Pakistan: Afghan refugees fear seeking medical care

Balochistan, Pakistan- “Since the deportations were announced, we live in constant anxiety,” says an Afghan refugee and father of two girls, while he visits a Médecins Sans Frontières (MSF) clinic in Balochistan, Pakistan. He describes how Afghan refugee communities are gripped by fear. “We avoid going out due to fear of arrest. Families are afraid to sleep at night, not knowing if there will be a raid. The children are traumatized.”

The government of Pakistan began a wider campaign of deporting Afghan refugees in November 2023. While at first this began with deporting unregistered Afghan refugees, all Afghan refugees have come to be targeted in this campaign, no matter their status. The government has now announced a halt on deporting Afghan refugees holding Proof of Registration cards, which was to begin on 1 July, but this will not ease the fears of Afghans in Pakistan, especially for refugees with another status

MSF teams are witnessing how the harsh reality of deportation is causing a climate of fear among Afghans in Pakistan. For many, the threat of deportation has turned accessing essential medical care into a perilous choice. The direct impact on people’s health is stark.

“I cannot come to the clinic for treatment because I will be arrested and deported. I have to skip my visit,” said one refugee during a call from an MSF health promoter, who was inquiring about his regularly missed doctor appointments.

MSF teams in Balochistan say men are now often too afraid of being harassed or arrested at checkpoints to accompany their female relatives to health facilities. This forces Afghan women to choose between breaching the deepseated cultural requirement of being escorted by a mahram (male relative) or, more often, to forgo critical healthcare altogether.

We are profoundly concerned about the welfare of people impacted by these deportation policies. For decades, many of these families have known no other home but Pakistan. Now, they live in constant fear.
Xu Weibing
Head of mission for MSF in Pakistan

he stories MSF heard from Afghan refugees in Pakistan illustrate the trauma and hardship caused by forced returns. When people are deported, they are effectively being shuttled from one dire situation to another, while also being separated from their family.

Many people who are forced to return to Afghanistan lose their livelihood and home, and have unmet healthcare needs, including those with non-communicable diseases that require ongoing treatment. The Afghan healthcare system is chronically underfunded, under-resourced, and already struggling due to dwindling international aid. It is under increasing stress, and the potential influx of hundreds of thousands more people will only exacerbate the pressure on the health system.
Stephen MacKay
Operations manager for MSF in Afghanistan and Pakistan
The pervasive anxiety of deportation is also causing immense psychological distress among communities.
 
“We have nothing to go back to,” says an Afghan woman seeking treatment at an MSF facility in Balochistan. “Many people who returned [to Afghanistan] have told us there is nothing left. I have no relatives there, and nowhere to go.

The deportation drive has seen over a million people forced to return to Afghanistan since November 2023, with more than 274,000 of those returns occurring in the first half of this year alone.

MSF has been working in Pakistan since 1986, providing medical care to people affected by conflict and disasters. We currently have projects in the Khyber Pakhtunkhwa, Punjab, Balochistan, and Sindh provinces, offering services that include maternal and child health, nutrition support, and treatment for infectious diseases.





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