoring classes in sciences, and preparation courses to the national test for university entrance. Without such classes, many girls would not have taken the exam, as parents do not have the means and motivation to send them to towns to get private lessons.

The role of Nai Qala’s teacher training in capacity building is much more than transferring scientific knowledge.
Inspired by her experience with western school systems that promote regular communication between teachers and parents, Nai Qala’s president motivated the teacher-trainers to establish such a culture. Trainers meet parents to encourage them to be supportive at home with their children. In remote rural regions, many parents are illiterate and cannot help children with their homework but can support them by giving them space and believing in them.

The trainers are very aware of the importance of the role of parents in children’s education and have realized that such support was missing in their time at school. Nai Qala’s teacher-trainers even go to visit parents of those students who do not participate during class; they walk for a few hours to find an almost isolated house, in the mountains, with a tiny piece of land and a few heads of cattle. When parents first see the teachers they are a bit afraid, wondering what they want from them and why they are coming to their house. However when the teachers introduce themselves and explain that it is part of their role to meet the parents, not only because their child comes to the capacity building class but also to congratulate the parents for sending them to the course, many parents cannot believe what they hear and get emotional. Amazingly, the teachers very often see a different attitude in their student in the next days. This girl or boy comes earlier to school and interacts more, now being aware that their teachers give them importance.

Teachers take initiatives to triggers girls involvement at school.
Teachers discuss among themselves the participation and involvement of students in the class. They, for example, decided to split into different classes two sisters who were too passive during the courses and encouraged the other girls in the classes to support the sisters. The girls cried and suffered a lot from the separation for a few days but then became the most talented students in the school after a few months.

A change in the mindset of teachers on girls’ education.
Nai Qala’s teacher-trainers themselves come from remote rural regions of central Afghanistan, originating from poor and traditional communities. “When I was in school, I studied in a mixed class, with girls. I always had one point in my mind: why should girls come to school? They are not made for school, what for?” remembered Jawad, a 26 year old, Nai Qala teacher-trainer. The job description of the teacher-trainers puts a special emphasis on girls’ education. Teachers have not only received training on human and women’s right but have also been coached by Nai Qala staff on how to encourage girls and their parents. Jawad recounted how once he saw a girl answering a very complex math problem in front of the class, his perception about girls was changed forever: “She started to write and competently solved the problem. In that minute, I went deep in thought and questioned myself: why was I so negative about girls? Is it the society that influenced me? Many questions came to my mind and on that night I could not sleep well… After that day, I became so determined that I must help girls. This is now my third year that I teach girls and help them in scientific subjects, together with my colleagues. Up to now, I have been helping about 1000 girls between the ages of 12 to 18. I never imagined I’d be able to do my job with such motivation. It is never too late to realize that girls have the same talents and deserve the same rights as boys. I am grateful to Nai Qala for helping me to realize this important point”.

With Nai Qala’s support, hundreds of girls are on their way to university. In one of the least developed rural regions of Afghanistan, this represents an extraordinary change and brings hope. The capacity building program is a tremendous platform that allows gradual cultural changes to be brought to the remote regions and promote girls’ education.

Gender equality

Nai Qala’s actions are aimed at reducing gender inequalities   

While the world has made progress towards gender equality and women’s empowerment, women and girls continue to suffer discrimination in all regions of Afghanistan. Literacy rate of young women is still only 57 percent of that of young men [1]. The indices for education attendance ratios also show unambiguous gender disparities, which decrease with the level of education (47.6 percent of girls attend primary; 23.7 percent attend secondary and 5.2 attend tertiary education level). The share of Afghan women participating in the economy is only one third of that of men, and the indices for unemployment and the proportion of youth outside education, employment or training show a very disadvantaged position of women on the labor market.

The gender gap in both education and economy suggests that cultural impediments prohibit tapping the development potential of girls and women in Afghan society and restrict their access to education and the labor market. In order to remedy this imbalance, Nai Qala has set gender equality at the core of all its projects. Nai Qala’s vision is an educated, healthy and balanced society in which women and men lead social, cultural and economic changes in an inclusive manner that enables their children – boys and girls – to thrive, focusing on neglected parts of Afghanistan.

Ease of access to quality education and health services

Long distance to school and reluctance to send children to school are by far the most common reasons for not starting school, whereas the need for child labor and perceived irrelevance of further education were the most important reasons highlighted by ALCS for terminating education [1]. In order to reduce walking distances, Nai Qala strives to build, or refurbish, schools and improve the quality of education in remote regions. A decent and closer learning environment as well as improved education services are a big motivation for children to (re-)attend school. Katawaie is a perfect illustration of the impact of a new building on children’s registration to school. After its inauguration, the school of Katawaie became a victim of its own success as the number of girl students increased by 25 percent and new classes had to be opened in the school’s courtyard. A similar impact is been seen in Zeera Gag  where initially the school was built for 520 girls but is today attended by 650 girls.

One of the most important findings of the living condition survey (ALCS) is that the main problem of the Afghan education system is not so much retention and drop out, but first and foremost making a start at school. Nai Qala has implemented early childhood education classes in two villages and plans to open new ones. Early childhood education classes not only help boys and girls to develop their imagination, talents and confidence from a very young age, but also teach them how to play together, inclusively, as a normal habit. Newly acquired attitudes, behaviors and experiences of young children contribute to their long-term success in school and reduce drop-out rates. The early childhood program also places a special focus on mothers, by actively involving them in the class. Such a program has a particular impact on the family. Mothers build their self-confidence and most importantly their awareness of how they can educate their children at young age to contribute to a more healthy family environment.

According to ALCS, an encouraging 70 percent of all women who had a baby in Afghanistan during the last five years had at least one antenatal check-up. However, only 16 percent received four antenatal check-ups, which is the number recommended by the World Health Organization for normal pregnancies. Again, distance to a health care center can be a contributing factor to low usage of health services but it is not the only one. Men with a health concern can travel to town to get treatment in a hospital, but the situation for sick or pregnant women is more challenging. A woman who is ill must be accompanied to hospital by a female and by a male relative. Some health problems require a longer stay in hospital and some need medical follow-up over months. Furthermore, families are often reluctant to pay the costs of prolonged hospitalization. Consequently, women simply do not travel to far away hospitals. Considering this fact, Nai Qala Association built a basic health center in Nawur. The percentage of births attended by skilled health personnel there is increasing each year; for 2017 alone, 126 babies were safely delivered in the Nawur health center. This clinic benefits 20’000 people and has transformed health conditions and hygiene habits in the region, for both women and men.

Leading the change by setting an example

The Nai Qala Association aims to contribute to cultural change in Afghanistan. The organization’s president, Taiba Rahim, is a role model in a country where female leadership [2] is still rare. Inspiring girls to see that change is possible and that women have an important role to play is crucial for the country’s future. There is a greater participation of women in Nai Qala’s projects than in any other similar project in the region. The women have seen that Nai Qala’s projects are proposed and led by a woman, which makes all the difference for them. Newly acquired strength and self-confidence prompted women in the remote village of Sokhtagi to create a women’s council, the first ever women’s council not only in the district, but certainly also throughout the province.

All Nai Qala’s local employees receive training on human rights and gender equality. Each staff member embodies the organization’s values through exemplarity of his/her practice and actions, in the office and in the field. Teacher-trainers have become Nai Qala’s best ambassadors to promote girls’ education, by discussing with the community and motivating parents in door-to-door operations.

Providing women and girls with equal access to education, health services, decent work, and representation in decision-making processes can fuel sustainable economies and benefit families, and communities at large. Gender equality is not only a fundamental human right, but also a foundation for a peaceful, prosperous and sustainable country. Any small improvement towards gender equality can bring big changes in the mindset of and benefit the whole society.

 

[1] All figures are taken from the Afghanistan Living Conditions Survey 2016 – 2017 (ALCS), released May 7, 2018. Central Statistics Organization (CSO) of the Government of the Islamic Republic of Afghanistan. http://cso.gov.af/Content/files/Surveys/ALCS/Final%20English%20ALCS%20Highlight(1).pdf

[2] The percentage of women working in managerial job position is still only 6.6 percent of that of men (ALCS, 2018).

Reducing Rural Poverty – Income Generation

The income generation related to the construction site promotes the growth of a local almost non-existent economy.

Although only 12% of the country is made up of arable land, the Afghan economy relies heavily on agriculture, especially in remote areas. The primary sector supports more than 60% of the population but half of the rural households only practice subsistence farming, and therefore do not market their own production. These populations are the most affected by seasonal variations: winters are often long and harsh and to survive until spring, a large part of these small farmers must sell cattle, find a job outside agriculture or borrow money. Poverty is particularly acute in mountainous regions, where the poor road conditions and difficult access to markets add to the changeable weather conditions.

Abuzhar is 35 years old and works as a cook at the Sokhtagi school site. He is very happy to have found a job. The unexpected income prompts this father to recount: “Without this job, I could not have satisfied the needs of the five members of my family. I had no hope because I do not own land and had no prospect of income.

Mohamed, 50 years old and head of a family of eight, took the opportunity to pass his truck driving license when he learned that Nai Qala would build a school in his village. His first months salary as a driver allowed him to support his family for a year. With the salary he will receive for the second phase of the project, he plans to buy livestock. Four of Mohamed’s children attend school, three girls and one boy. Thanks to his salary and the prospect of future livestock, he is optimistic about the education of his children; he is now sure to be able to send them to school.

The arrival of a construction site in remote areas, such as the Sokhtagi school, is often a unique and unexpected opportunity to get an income. To date, 34 people work on the site of the future school, of which 26 are local employees recruited from the village specifically for the project. In addition to providing wages to workers, the construction company buys food, to feed its employees, from families or on the local market. Wages and food purchases are a welcome contribution to the growth of the local economy and reduce family poverty.

Sustainable materials

Reducing the environmental impact of construction by using local materials

It is very important to us when building community infrastructures, to reduce the environmental impact to a minimum. The energy needed for the production and transport of materials does not just increase the costs of construction considerably, but can also have a significant impact on the environment.

The  “grey energy” calculation includes the full analysis of the life cycle of the product: Planning, extraction and transport of raw materials, transformation of materials and manufacture of the product, commercialisation, transport, use and implementation and finally, any possible recycling. From this point of view, local materials that are either not transformed or only slightly transformed have a distinct advantage over the others: Stone, earth, clay, straw, wood or wool are all materials that can be used in modern construction and that have very low « grey energy ».

In the remote areas of central Afghanistan, the long distances needed for transportation increase the “grey energy” rate. The manufacture of some construction materials also plays its part in inflating the energy costs and has a negative impact on the environment. For this reason stone was chosen rather than clay bricks for the majority of Nai Qala constructions. Although there is an almost limitless availability of clay and it is totally recyclable, the firing of bricks involves high energy consumption that can last up to several days at temperatures of more than 1000 degrees. The kilns sometimes function with the use of fossil fuels or often with wood sourced from already arid regions, which contributes to deforestation.

When choosing a construction company and signing contracts the construction materials are chosen very carefully so as to ensure safety and comfort for those who use the building at the same time as keeping the environmental impact to a minimum.  For example, Sokthagi school is built from stones extracted from the nearby mountains and are cut to size on the spot. The grit and sand used for the mortar come from a river close by. Only the wood for the framework, windows and doors is transported from other regions. The sourcing of materials brings about a more positive ecological balance to the construction.

Photographic exhibition

A photographic exhibition shows a positive image of Afghanistan and the changes that are taking place there.

Since 2007 the Nai Qala Association, through education has helped to create hope and opportunities in one of the most isolated areas of Afghanistan. Despite extreme poverty and the remoteness of the communities it is not despair and distress that we found there, but dignity and determination.

In 2017, to mark its 10th anniversary, Nai Qala asked a professional photographer, Haris Coussidis, who visited Afghanistan to take photos of the association’s activities, to make a pictorial record of the projects and their impact on the communities. This photographic report is part of a campaign to show the world that Afghans are committed to education, particularly for girls.

The association’s president presented the work to the city and canton of Geneva, who decided to support the association for an exhibition, which took place at “La Rotonde du Mont Blanc” from the 5th to the 25th March 2018.

This exhibition titled, “Women’s education, a hope for Afghanistan”, took place during the Geneva Equality week and the Human Rights Council, which was aptly symbolic for our work. Through these photographs we wanted to show a different side to Afghanistan, a positive image of men, women and children just like any others in the world – an image of a people with hope, aspiration and in search of opportunities. We wished to share the bravery of the parents in these rural regions, who despite poverty encouraged their girls to go to school to prepare a better future.

With particularly changeable weather, Nai Qala showcased on the Geneva lakeside. The exhibition was inaugurated with a press conference and opened with a debate which was covered by Swiss and international media.

Click here for a snapshot of the pictures that were shown in Geneva, including their captions.

Access the exhibition slide show here.

A clinic focusing on women

In the Nawur clinic project, mothers and babies are the primary focus of Nai Qala.

Men with a health concern can travel to town to get treatment in a hospital, but the situation for women is more challenging. A woman who is ill must be accompanied to hospital by at least one other female family member and by a male family member. If the woman has children, she must leave them behind if she goes for treatment. Some health problems require a longer stay in hospital and some need medical follow-up over months. Furthermore, families are often reluctant to pay the costs of prolonged hospitalization. Consequently, women simply do not travel to clinics or hospitals that are far away. This is one reason for high female and child mortality rates and it is also why the Nai Qala Association built the Nawur clinic.

Inaugurated in November 2011, the clinic now has 11 staff providing health services for a population of 20,000 in the surrounding region. Since its opening, there have been more than 60,000 consultations, of which over 11,000 concerned children. Some 750 babies had been born in the clinic as of December 2017.

Nai Qala Association is proud to have been in direct contact with the Ministry of Public Health since the beginning of the project. Our original partnership with the ministry was from 2012 to 2016 and we were offered an extension to 2020. The administration of the Nawur clinic was transferred to the ministry in June 2015. In many official meetings the example of the Nawur health centre has been cited to show that it is possible to provide health services to one of the most isolated regions of Afghanistan.

Women in Nawur typically have large families. It is unusual to see a couple with fewer than five children. Most families have more, and it is not outside the norm to have 12 children. Observers may question why parents have such large families, especially given the economic limitations. However, where the survival rate of children is low, it is understandable that parents have more to increase the chance that some will survive. Limitations in care both during pregnancy and in the postpartum period leave mothers and babies at risk.

Reducing or eliminating these risks will reduce parents’ anxiety about their children’s survival and will foster a subsequent reduction in supernumerary pregnancies. The clinic is vital to reducing these pervasive risks.

As of the end of December 2017, 3156 women and 1022 children had been vaccinated in the clinic. Some 13,000 outpatient visits took place for a range of conditions that, without the clinic, would have gone untreated until they became far more serious, and the records show 125 cases of severe malnutrition receiving medical care. Some 175 Nawur patients were referred to other health facilities for more specialized treatment.

The local people have realized the clinic’s value – more women and babies are surviving – and they are determined not to give it up.

Women take the lead

Inspired by the example of the founder and president of the Nai Qala Association, the women of Sokhtagi have created a women’s council.

Impressed by the fact that an Afghan woman could lead a project in their area and inspired by the founder and president of the Nai Qala Association, women have decided to take their fate into their own hands.

During fall 2017, the women in the village of  Sokhtagi created the “Women’s Council Association”. This is the first council of this type not only in the village and in the district, but certainly also throughout the province of Bamyan.

The goal of a women’s council is to provide a forum for discussion where everyone can share their ideas in confidence. Women are aware that if they want to be able to participate in decisions, they must be clear and precise in their demands. Women’s health and literacy are part of the council’s priorities.

Creation of the council

A few months ago Momena, a fifty-something, illiterate mother of seven, grandmother and shepherd’s wife had the vision of creating a women’s council to answer their specific problems. This need to assemble women was based on the observation that a group has more weight than an isolated individual; with this idea in mind, Momena started to bring women together.

The President of the Nai Qala Association’s first visit to Sokhtagi was a trigger for Momena. She accompanied the President in each of the meetings with the community and was inspired by Taiba Rahim’s leadership and the tasks that were distributed to the community.

One of the tasks entrusted to the community was to prepare the ground for the construction of the school. Momena took it upon herself to go door to door, and collect money to rent the bulldozer that would allow the community to prepare the ground. Thanks to her persuasiveness, Momena was able to collect the financing on her own. This first success allowed her not only to gain the community’s recognition and the men’s respect but also to send a strong message to the women, so that they joined her in her project.

During Nai Qala President’s visit in December 2017, the women discussed the statutes and elected the committee members of the newly created association. Momena hired some students from Sokhtagi school as treasurer, spokesperson or secretary of the new council association.

A source of motivation

The construction of a school by the Nai Qala Association brings a village not only development opportunities for children but also strength and confidence to the community, especially for women.

Momena expressed gratitude to Taiba Rahim, President of the Nai Qala Association: “Thank you for bringing change to our village. Your presence among us, the way you speak to men means a lot to us. It encourages me to convince women to join.”

We have seen a greater participation of women in Nai Qala projects than in any other similar project in the region. The women have seen that Nai Qala’s projects are proposed and led by a woman, which makes all the difference for them. This gives them more strength and self-confidence.

 

Nai Qala Association is showcasing in Geneva

The Nai Qala Association presents a photography exhibition on its activities in Afghanistan.

See for yourselves Nai Qala Association’s activities, come and join us in “Rotonde du Mont-Blanc”, in Geneva from March 5th to the 25th.

Admission is free.


For the past 10 years the Nai Qala Association has helped create hope and opportunity through education in one of the most remote regions of Afghanistan. In spite of extreme poverty and isolation, these communities we saw not hopelessness and despair but dignity and determination.

The Nai Qala Association engaged a professional photographer, Ms Haris Coussidis, to make a pictorial record of some of our activities in Afghanistan in 2017. We are very grateful to Haris.

Through these photographs, we wish to show a different image of Afghanistan; a positive image where Afghan men, women and children are the same as anybody else on this planet – an image of people with hope, aspiration and in search of opportunities.

The pictures in this exhibition will be available for sale. The funds will go to support Nai Qala Association projects in Afghanistan. For details please email at info@nai-qala.org