1. Peter Salama MD MPH Chief, Child Survival and Immunization, UNICEF
Working for UNICEF in Emergencies: The Role of the Health Professional in Emergencies
Peter Salama MD MPH
Chief, Child Survival and Immunization, UNICEF

2. Highest <5 MR Ranked Countries
1) Sierra Leone
2) Niger
3) Angola
4) Afghanistan
5) Liberia
6) Mali
7) Somalia
8) Guinea-Bissau
9) DRC
10) Zambia
11) Chad
12) Mozambique
13) Burkina Faso
14) Burundi
15) Malawi
16) Rwanda
17) Nigeria
18) Mauritania
19) CAR
20) Guinea
Countries in RED color are the ones considered ‘emergency countries’. Almost half of the countries in the top 20 list are emergency countries and Afghanistan in the only non-African country.
*Source: Lancet 2003

3. Background on Afghanistan
20 years of civil war
Human rights abuses
Infrastructure devastated
Late 2001: fall of Taliban regime
Bonn peace process
3 years of successive drought
Influx of refugees
Influx of aid and organizations

4. Background: Health Indicators
Under five mortality: 257/1000 LBs
Infant mortality: 165/1000 LBs
Maternal mortality ratio: high
Malnutrition prevalence: high
Incidence communicable diseases: high
Life Expectancy: 45 – 47 years

5. Causes of Death, Children < 5 yrs, Kohistan District, Afghanistan, April 2001
Source: SCF US / CDC/ UNICEF

6. Programme Management

8. Reported Measles Cases by Month, Afghanistan January 2001-March 2003
Number of measles cases per month
2002
2003
Month

9. Policy Making

11. Budget Summary

12. Advocacy

14. Maternal Mortality Ratios*
Province
Ratio
Kabul
400 ( )
Laghman
800 ( )
Kandahar
2200 ( )
Badakshan
6500 ( )
Combined estimate
1600*
* Maternal deaths / 100,000 live births per year,
*Source: Bartlett et al. Lancet 2005.

15. Comparison of International MMRs
*Source: UNICEF
Maternal Deaths per 100,000 Live Births

16. Number of Injuries per Month, by Explosive Type, Afghanistan, March 2001 – June 2002
Total = 1,636
Average = 102/mo
*Source: CDC MMWR 2003

17. Age distribution of victims
57% < 20 yrs
42% < 15 yrs

18. Risk Behavior by Age Group
22%
16%
14%
14%
11%
10% 8% 6%

19. Assessments

24. Other Roles
Capacity Building
Diplomacy
Fund-raising
Clinician