The novel strain of coronavirus, first identified in December 2019 in Wuhan, China, has spread around throughout the country and around the world, despite China’s efforts to contain the virus’ transmission. So far, 27 countries have reported cases of the coronavirus (officially known as COVID-19). The death toll due to COVID-19 has passed 1,800, with over 73,000 cases as of February 18.
Following the outbreak, countries showed a commitment to the health and well-being of their people by evacuating nationals stranded in Wuhan, the epicenter of the outbreak that has been under a tight quarantine since January 23. India, Bangladesh, Tajikistan, Uzbekistan, and Iran were among the countries that evacuated their nationals from Wuhan.
Even as other countries evacuate their nationals, Afghans are still waiting to receive a formal reply from Afghanistan’s government about evacuating or relocating them from the epicenter of the outbreak. There are approximately 45 Afghans, including children, in Wuhan. Most of them are students, living with their families or alone. In their interviews with media outlets, Afghans stranded in Wuhan report a miserable and deprived situation in the ghost town of Wuhan. According to their statements, many are under stressful conditions; they lack access to adequate food and safe drinking water, and they suffer from mental distress.
On February 2, 2019, the Afghan health minister hold a media briefing on the novel coronavirus. He mentioned that the Ministry of Health and a medical team were ready to bring home all the Afghan students stranded in Wuhan. They would then undergo a quarantine procedure for 14 days. Nevertheless, he then expressed his fear that evacuating the 45 Afghans from Wuhan to Afghanistan could endanger the lives of 30 million Afghans. He also mentioned Pakistan as an example of a country not evacuating nationals from Wuhan.
Almost two weeks after indicating its readiness to evacuate Afghan students, Afghanistan’s authorities have taken no action to actually do so. The inaction from Afghan authorities could be based on several different reasons.
First, the minister of public health’s briefing on the novel coronavirus reflects the inability of the country’s health system to prevent the spread of, diagnose, and treat the coronavirus infection in Afghanistan. Afghanistan’s health system lacks quarantine facilities and protocols, trained healthcare personnel and medical supplies; it also carries a heavy economic burden already from other diseases. A coronavirus outbreak would definitely overburden the current health system in Afghanistan and handling the epidemic would be challenging for the Ministry of Public Health. However, it is also important to remember that before evacuating the Afghans from Wuhan they would undergo screening procedure for infection. Only those who pass the screening will be eligible for evacuation. This should minimize the risk of infection within Afghanistan.
Second, the Afghan government could be showing solidarity with China in this dire situation by copying Pakistan’s stance on behalf of their nationals in Wuhan. Pakistan’s government has refused to evacuate their nationals from Wuhan as a demonstration of solidarity with China. It is obvious that China and Pakistan share geopolitical interests and Pakistan has been a good ally of China for decades. However, the situation for Afghanistan is different. China has had a limited role in reconstruction and development efforts in Afghanistan since 2002. In addition, high-level Chinese authorities have not visited Afghanistan in the last two decades, which shows the low level of bilateral relations between Afghanistan and China.
Given this background, is it a wise decision to refuse the evacuation or relocation of Afghan students from Wuhan?
Keeping Afghan students in the center of the novel coronavirus epidemic is hard to justify. The World Health Organization does not recommend travel bans. Thus, the government of Afghanistan should consider offering voluntary evacuation to those Afghans who pass screening for the coronavirus. The situation is quite stressful for the Afghan students and the families and relatives of those 45 Afghans are also concerned about their loved ones stranded in Wuhan. It would be morally inappropriate to refuse or delay their evacuation or relocation.
Moreover, the quarantine period for novel coronavirus is 14 days. If people remain asymptomatic for two weeks, then infection from the coronavirus is unlikely. The Afghan students in Wuhan have remained quarantined for more than four weeks in Wuhan, and they have not shown any symptoms of infection yet. On the other hand, the chances of infection will increase the longer the Afghan students remain in the epicenter. Therefore, evacuating the students from Wuhan now could decrease the chances of coronavirus infection in Afghan students. Moreover, the health system of China is already been overburdened with new cases of coronavirus infection, particularly at the epicenter. Therefore, treatment and management priorities may differ if international students get the infection.
It would be morally appropriate to consider prompt action in bringing Afghan students from Wuhan to Afghanistan. If authorities lack trust and confidence in the ability of Afghanistan’s health system to prevent the spread of the coronavirus, it would be helpful to consider evacuating Afghan students from Wuhan to a third country or even another province in China for additional obligatory quarantine. Some countries have already extended their support for evacuating nationals of other countries as a gesture of good friendship. For instance, India has evacuated Maldivian students from Wuhan, and Iran assisted in evacuating Iraqi and Syrian nationals along with Iranian nationals from Wuhan.
Mohammad Azeem Zmarial Kakar is academic member at Kandahar University, Faculty of Medicine, Afghanistan. Dr. Zmarial Kakar is a Fulbright Alumnus, and has also served as an acting Provincial Public Health Director of Kandahar Province, Afghanistan.