Afghanistan: COVID-19 Multi-Sectoral Response Operational Situation Report 13 May 2020 This report is produced by OCHA Afghanistan in collaboration with humanitarian partners via clusters. It covers activities carried out between 4-11 May 2020. HIGHLIGHTS • Confirmed COVID-19 cases reached 5,226 people across all 34 provinces. 130 people have died and 652 recovered. • Since the start of the crisis, partners have delivered WASH assistance and hygiene promotion activities to more than 624,000 people and supported more than 4,559 children with home-based learning materials to ensure the continuity of education during the pandemic. • Protection partners in Kabul, Nangarhar, Hirat and Mazar-e- Sharif report an increase in child protection issues, such as child labour and early child marriage, as families resort to negative coping strategies to meet needs exacerbated by extended lockdowns. • Humanitarians have condemned the recent attack on Sad Bistar Hospital in Kabul and call for an immediate end to the targeting of health facilities, health staff and civilians seeking care. In a statement, the Humanitarian Coordinator said “It beggars belief that such a heinous act could be committed when Afghanistan is being ravaged by the COVID-19 Source: Afghanistan Ministry of Public Health (MoPH) The boundaries and names shown and the designations used on this map pandemic. Civilians receiving care in hospitals, health workers, do not imply official endorsement or acceptance by the United Nations. medical infrastructure and aid workers are protected under International Humanitarian Law; violations must be investigated and those behind the attacks brought to justice.” SITUATION OVERVIEW MoPH data shows that 5,226 people across all 34 provinces in Afghanistan have tested positive for COVID-19. Some 652 people have recovered, and 130 people have died. Of the 130 people who have died from COVID-19, 111 had at least one underlying disease, the most common of which are cardio-vascular disease, diabetes, lung disease and neurological diseases. The majority of fatalities were between the ages of 40 and 69. Men between the ages of 40 and 69 represent more than 50 per cent of all COVID-19-related deaths. Cases are expected to increase rapidly over the weeks ahead as community transmission escalates, creating grave implications for Afghanistan’s economy and people’s well- being. Kabul is the most affected part of the country, followed by Hirat, Kandahar and Balkh. A number of provinces have instituted measures to limit the exposure of residents to COVID-19. Throughout the country, these ‘measured lockdowns’ have resulted in closures of sections of each city and/or movement limitations. Reports indicate that despite assurances by the Government that these would not limit critical program movements of NGOs and the UN, the measures continue to impact on the mobility of humanitarian organisations. Humanitarian partners remain active in responding to crises throughout the country and continue to urge the Government to employ a national approach to these movement issues so that individual negotiations are not required on a case-by-case basis. Between 8 and 9 May, protests took place in Chaghcharan district in Ghor province, Sharana district in Paktika province, and in Shinwar and Rodat districts in Nangahar province. Citizens were protesting over an alleged irregularities in bread distributions organised by the authorities. Humanitarians remain concerned about the impact of extended lockdown measures on the most-vulnerable, particularly families who rely on casual daily labour and lack alternative income sources. According to WFP’s market monitoring, the prices of wheat flour (low price) has increased by 19 per cent between 14 March and 11 May, while the cost of pulses, The mission of the United Nations Office for the Coordination of Humanitarian Affairs (OCHA) is to Coordinate the global emergency response to save lives and protect people in humanitarian crises. We advocate for effective and principled humanitarian action by all, for all. www.unocha.org | 2 sugar, cooking oil and rice (low quality) increased by 13 per cent, 8 per cent, 19 per cent, and 6 per cent, respectively, over the same period. FSAC partners have also noted that the purchasing power of casual labourers and pastoralists has significantly deteriorated by 16 per cent and 5 per cent, respectively, mainly due to the wheat price increase (compared to 14th March). While implementing activities to mitigate the spread of COVID-19, humanitarians continue to respond to other ongoing and emerging humanitarian needs. Conflict and natural disasters across the country continue to displace thousands of families, compounding pre-existing vulnerabilities and making them potentially more susceptible to serious consequences from COVID-19. During this week’s reporting period, partners have responded to the needs of 600 families affected by flooding with emergency NFI assistance. IDPs recently assessed by ES-NFI partners report difficulties in accessing medical facilities, medication and medical supplies as the price of medicines and other medical items (e.g. gloves, hand sanitisers and masks) have increased because of the crisis. IDP communities also raised the need for food assistance and hygiene kits as a priority. Protection partners also continue to monitor and respond to ongoing needs; 254 children without parental care were reunified with their families and provided with psychosocial support and temporary shelter. 653 women and girls were provided with dignity and sanitary packages in Bamyan and Balkh provinces. 1,209 children (694 boys and 515 girls) received case management, psychosocial and referral support, and 1,100 individuals received hygiene materials in the central region. 12 GBV cases were identified and referred to Family Protection Centres (FPCs) in Nimroz and Uruzgan provinces. As part of its regular programming, WFP has continued to respond to ongoing food needs, distributing food to more than 225,000 food insecure people over the past week. HUMANITARIAN RESPONSE 9 Pillars of COVID-19 Response - Summary Country‐level • Health partners continue to support Government-led planning and response. coordination and • Humanitarian partners are currently updating the Humanitarian Response Plan, integrating COVID-19 response planning needs into overall planning figures and assumptions. • The RCCE Working Group has produced rumour tracking sheet that has been disseminated through Risk communication MoPH and UN/NGO partners. and community engagement (RCCE - • The RCCE Working Group has carried out an assessment which outlines the communications accountability to preferences and the most trusted information sources by geographical area, down to the district level. affected populations) • IOM’s Displacement Tracking Matrix field teams have reached over 4,500 villages in 25 provinces with RCCE messaging • IOM has set up billboards in all four border provinces with Pakistan and Iran • The new AAP adviser has begun work with OCHA to support accountability aspects of the COVID-19 and ongoing response in line with the Collective Approach to Community Engagement strategy. • 350 WHO polio surveillance staff, 1,000 polio surveillance focal points, and 34,000 polio surveillance Surveillance, rapid volunteers have engaged in surveillance, case identification and community contact tracing activities. response teams, and case investigation • IOM Mobile Health Teams have trained over 400 Community Health Workers and more trainings are planned for Nimroz, Kandahar, Nangarhar, Hirat and Hilmand in the coming weeks on COVID-19 awareness, prevention, identification and referrals. • IOM plans on hiring an additional 100 health staff to support migration health programming, bringing IOM’s total health staff to over 150 personnel. Staff will be deployed to static health facilities, take on social mobilisation activities, and form 12 rapid response teams in coordination with MOPH/PPHD and WHO partners • Active surveillance and contact tracing activities are underway in Hirat IDP sites. • Partners have also scaled-up surveillance activities in other informal sites in nine provinces. • 7 IOM Mobile Health teams and 4 IOM TB and COVID-19 screening teams are deployed to major border crossing points to provide support to ongoing COVID-19 response efforts. Points of entry • Temperature checks and screening activities are ongoing at all major border crossings with Iran and Pakistan • 8 UNHCR staff have been deployed as part of monitoring teams operating at two border points (Spin Boldak in Kandahar province and Milak in Nimroz province). • 9 laboratories are now operational – two in Kabul, two in Hirat, one in Nangarhar, one in Mazar-e-Sharif, one in Paktya, one in Kandahar, and one in Kunduz. The latest one was inaugurated in Kunduz on 9 May. Laboratories • A shipment of RNA Extraction kit has arrived with enough supplies for 14 days of testing. This pipeline remains unstable due to global shortages and will influence the expansion of testing labs. United Nations Office for the Coordination of Humanitarian Affairs www.unocha.org | 3 • More than 15,000 units of PPE have been disseminated – the estimated need for the country is 425,000 Infection prevention and units (MoPH data). control (IPC) • IPC training conducted by partners for an additional 445 healthcare workers, taking the total number of staff trained to 2,798. Case management • 2,000 beds are now available for isolation and intensive care. • WHO has identified