But over the past several days, with 22 cases of the coronavirus confirmed nationwide, the impact of the pandemic has begun to hit home. Now, the divided government and its desperately poor health system must grapple with a crisis that is bringing life to a halt in the West — and it must do so while contending with a militant group vying for power across half of the country.
The country’s 22 cases have been linked to Afghans returning from next-door Iran, a country that has been hit hard by the virus, with nearly 1,000 deaths. In the past week alone, more than 50,000 Afghan refugees and workers have flooded back from Iran, mostly to escape the virus, with few border controls and no medical checks.
Pakistan, another neighboring country and a crucial source of imports, closed its border with Afghanistan this week, sending food prices skyrocketing and panicked shoppers emptying markets. Pakistan has also has a sharp spike in coronavirus cases, to nearly 200 over the past week, most linked to Shiite pilgrims returning from Iran.
Afghan President Ashraf Ghani has recently been preoccupied with other problems. Last month, he was declared the winner in September elections, but his rival, Abdullah Abdullah, insisted that he was the real winner and has vowed to form a “parallel” government. Meanwhile, Taliban leaders have suspended planned talks with Afghans about the country’s future until Ghani agrees to free 5,000 imprisoned insurgents.
On Tuesday, though, the president made a live televised appeal to the nation for calm and patience.
“Honorable and dignified people of Afghanistan,” Ghani cried. “Please do not listen to rumors. With the grace of God . . . our country is not facing any essential food shortages.” He also announced a large distribution of government-held wheat reserves.
Afghan authorities ordered schools shut down for a month and canceled sports events and celebrations for Nowruz, the Persian spring festival this weekend when Afghans flock to shrines and picnic spots.
The country’s greatest problem now is its poor health-care system, which is far from adequate to serve the impoverished country of 25 million under normal circumstances. Experts and health officials said it is even less prepared to test, treat and care for coronavirus victims.
“The first problem is that our case detection rate is low, which may lead to a surge of positive cases later,” said Mohammad Nowruz Haqmal, a public health expert in Kabul. “Second, our clinical facilities are very few for the ones who are seriously affected and need hospital services.”
There is only one laboratory in the entire country that can test for the coronavirus, and all samples must be sent there. Only 264 suspected cases have been tested since the first positive case was reported three weeks ago. There are no labs in Herat, a major city near the Iran border, and few medical facilities that can provide quarantine for infected patients.
On Monday, at least 37 people suspected of being infected broke out of a government quarantine center in Herat. Wahid Mayar, a government health ministry spokesman, said they smashed windows and beat doctors to escape. Officials said Monday that seven patients had been found and returned.
Haqmal said that there is no system at the Iran border to screen returning refugees and that tests are given only to patients who visit hospitals, while few health teams have been mobilized to test suspected cases in communities, work on home quarantines and refer cases to hospitals. He also said public hospitals have not received emergency funding to build quarantine centers and buy supplies.
One surprising offer of help has come from the Taliban, which controls large areas of the Afghan countryside. In a tweet Monday, Taliban spokesman Suhail Shaheen said, “The Islamic Emirate via its Health Commission assures all international health organizations . . . of its readiness to cooperate and coordinate with them in combating the Corona virus.” The religious insurgents call their government an Islamic emirate.
Afghan health officials confirmed that the Taliban was cooperating with them in some regions to distribute health services. They said the government was able to offer direct services in only three of the country’s 34 provinces.
In Kabul and other cities, health and civic activists have circulated in public, wearing masks and urging people to take precautions. Until this week, many people appeared to be paying scant attention, although some businesses shut down voluntarily for fear of a serious outbreak.
“The virus has come to fight against humanity. We are worried because it spreads fast,” said Abdul Rahim Farahi, who owns a popular restaurant in Kabul. Farahi said the government had taken little action to contain the virus, so he decided to act on his own. “I am ready to accept financial loss, but not to pose a threat to people’s health,” he said.
But lack of information remains widespread, and even people suspected of being infected have ignored health instructions and left treatment centers. Some residents said they are far more worried about terrorism and crime than about the spread of a disease.
Murtaza Ahmadi, 21, who sells bananas from a cart, said he had started washing his hands more often but still does not use a mask.
“It is hard to wear it from dawn to dusk,” he said. He also suggested that in other countries, “there are not so many people getting killed by criminals and terrorists. That’s why they are so scared of this virus.”
Sharif Hassan and Sayed Salahuddin contributed to this report.