Afghanistan

Soon I'll be off to Afghanistan to work on a USAID-sponsored assessment of the USG health-sector reconstruction activities. As part of this assessment, my office is also sponsoring a conference on the way ahead in health sector development. I have been coordinating this conference and will post the web announcement and registration page.

Meanwhile, I'm reading up on Afghanistan. Dave Kilkullen recently testified before Congress on "AFPAK" and a shortened version of his testimony can be found on the Small Wars Journal webiste here: http://smallwarsjournal.com/mag/docs-temp/177-kilcullen.pdf.

The interesting thing about all this is the growing (thankfully) recognition that there are geopolitical influences on health. Afghanistan cannot be treated as an entity in and of itself. USAID, apparently, has just sent out an assessment team to understand what can be done in the FATA region. It strikes me that repairing a hospital or training doctors is worthwhile, but probably not really the answer. It seems to me that there has to be structural change to the societies we are working in. And the way to understand this is to ascertain what their expectations and beliefs are. Normally, we do this through the Minister of Health in order to legitimize our actions. The problem with this is that while we gain approval and legitimacy for our actions, we don't understand whether our activities will actually prove viable or not. The normal answer for this problem is to hire NGOs. While NGOs provide part of the answer, I assume, they must be met with healthy skepticism as well since some NGOs are religiously-motivated, for example.

The effort in Afghanistan will continue to take time and patience. The American people will have to be reminded of 9/11 many times in the near future, I suspect. But as Kilkullen points out, there is no way to take short cuts here. Let's hope Charlie Wilson's War made its point.