QUETTA: In a province where 70 percent of population does not have access to healthcare due to deficient health facilities, 40 per cent of patients treated in Quetta’s hospitals are from Afghanistan, say health experts in Balochistan. “Three decades of conflict have weakened the health system in Afghanistan,” says Dr Hafeez Mandokhel, President of the Young Doctors’ Association. “Due to lack of healthcare in Afghanistan, Quetta has become a preferred health treatment base for Afghan patients that have been seeking treatment here for a long time.” Balochistan, with an estimated population of 8.5m, has few healthcare facilities, says Dr. Mandokhel, leaving 70 per cent of the population with little or no access to healthcare. Quetta, the capital and the largest city of south-eastern Balochistan province bordering Afghanistan and Iran, is easily accessible to Afghans who come here for treatment, he says. Balochistan is also home to about 3,30,000 Afghan refugees, roughly 20 per cent of the 1.5 m that still remain in Pakistan, according to Duniya Aslam Khan, media focal person for the United Nations High Commissioner for Refugees (UNHCR) “As a result the local healthcare system is burdened by Afghan patients,” says Dr. Mandokhel. Bashir, a resident of Kandahar in Afghanistan, who came to Quetta for health treatment said Afghan patients sought treatment in Quetta due to lack of medical facilities in Afghanistan and lack of public trust in Afghan doctors and healthcare system “We do not have competent and qualified doctors in Afghanistan so we just come here for better treatment,” said Bashir, who goes by one name, as most Afghan do. “We trust Pakistani doctors. Earlier Pakistani authorities allowed Afghans to enter Pakistan for treatment but now there are many restrictions on us. Patients without legal documents are not allowed to cross the border.” He said the governments of both countries should make travel and visa procedures easy because a lot of patients were going back from the border due to restrictions on entering Pakistan. Afghans also have the option to go to India for treatment but according to Bashir, few people can afford healthcare in India. He says: “The travel cost to India is four times more than Pakistan and treatment in Indian hospitals is very expensive.” Iqbal Shahwani, a patient at the Quetta civil hospital, said in the hospital wards, there were more Afghan patients than local, and they had access to equal facilities. He said the government should provide health facilities to the local population because the provincial health budget was funded by taxes paid by the people of the province. “Afghans do not pay taxes to government but get the same facilities as local citizens,” said Shahwani. “It is unfair that a majority of our patients are deprived of healthcare while the government provides it to Afghans.” He said there was shortage of qualified doctors in the province and the Civil Hospital Quetta and Bolan Medical College (BMC) were the only healthcare centers in the province with professional staff. “Even in these two hospitals we do not get medicine,” said Shahwani. “And because of shortage of doctors, poor patients are forced to seek treatment in private hospitals.” He said he had nothing against Afghan patients, but due to deficient health facilities, they were a burden on the Baluchistan healthcare system. “Because of them local patients are deprived of their right to health. The federal government should allocate special health budget for Afghans.” Dr. Muhammad Umar Baloch, Secretary Health Balochistan, told News Lens Pakistan that the country had legally accepted Afghan refugees and given refuge to them. “This is our national policy and we cannot refuse help to anyone on humanitarian basis if they come to hospitals. If someone says there are more than 40 per cent afghan patients in government hospital in Quetta, I will not contest that figure.” He said despite the fact that Afghan patient were a burden on the limited health resources in the province, the Health Department was bound to the international agreements on refugees and could not deny them healthcare. There was no separate budget for Afghan patients, said Baloch. The government made allocation in the health budget only for the local population, he said, and the Afghans received healthcare under that budget. “We don’t have authority to appeal to international organisations to assist Afghan patients,” said Baloch, “but we get facilities for 50 patients and end up with 150 for treatment.” Dr. Mandokhel said Afghan refugees came to Balochistan under an international agreement. He said international organisations should provide support and health facilities to them. He said due to absence of hospitals supported by international aid for refugees, the majority of Afghan patients sought treatment in government hospitals. He said international organizations were doing little to support Afghan patients but UNHCR’s Refugee Affected and Hosting Areas (RAHA) programme was helping build a kidney centre at the Quetta Civil Hospital. This article originally appeared in News Lens and has been reproduced with permission