When countries close borders, waves of people surging without supervision of international boundaries in volatile and vulnerable parts of the world have triggered warnings about the uncontrolled spread of the virus there.
In March, more than 150,000 Afghans spontaneously returned from Iran, one of the countries worst affected by the corona virus – thousands more arrived every day.
Tens of thousands have also just returned from Pakistan – among the worst affected countries in South Asia.
Officials are struggling to control this unprecedented movement across what is always porous and often without legal limits.
So far, Afghanistan is not among countries that have been severely affected by the virus, reporting 423 cases and 14 deaths, but this wave has raised fears of a much higher transmission rate.
“With the number of potentially infected people who have crossed the border, I estimate the number of cases and deaths [in Afghanistan] rose significantly, “said Natasha Howard, professor of health and global conflict at Singapore’s National University.
If there is an explosion of cases, as we have seen in the US, Spain and Italy, Afghanistan’s health system that was destroyed by war and poverty will be completely overwhelmed.
Iran crossing: Full of numbers
Abdul Maez Mohammadi and his family have been in Iran for eight years. But after the boss at the construction company where he worked stopped paying his salary, he gathered his wife, brother, and one-year-old son and headed home.
This week they crossed the Qala Islam border into Herat as undocumented migrants and will return to their Taliban-controlled villages where there are no health facilities.
“The situation in Covid-19 Iran is very dangerous and I hear there is no place to accept cases,” Mohammadi said.
At this border crossing there are no quarantine centers on either side. The provincial government is conducting a basic health check, but they are overwhelmed by the number of people.
Herat has a shortage of Covid-19 test equipment and the results take four or five days for those who are tested – and by that time they might have gone to their village.
Mohammadi said he had to get the money once he returned to his village, but he knew they had to take precautions.
“We have to wash our hands when we wake up from sleep, brush our teeth three times a day, avoid mass gatherings, not travel to neighboring areas and food must be cooked well,” he said.
The International Organization for Migration (IOM), part of the United Nations, has established centers to provide humanitarian assistance to those most vulnerable of those returning to Afghanistan.
Aziz Ahmad Rahimi, senior regional director for IOM in Herat province, said when they saw someone showing symptoms of Covid-19, they moved him to a local hospital. Ten to 15 people have so far tested positive.
Pakistan crossed: Forced to leave control
A similar situation occurs on the border with Pakistan.
The Afghan government asks Pakistani authorities to open border crossings to allow Afghans who are stranded after Pakistan closes its borders to go home.
Authorities say they will allow 1,000 people per day but 20,000 have reportedly crossed the Chaman border in the past two days prompting authorities to ignore the provisions that only those who have legal documents are allowed to cross.
Afghan authorities have made arrangements to quarantine 4,000 Afghans for 14 days in Torkham but were quickly overwhelmed by the numbers, the report said.
A total of 60,000 crossed into Afghanistan in three days, according to IOM.
An unverified video that has been widely shared by media outlets shows people rushing across the border without showing any documentation.
And these are people who went through official checkpoints. Over the years there have been illegal cross-border movements between Afghanistan and Pakistan – these numbers are far more difficult to trace.
All this has led aid agencies and NGOs working in the region to give dire warnings about the spread of coronaviruses across this border.
And if, because they are worried, cases erupt in the next few weeks, how Afghanistan can handle the amount provided by developed countries with the upper-class health system is struggling, leading to some frightening estimates.
How can Afghanistan overcome it?
The Afghan Ministry of Public Health estimates that 16 million of the population of more than 30 million can get the corona virus, citing the World Health Organization (WHO).
Waheedullah Mayar, a spokesman for the ministry of public health, said in the worst-case scenario 700,000 people would require hospitalization, 220,000 of them might require ICU care. Of that number, 110,000 people can die from Covid-19.
Afghanistan has 10,400 hospital beds throughout the country. In Herat province, some estimates put the number of ventilators at least 12.
“Afghanistan will not have such a number of beds in even 10 years,” he said, adding that health authorities were focusing on preventative measures.
Kabul is now fully locked and public gatherings have been banned in Herat.
But this is a population where many have pre-existing conditions such as tuberculosis, cancer, diabetes and there are around 2.5 million malnourished children, according to the charity Save the Children.
Afghan health resources
But if the situation in Afghanistan is so terrible why do so many want to come back?
Most of it was driven by the Covid-19 outbreaks in Iran and Pakistan and the lockdowns that had squeezed financial opportunities. People are also afraid they will not get medical treatment there.
“The impression among those returning is that if I die, it’s better to die in my home country,” Rahimi said.
Some experts believe it is too late to prevent the widespread spread of the virus in Afghanistan. And help is not likely to come from the international community consumed by the virus itself.
“The situation is likely to be very desperate – we can almost think of it as a time bomb,” said Natasha Howard of the National University of Singapore.
Additional reporting by Mahfouz Zubaide in Kabul and M Ilyas Khan in Islamabad.
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