Afghan public healthcare system is among the worst in the world (if not the worst). A multitude of factors limit access to health —one can guess most of such difficulties. There are several specific problems. For instance, there are not enough physicians available to treat patients to start with. Second, the physicians congregate in cities and populated areas for security and convenient lifestyle reasons. Thus the vast majority of Afghanistan is under served, most of it is not medically served at all.

Foreign help has not produced any dramatic effects thus far either. After 10 years of substantial assistance from the world community to Afghans (after intervention of global community in Afghan affairs since 2001); the access to most basic healthcare needs still remains dire for most of the Afghanistan . To cope with shortage of clinicians especially in rural areas, foreign NGO's have trained Afghan literate population (most of whom may have not even completed 12 th   grade education) to deliver healthcare. Such individuals have opened clinics, run laboratories, and provide medications and perform simple procedures to treat the population. Occasionally, these “entrepreneurs” will “hire” physician episodically to 1. Learn new methods of treatment from them and 2. Utilize their expertise in promoting their care delivery and market their enterprise.

When I was in second year medical school, I volunteered at a laboratory in a Afghan refugee camp in Pakistan . My “mentor (I cannot recall his name though)” could barely read, but was trained (actually quite good) in basic laboratory techniques. For instance, he would identify malaria in a blood sample as well (if not better than) as a state of the art facility. After working for a few months with him, he had to go to Afghanistan and had me run his laboratory for one week. This is an example how dire the situation in delivering healthcare in Afghanistan is. Being a second year medical student and having exposure to histology and histopathology, I was probably among the most learned laboratory technicians in that refugee camp. What is even more disturbing is that my mentor had received three months training and he would actually prescribe medications as well for most common illnesses. After fall of the Taliban, he returned to Afghanistan and I am sure he is still running some sort of a clinic inside Afghanistan . In this issue, we will focus on the challenges that Afghan people face in accessing healthcare and mental health assistance, we will especially address barriers rendering healthcare close to impossible to women and children.