nlp-thedeep/humsetbias huggingface dataset:
Women in Afghanistan face various gender based discrimination and restrictions with limited decision making power and restricted mobility, as well as being at risk of gender based violence. The COVID 19 pandemic is more likely to increase their dependency and challenge their limited rights and freedoms.
The strict measures put in place to curb the spread of the virus have raised hurdles and increased risks for people seeking help.
Moreover, 100% of surveyed children said they couldn't interact remotely with their friends mainly due to the lack of connectivity and devices.
Spending time in person with friends is also affected by the pandemic with 88% of children who said it was less than the period before the outbreak.
With regards to sleep time, more than half of the surveyed children  ( 56.3% )  continue to have the same sleeping patterns than before COVID 19 outbreak while 20% are sleeping less
Finally, 78% of girls versus 43.6% of boys are worried about the health of their beloved ones and being sick from COVID 19  ( p=0.02 )
During the past week, IOM's 7 Mobile Health Teams provided 21,042 patients in need with basic health services. This bring the total number of patients served to 296,066 in 2020.
Idress Seyawash, founder of Ketab lwast, a mobile library, travels from Jalalabad city to Behsood District – around 300 km – as part of a 25 day campaign to raise awareness on how to prevent COVID 19 and to promote handwashing among children.
The number of people in crisis acute food insecurity  ( IPC Phase 3 )  is expected to increase in January 2021 as the lean season progresses, with the Central Highlands worst affected.
Mobilization of the national health system capacities for public awareness  ( 3,386 public and private health facilities, 40,000 civil servants, 60,000 community health workers and private sector staff ) ; utilize citizen charter network, Health Shura, school teachers and students, Mullahs; and use of media  ( Radio & TV )
The proportion of COVID 19 positive infection is higher in urban areas compared to rural areas. It means that the COVID 19 spread will be towards rural areas in the coming months, therefore, there is need to improve health care facilities and services in these areas.
Based on the information of countries with a similar context to Afghanistan, if we assume the Ro = 2 to 3 in the country , the required proportion of COVID 19 infection which is required to build a herd community is between 56 to 75%; Kabul province with 53% COVID 19 morbidity is in this range. The eastern and central regions with 34 to 42% COVID 19 adult morbidity are relatively in good position, but the western, northeastern, southeastern, northern, southern and central highlands regions with less than 35% of morbidity are not in relatively good condition and not close to the herd immunity.
According to the Ministry of Public Health teams at the border, who are monitoring the COVID 19 situation, there are about 15,000 people returning to Afghanistan from Iran every day.
Given the results of all the above studies and the existing survey which shows the current and past COVID 19 infection rate is about 10 million people  ( 31.5% ) , it can be summarized that 32% of population were infected with the COVID 19 which does not indicate a herd immunity for the entire country, and most of the population are still at the risk of infection.
One of the core constraints to programming is the lack of knowledge of needs. COVID 19 risks widening the gap – unless we can meet these needs through conversations and information sharing with minor returnees and their families.
The total proportion of COVID 19 positive infection  ( including all positive results, IgG positive  ( past infection )  IgM positive  ( current infection )  or both IgG and IgM positive )  was 31.5% for Afghanistan.
Afghanistan has reported the first case of COVID 19 in Herat province on 24th Feb 2020 who had travel history to Iran.
54% of the health workers mentioned that the patients need a medical certificate stating that they are negative to COVID 19 on that specific date. This is high among the health professional actually treating or working on COVID 19 related work  ( 65% ) .
36% have mentioned that if the patient is well and have been 48 Hour in isolation and has shown no symptoms, then the patient can be asked to do normal daily activity • 24% said that as a normal procedure, they refer them to higher grade hospital
66% mentioned that they advise the patient to complete the full 14 day quarantine period if they have returned from overseas or have close contact with someone with the virus
34% have mentioned that people use their own transportation or hired vehicles and go self to these designated locations
40% of the health workers mentioned that they received training on use of PPE. This percentage is high among those who are directly responding currently to COVID 19, where 72% have mentioned that they have received training on PPE.
49% mentioned that it is the aid agencies/government ambulances are used mostly for transportation of suspected or positive persons to designated hospitals
There were only two laboratories to start with in entire country when the responses have begun in early March 2020. Thus, few questions were included in the health workers survey related to infrastructure and equipment to COVID 19 response.
It is important to know the information sources and their authenticity which is critical for health workers to prepare and respond to the pandemic.
At the same time, they cope with societal shifts and emotional stressors faced by all people, health care workers face greater risk of exposure, extreme workloads, moral dilemmas, and a rapid evolving practice environment that differs greatly from what they are familiar with.
A new 100 bed COVID 19 hospital is now open in Herat. The Darulaman Palace  ( 300 beds )  and Kabul and Polytechnic universities' dormitories have been converted into isolation facilities in Kabul city.
In many of the health clinics managed by the Ministry of Public Health were instructed to do follow up of tests to the patients with ARI complaints.
The 2020 WoA Assessment also showed that the rate of child marriage for girls was highest for non recent returnee children when compared to other population groups, with 15 per cent of these households reporting having married a child in the 30 days prior to data collection.
CP AoR  [ Child Protection Area of Responsibility ]  and PC  [ Protection Cluster ]  identify for HCT  [ Humanitarian Country Team ]  members how to best support UNAMA  [ UN Assistance Mission in Afghanistan ]  Human Rights and other interlocutors engaged with the Commission to find ways to encourage Non State Armed Actors to use 18 as the age a child reaches adulthood in accordance with the Convention on the Rights of the Child and the law in Afghanistan
CP AoR  [ Child Protection Area of Responsibility ]  and PC  [ Protection Cluster ]  identify for HCT  [ Humanitarian Country Team ]  members how to best support UNAMA  [ UN Assistance Mission in Afghanistan ]  Human Rights and other interlocutors engaged with the Commission to avoid using schools or premises primarily used by children for military purposes
Large numbers of cross border returnees are also at risk from land mines and ERW in terrain that may be unfamiliar, increasing the need for mine risk awareness
Utilisation of health services has gone down, and vaccination services for other diseases were also disrupted due to physical distancing requirements, affecting polio vaccination campaigns. This will mean a likely deterioration of health conditions throughout 2021  ( higher maternal deaths; higher trauma related deaths; higher prevalence of disability; etc. ) , as well as higher GBV risks, with survivors having had reduced access to life saving GBV services that are part of the health response.
FSAC is also particularly concerned about people selling their productive assets as a means to weather income loss and food consumption gaps. This not only affects people's productivity but is more difficult to reverse in the future with implications for their recovery.
Another option that experts are urging courts and law enforcement to consider is simply not imprisoning anyone who doesn't pose a risk to public safety
100% have reported of increase of stress, anxiety, anger, fear and sleeplessness. Thus it is suggested to have helplines and telephone counselling services and follow up through periodic sessions on Mental health and PSS for prisoners are essential.
People are aware of preventive Measures like proper hygiene practices, physical distancing  ( social distancing ) , but in a prison with overcrowding it is not possible to maintain physical distance. It is important for authorities to follow the Presidential Decree or move the prisoner to temporarily hired building and thus providing adequate living space
Prisoners who have been deemed safe for release by the Parole Board should be released to relieve the stress on the system.
The lack of a dedicated prison for female offenders in some of the province headquarters continue to create difficulties for relatives and inmates.
Acute Watery Diarrhoea  ( AWD )  appears at high rates among infants, especially among households headed by women and people with a disability.
The prisoners suffering infectious diseases are being kept in the same room as the rest of the prison population and the lack of sufficient space has meant that no step has been taken to quarantine them, despite the fact that the reports show that some of the prisoners are suffering from very serious illnesses such as TB and hepatitis
The issue of access to potable water and water for general washing in the prisons is another challenge to creating safe, hygienic prisons.
The overcrowding in the detention centres and prisons has negative impacts on the prisoners and the detainees. Overcrowding can undermine basic human dignity and even cause mental illness.It paves the way for the spread of contagious diseases like TB and COVID 19, dangerously affecting the prisoners' general health.
100% of women have learnt from the visiting Mullah/ from the announcement made at the local prayer hall, where as it is about 87% among men
52% of the interviewed mentioned that provision of Soaps, masks and hand sanitisers are needed for the prisoners  ( 100% of women sought this and only 20% men sought this ) . Among men, the most essential thing to consider was the physical distancing where 60% of them have mentioned that they need either separate cells to reduce the number of inmates in the prison or have lesser number of prisoners.
Most of the prisoners are not aware of the Presidential Decree to release of prisoners like women, children, elderly and those who have committed lesser crime due to overcrowding in the prison and reduce spread of COVID 19 among the prisoners.
92% of the respondents have mentioned that spraying disinfectants is critical by the prison authorities to consider and 8% mentioned about health education and awareness drive in the prison  ( mostly among the men )
20% of men mentioned that they learnt about the disease from Prison guards.
96% of the respondents mentioned that they think that their family members are at risk of getting sick from the coronavirus and it is high among the women  ( 100% )
Only 53% of men mentioned that diarrhoea as symptom for COVID 19 and none of women considered this as a symptom.
100% of women also mentioned that shortness of breath and head ached are the symptoms along with fever and cough, whereas among men, 73% mentioned shortness breath and 87% related to head ache as symptoms for COVID 19.
100% of the interviewed mentioned that Fever and Cough are the main symptoms for COVID 19.
WHO suspects this to be the case and reiterates that vigilance should be maintained.
Only 67% of men are aware of the symptoms and protective steps. About 40% men are aware of transmission and only 27% are aware about self care.
Overcrowding in prisons is a serious issue in the prison in Kunduz in particular and Afghanistan in general. As per the prisoner's perception, that the prison's capacity is meant from 300 male prisoners and 20 female prisoners. As per this norm, female prisoners are living in adequate space. The perception survey also states that 100% of the female respondents have agreed that the living rooms are spacious and separates teenage girls from older women.
As per the AHDO NGO's record there are two HIV + recorded among the prisoners. YHDO is providing harm reduction services.
These lockdowns have also impacted the movement of civil society organizations in many provinces. All these have impacted the poorest and the most marginalized informal sector workers in the urban areas and other marginalized groups in rural areas.
On 30 March, about 700 prisoners across the country were released in the first batch. However, Amnesty International has given a call on the authorities to prioritise women prisoners
Prison crowding and lack of sanitation measures contribute to risk of contracting disease in prisons and jails.
. In addition, COVID 19 protection monitoring assessments were conducted for 130 cases all of whom received specific information on COVID 19 awareness and prevention.
Access is often restricted due to ongoing hostilities, mine contamination, NSAG presence and remoteness, which subsequently decreases the accuracy of assessments of humanitarian needs.
Women face restrictions in accessing property, education, and healthcare, and experience high rates of gender based violence.
Regular attacks on healthcare facilities and personnel limit people's access to healthcare.
Approximately 40% of the total population experience Crisis  ( IPC Phase 3 )  or Emergency  ( IPC Phase 4 )  levels of food insecurity. The provinces of Badghis, Ghor, Daykundi, Uruzgan, Samangan, Badakhshan, and Nuristan and the cities of Faryab, Herat and Kandahar are the worst affected, with at least 20% of the population facing Emergency  ( IPC Phase 4 )  levels
In addition to water, the people are facing shortage of health clinic, shelter and school as well.
Need assessment finding revealed that 430 IDPs families are living in See pay village of Batikot district of Nangarhar
IMC and Nangarhar PRRD representative carried out need assessment in the See pay village  ( Qatar CDC )
He further mentioned that Batikot district people affected by conflict in last 4 years and they lost their home and everything.
Humanitarian operations are also constrained by conflict, IEDs, and checkpoints, which often lead to the suspension of humanitarian activities and inhibit the free movement of people. A number of health facilities have been forced to close because of insecurity, affecting the provision of essential health services. In August, humanitarian access was hampered by flooding and landslides and the upcoming winter season is likely to hinder movement. Given the overlap between humanitarian and political issues, the outcome of intra Afghan peace talks and the foreign policy adopted by the new US administration will be key in shaping future humanitarian access.
Prolonged and escalating conflict across the country continues to hamper humanitarian access. Active conflict between the Afghan National Security Forces and the Taliban is still triggering short term and protracted displace   ment, which limits the access of displaced people to livelihood opportunities and to humanitarian aid. This is even more difficult for those without any formal documentation who are unable to access education programmes, hu   manitarian aid distributions, formal employment, and medical treatment. A considerable number of humanitarian agencies operate across the country. Their access is subject to considerable bureaucratic processes, however, including registration processes, both in government controlled areas and areas controlled by non state armed groups.
The Afghan frontier with Pakistan at Spin Boldak officially opened on 21 August but the border with Torkham remains partially closed since 16 March, due to coronavirus restrictions however effective from 29 September the border will reopen to pedestrian traffic on Tuesday, Wednesday, Thursday and Saturday.
COVID 19 protection monitoring assessments were conducted for 83 cases all of whom received information on COVID 19 awareness and prevention
IOM  [ International Organization for Migration ]  is actively supporting the Ministry of Public Health  ( MoPH )  and WHO in addressing preparedness and emergency coordination actions through its Cross Border Return, Migration Health and Displacement Tracking Matrix  ( DTM )  Units.
An IOM study with migrants preparing to leave Afghanistan found that 35 per cent had been internally displaced, an increase of more than 20 points compared with the survey conducted with returnees.
Mechanisms put in place to coordinate the response  ( e.g. COVID 19 Task Force ) :UNHCR Covid 19 TF, bi weekly ICCT chaired by OCHA, monthly APC meetings.
Mitigation: Monitoring of GBV occurrences by GBV partners, awareness raising on positive coping mechanisms, distribution of GBV dignity kits to survivors, vulnerable women and girls.
Through UNHCR's Cash for Shelter project, vulnerable households receive a cash grant that enables them to build their own shelter and sanitation facilities, with the technical support of UNHCR and partners. This innovative approach aims to ensure safe, dignified and sustainable housing; empower households and communities while reducing their dependency on humanitarian assistance; address protection concerns; and inject investment into the local economy.
INFORM indicates that Afghanistan's risk of humanitarian crisis is very high, with a score of 8.1/10. This is because of the country's high hazard exposure and vulnerability.?
Returnees receive a cash grant averaging USD 250 per person to meet immediate needs including transportation. Returnees also receive services including basic health screening, vaccinations for children, mine risk awareness training, referrals to legal assistance to obtain civil documentation, and referrals of persons with specific needs.
Over the past week 89 undocumented Afghans returned from Pakistan through the Torkham  ( 59 returnees and 9 deportees )  and Spin Boldak  ( 21 returnees )  borders
• 29 isolation wards have been opened by partners since the start of the crisis.
The Protection Unit completed case management assessments for 62 PSN cases in Ghor, Kabul, Sar i Pul, Takhar, Kunduz, and Nimroz including 32 persons with specific situations, 9 people with serious medical conditions, 6 children at risk, 4 separated or unaccompanied migrant children, 4 women at risk, 4 single parents, and 3 older persons at risk.
During the past week a total of 17,796 patients were served by IOM's 7 mobile health teams, inclusive of 3,107 outpatient consultations, health education sessions for 14,689 persons and psychosocial counselling sessions for 504 patients.
In 2020, 432,849 patients have been reached by IOM's Migration Health Unit in Nimroz, Helmand, Ghor, Herat, Kandahar and Nangarhar provinces with basic health care services  outpatient consultations for general illnesses, maternal, child and neo natal health care, reproductive health, family planning services and COVID 19 response. This programming is supported by the United Kingdom's FCDO, the Governments of Japan, Canada, Germany, DG ECHO, the Afghanistan Humanitarian Fund and the United States' Bureau for Population, Refugees and Migration  ( BPRM ) .
IOM support is primarily focused across 4 of WHO's Global Response Pillars include 1. Coordination; 2. Risk Communication and Community Engagement; 3. Surveillance/DTM; and 4. Points of Entry. Activities include training for frontline health workers, deployment of staffing to areas of need including placement in health facilities, secondment of staff to cross border surveillance, material support of PPE and other equipment, ambulance based referral services, distribution of MOPH WHO IEC materials and community level awareness raising and sensitization efforts through health education sessions including within Displacement Tracking Matrix focus group discussions in over 12,000 settlements across 34 provinces.
According to the Border Monitoring Team of the Directorate of Refugees and Repatriation  ( DoRR ) , a total of 29,420 Afghans returned from Iran through the Nimroz  ( Milak )  and Herat  ( Islam Qala )  borders between 25 31 Oct 2020, a 7% increase from the previous week  ( 27,524 ) . 20,143 persons returned voluntarily and 9,277 were deported. Since 01 January 2020, the total number of undocumented returnees from Iran is 695,677 individuals. IOM provided post arrival humanitarian assistance to 1,271  ( 4% )  of all undocumented Afghans at the IOM Transit Centers in Herat and Nimroz during the past week.
Victim interviews have revealed a significant failure of the parties to the conflict to acknowledge harm, to seek to reconcile the damage done, or even to make contact with victims and their families.
The Government of Afghanistan can improve its ability to fight the pandemic and to service debt by improving governance  ( reducing corruption )  and raising tax collection.
The duration of displacement can also influence people's decision about returning. Among the IDPs surveyed, only one displaced before 2018 wanted to return, compared with 22 per cent of those displaced in the last two years
Adults' education levels appear to play a significant role in determining their resilience and shaping their experiences of displacement. Ninety per cent of respondents with no education said they found it difficult to get by, compared with 41 per cent of those with some education
In a country where winter temperatures drop below freezing in some areas, almost 500,000 returnees and IDPs live in tents or in the open air.
Around 450,000 people are thought to have returned from abroad between January and November 2019
There is a need to increase both the distribution of hygiene kits as well as targeted preventive awareness campaigns to protect beneficiaries from the spread of COVID 19.
However those who were forced to flee  ( because of floods )  were exposed to a higher COVID 19 risks because inadequate WASH systems and facilities in displacement sites meant they were not able to comply with physical distancing and other preventative measures.
Between 1 January and 13 November 2020, more than 110,500 people were impacted by natural disasters, including flooding, heavy snowfall, landslides and avalanches.
Afghanistan is affected by insecurity, infrastructure decay, and economic stagnation caused by decades of conflict, recurring natural hazards, and protracted and multiple displacement. 18.4 million people are in need of humanitarian assistance
4,490 People displaced by conflict  ( verified )  in 2021  ( AS OF 7 FEBRUARY ) .
The weaker revenue performance in 2020 reflected lower economic activity, trade disruptions, and weaker compliance since the onset of the COVID 19 crisis. Government revenue estimates for 2020 were therefore revised downward from 209 billion Afs  ( 2.71 billion USD )  to 144 billion Afs  ( 1.87 billion USD )  in the mid year review of the budget. Grants support increased by 38.4 billion Afs  ( 500 million USD ) , partially offsetting the decline in domestic revenues  ( World Bank, 2020 ) .
Months of higher temperatures, usually from April to October/November, represent the Afghan fighting season, because milder temperatures make roads and other infrastructure, as well as mountain passes, more accessible
2020 marked the highest rate of return for undocumented Afghan migrants  ( 856,793 compared to 805,000 in 2018 ) , mainly because of loss of work and wages, movement restrictions connected to COVID 19, and lack of access to medical services in host countries. The provinces with the highest number of returnees are Kandahar, Nangarhar, Herat, and Takhar.
13.1 million people are projected to face Crisis  ( IPC Phase 3 )  or higher levels of food insecurity between November 2020–March 2021, a 6% increase from the previously reported 11.1 million from August to October 2020
The effects of conflict, economic decline, natural hazards, and COVID 19 contributed to a marked deterioration in food security in 2020.
Afghanistan is also prone to natural disasters, including earthquakes, droughts, and floods. In 2020, 104,000 people were affected and 200 killed by natural disasters, marking a significant decrease from 306,000 people affected in 2019
Since 2012, 4.8 million people remain internally displaced outside their area of origin because of conflict and natural disasters. The largest IDP hosting areas are in the north, north east, and eastern provinces, where conflict is active. More than half of IDPs live in provincial capitals, where public services are strained and struggling to cope
UNAMA calls on all parties to immediately cease fighting in the vicinity of healthcare facilities as well as the use of indirect fire  ( mortars, rockets, grenades )  in populated areas that could impact healthcare facilities, medical transports, and patients' access to health care. UNAMA calls on the Taliban to immediately cease all direct attacks and threats against healthcare facilities and workers, as well as abductions of healthcare workers.
The positivity rate of samples is also increasing day to day. For instance, the positivity rate was around 20% nationally on 24 February but now it has raised to 42%. It seems that 38% of provinces has more positivity rate as compare to national average  ( 42% ) . The highest positivity rate was recorded in Nangarhar  ( 65.4% )  and lowest in Nooristan  ( 16% )
As a consequence of the pandemic, complete or partial lockdown measures have been imposed in the country, resulting in a significant decrease in daily wage opportunities and small trader income.
COVID 19 poses grave dangers to the health of Afghans. Community transmission is expected to escalate due to the infeasibility of social distancing measures, particularly in overcrowded homes, IDP settlements, detention centres and prisons.
COVID 19 was first identified in Herat and Nimroz provinces  ( bordering Iran ) , brought into the country by Afghan returnees. The virus has spread to at least 33 of the 34 provinces of Afghanistan.
Urban areas of Afghanistan are expected to be more acutely impacted by the pandemic with ongoing lockdowns across major cities and towns leading to widespread economic downturns.
The border was closed for civilian movement since early March  ( till 4 April, IOM has recorded only 1,833 returnees from Pakistan ) .
Afghanistan has seen one of the World's largest cross border migration since COVID 19 pandemic began. 226,316 have cross borders from Iran since January this year till 04 April  ( IOM )  and about 65,000 in three days during 6 8 April 2020 from Pakistan.
With 15 health workers found positive on one single day in Kunduz and death of few of their relatives pose threat of community spread of COVID 19 in most part of the country.
Lastly, political elites in Kabul are still divided since both President Ashraf Ghani and Chief Executive Abdullah declared themselves the winners of the October 2019 presidential election and conducted separate inauguration ceremonies last month. Reportedly, several politicians and strongmen are still busy resolving differences between Ghani and Abdullah, but no official word has been released.
The availability of Intensive Care Facilities  ( ICU )  in Afghanistan has also been a key challenge. There are only 1,000 ICU facilities in Afghanistan, approximately 520 of which are equipped with ventilators.
The provision of unconditional cash transfers to residents of informal settlements during the pandemic would enable residents to purchase sufficient food and water
UNAMA continues to monitor the human rights impact of the armed conflict on victims and their family members through post incident interviews. This line of monitoring and reporting seeks to amplify voices of those affected by the armed conflict through gathering victims' accounts and examining how their economic, social and cultural rights were, and are, affected.
A similar proportion of respondents were dissatisfied with the education services available, with distances to the nearest school cited as a barrier to their children attending. Many schools have also been destroyed during conflict, and attacks on education facilities tripled between 2017 and 2018
The deteriorating economic situation in Iran has prompted many Afghans to return, both recent arrivals unable to find work and others who had been living in Iran for decades. One 2018 study found that more than half of returnees from Iran cited poor economic conditions, including unemployment, as their reason for return.
There were almost 1,000 people every day being deported,' the MoRR official interviewed for this study said. “But now there are various types of pressure on the refugees so they return.'
The number of forced returns has decreased since 2016, but return journeys are rarely free of coercion. Seventy per cent of returnees surveyed by IOM in 2019 reported having been deported, and nearly 20 per cent had returned for economic reasons, because they had been unable to make enough money to meet their needs or had lost their job.
The distinction between forced and voluntary returns tends to be blurred. More than half of the returnees who participated in this study said they had not returned voluntarily. A third of them had been deported and two thirds had left because of the threat of deportation.
Pakistan's government cracked down on Afghan refugees and migrants in 2016, and many of the 756,000 returns that year were considered involuntary.
More than 820,000 Afghans returned from Iran and Pakistan in 2018 alone.
A 2017 survey of more than 10,000 Afghans also points to a relationship between insecurity and migration. It found that 43.5 per cent of those who had experienced violence in the past year wanted to leave the country, compared with fewer than 38 per cent of those who had not.
The decision to cross borders is multifaceted. Lack of jobs and livelihood opportunities are the main driver of migration among those preparing to leave the country and many decisions to migrate are triggered by unemployment, but 11 per cent of departing migrants surveyed by IOM said it was a security event that triggered their decision to leave
Vulnerable groups, including women, youth and the disabled, suffer particular hardship, which has been exacerbated by the COVID 19 pandemic  ( UN Habitat, 2020 ) .
More than 2.4 million Afghans have moved or fled abroad since 2012, including around 385,600 in 2018
Social networks appear to carry more weight. Nearly two thirds of the research participants said the presence of family and friends had influenced their choice of destination. IOM likewise found that proximity to home villages, relatives and assets was the second most important appeal of host communities after physical safety. An official at the Ministry of Refugees and Repatriation  ( MoRR )  said that welcoming and supporting relatives was a cultural imperative for Afghans.
Eighty per cent of IDPs chose their location because of better security. Despite the belief that the presence of humanitarian organisations and the availability of services attract large numbers of displaced people, only a quarter said the prospect of assistance had influenced their choice of destination. Less than a third cited economic opportunities. IOM also found the availability of humanitarian aid to feature very low in the order of priorities
Displacement is also on the rise again. IDMC recorded 213,000 new internal displacements associated with conflict in the first half of 2019, and projections for the year as a whole are well above the figure for 2018.
Afghanistan adopted a national policy on internally displaced people  ( IDPs )  in 2013 and a policy framework for returnees and IDPs in 2016, but the country continues to struggle with widespread displacement. Conflict and violence triggered 372,000 new internal displacements in 2018, and there were nearly 2.6 million internally displaced people as of the end of the year. Drought displaced nearly as many as conflict in 2018 adding to the existing crisis.
1,681 pregnant and lactating women  ( PLW )  received assistance through targeted supplementary feeding programmes  ( TSFP ) , while 3,165 caregivers received Infant and Young Child Feeding  ( IYCF )  counselling and maternal counselling during the reporting period. 609 community members received Maternal, Infant and Young Child Nutrition  ( MIYCN )  counselling.
Afghanistan is one of the few countries where the number of deaths has not decreased over the past few years, with the scope and intensity of the conflict there actually increasing since 2014. Afghanistan is now the country with the highest total number of deaths from internal conflict.
The majority of recorded deaths were men between the ages of 50 and 79. Men account for more than 69 per cent of the total COVID 19 confirmed cases in the MOPH data, although this may be the result of over representation of men in testing.
Design and implementation of national plan to action dynamic urban agriculture investments in IDP sites and informal settlements through integrated HLP/ FSAC programming.
The latest IPC analysis identifies 32% of the Afghan population as facing acute food insecurity  ( Afghanistan IPC, Apr 2020 ) .
The programme's multi sector group of participants also received training on entrepreneurship and women's leadership, key skills to help women successfully utilize these new technologies.
Small and medium enterprises are a lifeline for Afghan women seeking economic independence. But these businesses are threatened by the lockdowns and reduced economic activity brought on by the COVID 19 pandemic.
Such attacks highlight the need for all parties to the conflict to respect international humanitarian law, including the principles of precaution, distinction and proportionality.
The attack on a Kabul hospital on 12 May, targeting its maternity ward, which resulted in at least 24 civilians killed, almost all of whom were female patients, leaving many newborn babies motherless.
The PD 305 provides returnees the legal right to apply for land allocations and housing support from the state to provide a durable solution to tenure insecurity and poor living conditions suffered by millions of displaced Afghans.
The PD 305 was promulgated in August 2018 and is intended to provide the long term framework for the reintegration of returnees and protracted IDPs into Afghanistan's society and economy.
Internally displaced people are particularly affected by the pandemic. Many live in crowded camps on the outskirts of cities in unhygienic conditions and without access to healthcare.
Given the importance of sanitary environments to prevent the spread of COVID 19, a key issue affecting all residents is access to clean water. Residents report that the water from available boreholes located in the settlement is dirty and unfit for consumption. As a result, residents purchase clean water from tankers, which has led to water rationing and associated hygiene risks that heighten COVID 19 transmission.
At the time of writing, Afghanistan's Ministry of Public Health  ( MoPH )  has reported 10,582 confirmed cases. However with limited testing capacity, true numbers are likely to be far higher.
In addition to issues with wastewater, the settlement is not served by municipal solid waste disposal services. In this context, low capacity solid waste management has been shown to pose an increased risk to COVID 19 transmission associated with the incorrect disposal of infected material  ( Mol and Caldas 2020 ) .
In the absence of effective treatments or a vaccine for SARS CoV 2, the global defence against the virus has centred on limiting transmission. This strategy is particularly applicable to Afghanistan, where there are very limited health facilities to treat COVID 19 patients. The country already suffers from some of the poorest doctor per capita statistics in the region, and healthcare facilities typically provide only basic care. For residents of Surkh Dewall, there is only one hospital with the capacity to treat critical COVID 19 patients in Jalalabad, and their facilities for critical care would likely be quickly overwhelmed in an outbreak.
In the capital, Kabul, a recent survey by UN Habitat identified 54 settlements across the municipality. This group represents a significant public health risk in the context of the COVID 19 pandemic.
Since Iran's outbreak began in January 2020, the IOM reports over 250,000 people have crossed the border from Iran into Afghanistan  ( IOM 2020 ) , presenting severe transmission risks to the Afghan population  ( Mousavi et al. 2020 ) .
Despite the lifting of COVID 19 restrictions, labour opportunities and wage income, high food prices in local markets and poor inflow of remittances have not improved, as was projected to happen in the April 2020 analysis.
High food prices of commodities already in the post harvest time have negatively impacted the purchasing power of people and further exacerbated food access constraints, especially for the households already living below the poverty line.
In 2020, 450,621 patients have been reached by IOM's Migration Health Unit in Nimroz, Helmand, Ghor, Herat, Kandahar and Nangarhar provinces with basic health care services  outpatient consultations for general illnesses, maternal, child and neo natal health care, reproductive health, family planning services and COVID 19 response. This programming is supported by the United Kingdom's FCDO, the Governments of Japan, Canada, Germany, DG ECHO, the Afghanistan Humanitarian Fund and the United States' Bureau for Population, Refugees and Migration  ( BPRM ) .
This price increase is accompanied by declining purchasing power of casual labourers and pastoralists – which have deteriorated by 9 per cent and 13 per cent respectively  ( compared to 14 March ) .
Second Wave: Following two months of consistently lower confirmed COVID 19 cases, MoPH tracking data is beginning to reflect anecdotal reports of a recent uptick in cases, with 86 new COVID 19 cases recorded over the past 24 hours. According to WHO, in the past 7 days, there has been a 10 per cent increase in the number of deaths reported regionally compared to the previous week. As the winter months approach, the spike in new cases suggest a second wave of the pandemic is either looming or has already begun. While the official numbers are not yet at the same level as the May/June peak, when taken together with reports of increased hospitalisations for COVID 19 like symptoms, the need for vigilance should be reinforced.
The C 19 pandemic had a significant impact on humanitarian operations, with many organizations temporarily suspending or delaying program activities or limiting field missions and assessments, due to concerns over staff and beneficiary health. Frontline workers providing health services were particularly impacted, with almost 10 per cent of the total confirmed C 19 cases being among healthcare staff.
Following engagement of OCHA with provincial authorities and an overall relaxation of lockdown measures, the situation improved with humanitarian movement no longer impeded by C 19 related lockdown measures.
IOM is conducting nationwide mobility and needs assessments in over 11,670 settlements hosting returnees and internally displaced persons. The mission is also engaging communities and mobilizing community leaders to raise COVID 19 risk awareness, demonstrate effective infection prevention and control measures, and dispel misinformation and stigma surrounding COVID 19 in each assessed community. As of 6th July 2020, 10,571 villages had been reached
WVA supplied much needed medical and hygiene kits including Personal Protective Equipment  ( PPE )  to the public health institutions and administrations.
Between 6 and 12 July, 55,392 people were reached with WASH assistance, bringing the total to 2,116,878 people reached since the start of the crisis.
Respondents highlighted the insecurity/conflict in the areas of origin and extreme cold temperatures in the winter as the main reasons for not returning or for staying in their current location.
According to FGDs data the intention to return remained the same between January and February with 98% of the respondents indicating having no intention to return.
IOM Afghanistan continues to monitor and report ongoing cross border population movements, cross analysed with regional COVID 19 case data, to identify destination areas at greater risk of cross border transmission of COVID 19 to inform better targeted, evidence based health response and recovery programming.
The border issues have affected the main supply routes for critical relief items – notably food. Several metric tons of food was stuck across the border in Pakistan with further delays in the arrival of life saving relief supplies expected over the coming weeks and months. Sustained cross border access from Pakistan is critical to maintaining supplies of both commercial goods and humanitarian items for people in need in Afghanistan.
Mother led mid upper arm circumference  ( MUAC )  screening has been prioritised by Nutrition Cluster partners in order to minimise the physical contact between service providers, caregivers and children. 1,275 children were screened with MUAC tape by their family members during the reporting period. Additional production of MUAC tapes is needed
In an effort to reduce the spread of COVID 19, Mobile Health and Nutrition Team's  ( MHNT )  are enforcing hygiene measures including hand washing and physical distancing upon entering MHNT service sites.
More than 65 per cent of returnees  ( majority of whom coming from Iran )  live in settlements that do not have access to any WASH services, whilst others stay with host communities where services are already over stretched
Nutrition Cluster partners report that there is a general fear amongst community health workers of becoming infected with COVID 19 when carrying out follow up visits at the community level.
Although MHNTs  [ Mobile Health and Nutrition Teams ]  are being increased to move services closer to the community, COVID 19 continues to have an effect on health and nutrition service seeking habits by community members, resulting in delayed diagnosis of children for their nutritional status, slower nutritional gain and/or lower admission at the facilities
The Nutrition Cluster urges the Government of Afghanistan to ensure access to the most vulnerable provinces and people impacted by food insecurity and COVID 19. This includes reaching the most vulnerable with adequate health and nutrition services  ( especially children under five and mothers/PLW  [ Pregnant and Lactating Women ]  ) .
Insufficient spacing at health and nutrition facilities continues to be a challenge in terms of enforcing physical distancing.
Between 14 and 15 March, more than 20,000 returnees arrived into Afghanistan from Iran through this crossing – the largest two day return ever recorded.
Malnutrition is putting people at increased risk from COVID 19. Under nourished people have weaker immune systems exposing them to greater risk of severe illness due to the virus. For instance, a severely undernourished child is nine times more likely to die from common infections than a well nourished child.
Only 28% of respondents mentioned Masjid/Mosque as the source of health information. Women  ( 18% )  fare much lower compared to men  ( 36% )  in their responses as entry of women is prohibited in mosques.
The Education in Emergencies  ( EiE )  Working Group is supporting the Government of Afghanistan in their efforts to facilitate the continuity of education for all through remote learning.
More than 7m children in regular schools and more than 500,000 children enrolled in communitybased education  ( CBE )  programmes did not start regular schooling as per the normal schedule. This is in addition to some 3.7m children who were already out of school.
Humanitarian partners have further installed temporary washing stations for returnees at border screening facilities and are completing the construction of permanent WASH facilities – 19 facilities at the Islam Qala border crossing. Some 55 handwashing stations have been installed in all transit facilities in border areas in an effort to limit transmission.
Health partners are also supporting the operational costs of response teams at land and air points of entry. Health partners are training surveillance personnel on case definition, screening and contact tracing. Since the outbreak was first reported in Afghanistan, in excess of 100,000 people have been screened.
The delivery of assistance to COVID 19 affected people alongside the distribution of seasonal food support is continuing across the country.
Distrust of the authorities, loss of livelihoods issues, hospital conditions, stigma and lack of understanding of risk and fear are all contributing to this situation and warrant a scale up of awareness raising among those being isolated in hospitals and more generally in local communities.
At present, the Health Cluster, via WHO, is supporting the Government in the establishment of a national isolation centre with a capacity of 100 beds, as well as regional and provincial isolation centres with total capacity of 991 beds
The ICCT has collectively agreed that all Health and WASH activities listed in this plan, as well as UNHAS, should be considered priority actions for funding.
Disease control measures that do not adequately consider the gender specific needs and vulnerabilities of women and girls may also increase their protection risks and lead to negative coping mechanisms.
Some 12.4 million people are in acute food insecurity, 4 million of whom are in ‘emergency' levels of food insecurity  ( IPC 4 ) .
12,977 people across 12 provinces received Child Protection community based awareness raising on the protection of children and positive coping mechanisms during the COVID 19 pandemic.
Furthermore, the immune response of children affected by acute watery diarrhoea is highly compromised, increasing their risk of mortality when exposed to other diseases – such as COVID 19.
As many as 68 per cent of displaced households report not having access to or being unable to afford basic hygiene items in the 2019 Whole of Afghanistan Assessment.
The Afghan government has struggled to control the coronavirus spread with its partial lockdown measures.
Between 14 and 15 March, more than 20,000 returnees arrived into Afghanistan from Iran through this crossing – the largest two day return ever recorded. This excludes commercial movements. Overall numbers for the first three months of the year are similar to 2018 when there was a previous spike in returns.
In 2019, more than 540,700 returnees and refugees came to Afghanistan from Iran  ( 487,035 ) , Pakistan  ( 25,493 ) , Turkey  ( 25,715 )  and other countries  ( 2,034 ) .
High levels of fear are being reported among health staff in the field and need to be effectively countered with facts.
UNHAS is exploring options for an international airbridge to maintain a transport link for humanitarian staff in and out of the country.
Humanitarian partners are closely monitoring market prices for key food commodities.
There are increasing risks for women and girls with the added impact of the pandemic – GBV, high burden of care and early marriage – while disability and mental health remain critical vulnerabilities.
Although it was not part of the initial assessment, most teachers flagged the additional assistance they need to support the well being of children ,specifically during this critical time. A specific focus on supporting children's multi  dimensional wellbeing, as well as teachers' own wellbeing, should be a specific focus of work.
The more commonly reported coping mechanisms centre around selling existing assets  ( 39% )  and borrowing money  ( 35% ) . This poses long term challenges to households' economic wellbeing, as households lose means of income, and can lead to further negative coping mechanisms when resources are depleted. Should the situation continue,
47.7% of the respondents also reported that they have lost their jobs or revenues as a result of global pandemic
 Some community elders and teachers in both Kabul and Badghis flagged that families are not taking COVID 19 health messages seriously, including social distancing and washing hands.