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Diplomacy in Action

Signing of Memorandum of Understanding With Afghan Minister of Public Health Dr. Dalil

Anne C. Richard
Assistant Secretary, Bureau of Population, Refugees, and Migration
Washington, DC
April 25, 2012


Thank you. Madame Minister, Ambassador Hakimi, it truly is a pleasure to welcome you here to the State Department today.

Through your leadership, Dr. Dalil, the Afghan Ministry of Public Health has become a capable and effective organization which is a real benefit to all Afghans. You are an accomplished and effective woman leader who serves as a remarkable example for all women, and Afghan women in particular. Like you and your ministry, they have faced many challenges and still have many obstacles to overcome.

We both share the same concerns for refugees, and I admire the work you have done. Even before becoming the Minister of Public Health, you set up medical clinics in refugee camps, provided medical consultations, and prevented and treated communicable diseases. You understand the importance of medical assistance for returning refugees, and from your many years with UNICEF, your accomplishments training midwives and doctors, and implementing immunization programs, you have improved the lives of many women and children.

In your current capacity, your leadership has been instrumental in helping your country decrease the maternal, infant and child mortality rates -- something from which future generations of Afghans will benefit. A decade ago, the Afghan health system lay shattered. Malnutrition, infectious disease, and high infant and maternal mortality rates prevailed. The past decade has seen the rebuilding of the healthcare system. Last fall, a new study showed impressive gains in key health, education, and quality of life indicators and a dramatic decrease in infant and child mortality rates over the last five years. Now more Afghan women survive pregnancy and childbirth. These dramatic improvements also serve as a good reminder to the international community that with sound investments in tackling Afghanistan's still daunting humanitarian and development needs – especially when these investments are made with strong and effective partners like Doctor Dalil – progress can and will be achieved.

But we also must be pragmatic. As the Assistant Secretary of the Department’s Humanitarian Bureau, I should note that refugees and refugee returnees – who constitute as high as a quarter of Afghanistan's total population – often have special health needs. Socioeconomic factors influence a child’s risk of dying. Urban children are more likely to survive childhood than rural children. As expected, a mother’s education improves a child’s chances of survival, as does wealth. Most refugees lack these advantages.

In signing this Memorandum of Understanding, we are agreeing to collaborate to provide services to some of the most underprivileged and at-risk populations: refugee returnees. Two of PRM’s partner organizations have worked hard and are doing a great job responding to the health needs of returned refugees in 26 clinics in Nangarhar, Laghman, and Kunar provinces. This Memorandum will enable the clinics to ensure that this segment of the population receives the full range of services offered by the Afghan government’s Basic Package of Health Services, and that returned refugees will continue to receive this standard of care as these clinics are incorporated into the Ministry of Public Health’s planning in 2013. By July 31, 2013, these clinics – and the essential services they provide -- will be fully turned over to the Ministry of Public Health. And we’ll work together to make sure that transition is both responsible and smooth.

We undertake this transition in conjunction with the overall transition that has been taking place throughout many areas of Afghanistan. Our continuing collaboration in healthcare for returning refugees is just one piece of the United States’ enduring partnership with Afghanistan that strengthens Afghan sovereignty, stability and prosperity.

When people flee persecution and conflict, their first and most immediate needs are basic: food, shelter, protection. And addressing those needs is our primary concern at the State Department's Bureau of Population, Refugees and Migration. But as displaced people return to their homes and their lives, governments should address the long-term development needs of these populations. The link between relief and development is especially important in increasing the self-reliance of conflict victims after their displacement.

The signing of this agreement demonstrates the need to link our assistance programs to development strategies in Afghanistan. By aiding in the responsible transition of these clinics to the Ministry of Public Health, we are supporting the ability of the national and local government to provide for these vulnerable people.

Next week, I will go to Geneva to participate in the Afghan refugee conference where we expect to endorse the Solutions Strategy for Afghan refugees. The governments of Afghanistan, Pakistan and Iran are working with the UN Refugee Agency to find a way forward. I applaud the Government of Afghanistan’s leadership to help nearly 6 million Afghan refugees reintegrate into their communities, and I look forward to continuing our work with Afghanistan and its neighbors, towards a dignified return and reintegration of refugees wishing to return and to sustain protection for those Afghan refugees who cannot return.

So it certainly is my pleasure to be here today, with you, Dr. Dalil, as we both take this step forward to contribute to true, sustainable human development that supports the own dignity, health, and human rights of Afghan refugees who have returned to their homes. Thank you. Dr. Dalil.

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