South Asia Intelligence Review
The Taliban: Bad for Health
A report titled, “Afghanistan: Violence Against Health Care in Conflict 2023“, published on June 24, 2024, exposed the horrid situation of health workers and staff in the country under the Taliban regime. More than 80 per cent of cases of violence against health care were ascribed to the Afghan government, Police, and intelligence forces, all of which are under the active control of the Taliban. The report identified 109 incidents of violence against, or obstruction of health care personnel and organisations in Afghanistan in 2023, compared to 87 in 2022.
In addition, at least 65 health workers were arrested or detained for questioning by Taliban forces in 38 incidents in 2023, compared to 33 arrests in 25 incidents in 2022.
The report further stated that violent incidents were widely dispersed across 28 of Afghanistan’s 34 provinces. Zabul province recorded the highest number of such cases. Cases attributed to the Taliban more than doubled in Balkh province between 2022 and 2023. As in previous years, incidents continued to be reported in Herat and Kabul provinces.
According to partial data collated by Institute for Conflict Management, 16 health care workers and doctors have been killed in 10 incidents (data till June 30), since the Taliban takeover of August, 2021.
Often Taliban operatives and ‘unknown perpetrators’ armed with guns beat health workers, shut down medical facilities, arrest and harass doctors and health providers.
Some such incidents include:
As reported on June 10, 2024, Taliban closed the Baran Health Institute in Bamiyan Province and detained its Director, Nvid Mozaffari, for giving anti-Taliban statements.
As reported on May 24, 2024, Dr. Sardar, owner of a hospital in Badakhshan Province, lost his life due to brutal torture inflicted by the Taliban. According to local reports, he was beaten by Taliban fighters, which led to his death.
On December 27, 2023, the head of the Medical Education Development Section at the Kabul University of Medical Sciences, Abdul Ghafar Hamdard, was shot dead by unidentified armed assailants inside his clinic at Roshan Hospital in the Kart-e-Naw area of Kabul.
As reported on November 25, 2023, in the Sarak-e Char area in Taloqan city of Takhar Province, Taliban forces apprehended Nabila Rahimi, a human rights activist and UNDP-affiliated health educator. She was reported to have been mistreated during her arrest.
On October 10, 2023, a female doctor, in the Maimana City maternity hospital in Faryab Province was forcibly removed from her workplace by a Taliban fighter.
On June 5, 2023, three Taliban operatives beat up a female nurse in Mazar-e-Sharif, Balkh Province. Based on reports from local sources, the nurse was severely injured.
On May 30, 2023, 28 NGO-funded and private health centers were raided and equipment destroyed by Taliban forces in Qalat city.
In May 2024, with a dire health crisis ongoing across the country, Qalandar Ebad a qualified physician and Taliban’s Minister of Public Health, was removed from his position, and in his place Noor Jalal, a cleric and former Deputy Minister of the Ministry of Interior, was appointed.
Worse still, Afghanistan’s healthcare system teeters at the edge of collapse, as the Taliban channel most state resources toward defense and intelligence services. The Taliban’s budget for 2023-24 of USD 3,548.00 million provides an insight into the regime’s priorities, in which the budget of Ministry of Defence was USD 616.80 million, 17. 38 per cent of the total budget, and on the other hand, the Ministry of Public Health was allocated USD 80.00 million, 2.25 per cent of the total budget.
Further, nonprofit organisations and international donors are prohibited from employing female staff, and financial curbs have limited the outreach of aid organizations. In turn, vital community lifelines, such as rural clinics and nutrition centers have also been closed.
As reported on June 11, 2024, 17.9 million people require health assistance in Afghanistan, while 9.5 million have limited or no access to healthcare facilities. Afghanistan is one of the two countries in the world (the second is Pakistan) where polio is still prevalent. Recent estimates have suggested that under the Taliban regime, Afghanistan has 0.33 doctors per 1,000 people, as compared to 20 per 1,000 in high-income countries. The World Health Organization (WHO) recommends a minimum rate of 2.5 doctors per 1,000. This shortage is disastrous in a country already grappling with some of the world’s worst health outcomes, including acute malnutrition, stunting, and high child and maternal mortality. According to WHO, as reported, on May 25, 2024, Afghanistan has the highest maternal mortality rate in Asia, with 638 deaths per 100,000 live births. Also, since the start of 2024, over 1,000 children under the age of five have died in Afghanistan from pneumonia, accounting for 88 per cent of all pediatric respiratory infection deaths. Sadly, the United Nations Children’s Fund (UNICEF) reported on March 5, 2024, that 10 per cent of Afghan children under the age of five are malnourished and 45 per cent are stunted. According to UN Women’s Afghanistan Gender Country Profile 2024, published in June, 2024, only 10 per cent of women were able to cover their basic health needs, and approximately, 24,000 women give birth in hard-to-reach places in Afghanistan each month.
The healthcare system in Afghanistan has faced a severe crisis under Taliban rule. Citizens’ access to healthcare services has drastically decreased, and the majority of people, due to increasing poverty and persistent unemployment, cannot visit healthcare centers, enduring physical ailments along with mental distress. According to a June 9, 2024 report, last year (2023), 428 fixed and mobile health centers were forced to close in Afghanistan due to financial constraints. Besides, as reported on May 1, 2024, nearly 18 million Afghans, about 40 per cent of the population, have limited access to healthcare. Explaining the mental health challenges facing the population, Dr. Hanan Balkhy, the WHO Regional Director for the Eastern Mediterranean, stated in March 2024, “50 per cent of Afghanistan’s population suffers from mental distress, impacting productivity and quality of life. This renders individuals vulnerable to mental health disorders and substance use.”
Moreover, Afghanistan has an urgent need for female doctors, as they are often the only healthcare providers available for women and children. Since December 2022, Taliban has banned women in higher education, and more than 3,000 women who had already graduated from medical schools were barred from taking the board exams required to practice, depriving the country of a critical resource.
The Taliban’s governance in Afghanistan has no doubt failed to establish crucial regulatory frameworks necessary for advancing Sustainable Development Goals (SDGs) particularly SDG 3 (Good Health and Well-being), SDG 4 (Quality Education), and SDG 5 (Gender Equality). Their inability to enforce policies ensuring equitable access to healthcare services, exacerbates health disparities and obstructs progress toward SDG 3. Following the Taliban takeover in August 2021, international development aid was suspended, while in 2023 humanitarian aid also decreased in value by over USD 1 billion. This decrease in aid occurred against the backdrop of rising humanitarian needs. Furthermore, as 428 fixed and mobile healthcare centers were forced to shut down (as mentioned above) between January and December 2023, which has had detrimental impact on access to healthcare for over three million people, including more than 600,000 children under five and over 240,000 pregnant women.
The existing problems of the health system in Afghanistan have been amplified by the Taliban’s August 2021 takeover, after which the country has faced a problematic security situation, financial stoppages, donor funding disruptions and international health staff evacuations. The health sector of Afghanistan is in total shambles, and worsening with the continuation of the Taliban regime. The Taliban apathy towards the general welfare of the population, including their health needs, is proving disastrous for the population of a country that has neither the resources nor the facilities to maintain even a basic minimum health service.
Maharashtra, Gadchiroli – On the road to peace
On June 27, 2024, two women Communist Party of India-Maoist (CPI-Maoist) cadres carrying a cumulative reward of INR 1.6 million on their heads surrendered in Gadchiroli District. A release from the office of the Superintendent of Police (SP) identified them as Bali alias Rambatti alias Zarina Narote (28) and Shashikala alias Chandrakala alias Manisha Uike (29), both ‘platoon party committee’ members of the proscribed CPI-Maoist ‘company No. 10’. The surrender of these two women, with rewards of INR 800,000 each on their heads, comes within a week of Dandakaranya Special Zonal Committee Member (DKSZCM) Giridhar, who was the district’s top Naxalite [left Wing Extremist, LWE], and his wife Sangeeta Usendi laying down arms. A total of 21 cases are registered against Narote, comprising 10 related to encounters, one each of arson and abduction, and nine related to other offences. Uike has eight cases against her name, of which six are related to encounters.
On June 23, 2024, CPI-Maoist ‘commander’ Nangsu Tumaretti alias Giridhar (44), involved in major Naxal activities and carrying a cash award of INR 2.5 million, surrendered along with his wife Sangeeta Usendi alias Lalita (35) in the presence of Maharashtra Deputy Chief Minister Devendra Fadnavis in Gadchiroli District. Giridhar is an ambush and improvised explosive device (IED) specialist, whose efforts had fortified Maoist headquarters Abujhmarh and strongholds along the Maharashtra-Chhattisgarh border. He and his wife faced around 220 criminal charges and carried bounties totaling INR 4.1 million (Giridhar INR 2.5 million and Lalita INR 1.6 million).
On June 10, 2024, a wanted CPI-Maoist cadre, Kishor alias Mukesh Kannake (37), with an INR 200,000 reward on his head, surrendered before the Police and the Central Reserve Police Force (CRPF) in Gadchiroli District. After joining ‘Jan Militia’ (the people’s army of the Maoists) as a member in 2014, Kannake quickly rose in the ranks and became the head of multiple Maoist factions like the Revolutionary People’s Council (RPC) and Dandakaranya Adivasi Kisan Majdoor Sangthan (DAKMS). He was involved in three encounters, four murders, setting multiple vehicles ablaze, planting explosives in forests, and propagating the Naxalite ideology. In a statement to the Police, Kannake revealed that many senior Maoist leaders not only exploited the tribal youth but also misused funds. He added that many tribals were killed by their leaders, suspecting them to be ‘police informers’.
These incidents of surrender are indicative of the growing disillusionment among cadres in the district.
According to partial data collated by the South Asia Terrorism Portal (SATP), at least six Naxalites [Left Wing Extremists, LWEs] have surrendered in Gadchiroli District since the beginning of 2024 (data till June 30). During the corresponding period in 2023, no surrender was reported. However, three Naxalites had surrendered in the remaining period of 2023. A total of 273 Naxalites has surrendered in the district since March 6, 2000, when SATP started documenting Naxalite violence and activities in the district and the State, as well as across the country. The first incident of surrender was registered on May 22, 2003, when 16 Naxalites of the People’s War Group (PWG) surrendered at Ghot village, Gadchiroli District. The Naxalites surrendered during a ‘Jan Jagran Abhiyan’ (Public Awareness Campaign) to create awareness among the villagers about Naxalite activities and also to bring back misguided youth to the mainstream.
Meanwhile, SFs have arrested seven Naxalites in the District in the current year (data till June 30, 2024), in addition, to seven cadres in 2023. A total of 364 Naxalites has been arrested since March 6, 2000. Significantly, the first incident of arrest was recorded by SATP on December 8, 2007, when Police detained three CPI-Maoist cadres from Jhadapapda village under Pendry Police Station limits in Gadchiroli District. The arrested Maoists were involved in several incidents in the neighbouring Kanker district of Chhattisgarh.
According to the SATP database, Gadchiroli has recorded eight fatalities (one civilian and seven Maoists) in Maoist-related violence in the current year (data till June 30, 2024). During the corresponding period in 2023, five fatalities (one civilian and four Maoists) were recorded in the district, while another six fatalities (four civilians and two Maoists) were recorded in the remaining period of 2023, taking the total to 11 fatalities (five civilians and six Maoists) through 2023. Significantly, while there has been an increase in overall fatalities in the current year, as compared to 2023, a closer analysis of the numbers suggests that the situation on the ground has actually improved. No fatality has been recorded in SF category thus far in 2024 (data till June 30, 2024). The last SF fatality was recorded on August 14, 2020, when a Police Constable, Dushyant Nandeshwar (26), was killed, while another Constable, Dinesh Bhosale, was injured when an CPI-Maoist ‘action team’ shot them in a market at Kothi village under the Bhamragad Tehsil (revenue unit) in Gadchiroli District.
Significantly, the overall SF:Naxalite kill ratio has remained in favour of the SFs, at 1:1.99, since March 6, 2000. However, the SFs have been ever more dominant since September 2020; (September 1, 2020, to July 30, 2024), killing 69 Naxalites, without losing any of their own personnel. Replying to a question in an interview on June 17, 2024, Gadchiroli Superintendent of Police (SP) Neelotpal, thus stated,
August 2020 was the last day in which Gadchiroli police had suffered any casualty. They had laid IEDs on our patrolling routes which we defused successfully. This year we have busted four camps. We seized three IEDs in three separate instances this year. There have been eight instances of exchange of fire this year in which we have neutralised seven Naxals. We have recovered several AK 47s, carbines and rifles. Four Naxals surrendered this year.
The security scenario in the district improved dramatically after the successful major assault [LINK: SAIR-20.21] of November 13, 2021. In the encounter initiated by Commando-60 (C-60, the special anti-Maoist Force of the Maharashtra Police) units in the Mardintola forests of the Gyarapatti area in Korchi Tehsil (revenue unit) of Gadchiroli District, the Maoists lost 27 top ranking cadres, including top Maoist leader Milind Baburao Teltumbde aka Deepak Teltumbde aka Sahyadri aka Jeeva, a ‘central committee’ member and ‘secretary’ of the CPI-Maoist ‘Maharashtra State Committee’, carrying a reward of INR five million on his head. Teltumbde was the ‘head’ of the MMC (Maharashtra-Madhya Pradesh-Chhattisgarh) confluence zone of the rebels and was instrumental in building the Maoist movement in the State, along the Gondia, Balaghat and Mandla regions in Madhya Pradesh and the Rajnandgaon region of Chhattisgarh, over the preceding two decades. After his elimination, Maoist strength in the region declined substantially.
Moreover, in a recent assault on May 13, 2024, after 39 years, commandos in Gadchiroli crushed the Permili Dalam (armed squad) formation of the Peoples’ Liberation Guerrilla Army (PLGA), severing the supply chain to the Maoist headquarters in Abujhmarh. In the encounter, Permili Dalam, ‘commander’ Vasu Samar Korcha, who carried an INR 2.2 million bounty, was killed along with two women cadres, Reshma Madkam and Kamla Madavi, both members of Company No. 10 of Perimili Dalam. Reshma was also an ‘area committee member (ACM)’ of the PLGA. The Permili Dalam, established by educated Telugu youths, had turned Gadchiroli into the epicentre of Maoist violence since 1985, was one of the five armed formations under the South Gadchiroli division of Maoists in Dandakaranya zone, and was crucial for providing logistic support to insurgents in the ‘red corridor’, linking the north-south axis in the Maoist-affected district, spanning 14,400 square kilometres in northeastern Maharashtra.
Meanwhile, civilian fatalities, a key index of security of an area, have followed a cyclical trend in the district. One civilian fatality has been registered in the district in the current year (data till July 30, 2024). During the corresponding period of 2023, one civilian fatality was recorded, and another four in the remaining period of 2023, taking the total to five 2023. A maximum of 36 civilian fatalities was recorded in 2011, while a low of one fatality has been recorded on three occasions, in 2002, 2004, and 2024 (data till June 30, 2024).
According to a June 17, 2024, report, people from seven villages in Gadchiroli District have come together to stop Naxals from entering their villages. During an agricultural event, villagers gave copies of their decision to the Police at Dhodraj Station. The villages include Parayanar, Nelgunda, Kucher, Kawande, Gongwada, Mundapalli, and Mahakapadi. Further, according to a June 25, 2024, report, another six villages have taken commendable initiatives against the Naxalites. The villages include Aldandi, Bhatpar, Gopnar, Koir, Murungal, and Moradpar. The villagers of these 13 villages have opposed Naxalites and stopped providing them rations and water. Speaking on this initiative, SP Neelotpal observed,
13 villages have united today and declared a village bandh for the Naxalites. They have declared that they will not give food, rations, and water to the Naxalites. Also, the villagers have deposited the Naxalites’ cooker IED bombs, wires, batteries, 300 rods, and 5 loaded guns at the Gadchiroli police station.
Meanwhile, during an interview on June 17, 2024, while replying to a question on the support of the locals to the Police in combating Naxalism, SP Neelotpal, noted,
We invested heavily in community policing, Police Dadalora Khidki, and Project Udaan. It has reached to 6.5 lakh beneficiaries in the last three years. These initiatives have led to winning hearts of people in Gadchiroli. Naxals rely on ground support for their execution of low-exposure warfare. Now, the people are not supporting them or not giving information about the location of the Police parties. This has also led to zero recruitment from Gadchiroli in the last three years in the Naxal fold.
Gadchiroli has a total area of 14,412 square kilometres, of which 11,694 square kilometres, i.e., 78.40 per cent, fall under forest cover. The district has, for long, provided perfect topography for the Maoists to operate, as the task of locating and sanitising rebel hideouts is made difficult by the terrain. Further, its borders with four districts — Bijapur, Kanker, Narayanpur, and Rajnandgaon — in Chhattisgarh, the worst Naxal-affected Indian state, as well as two Maoist-affected districts — Adilabad and Karimnagar — of Telangana, make it an ideal safe haven for the Maoists. Gadchiroli emerged as the epicentre of Maoist violence in Maharashtra and, at its peak in 2009, had registered at least 99 fatalities, including 52 SF personnel, 37 Maoists, and 10 civilians. Subsequently, however, the district has seen a perceptible decline in impact and influence.
Several other parameters also indicate that the Maoists are losing control in Gadchiroli since the major assault of November 13, 2021. Apart from the cadre’s disillusionment, there has been noticeable waning in the other indicators of Maoist disruptive actions. No major incidents (each involving three or more fatalities) have been reported since November 13, 2021. At peak, eight such incidents were recorded in 2006. Four arson-related incidents have been recorded since November 13, 2021 – three in 2022, and one in 2023. At peak, 11 such incidents were recorded in 2019. Significantly, the Maoists have been unable to engineer an incident of explosion since 2019. The last explosion was orchestrated by the rebels on May 27, 2019, when CPI-Maoist cadres exchanged fire with a team of elite C-60 Commandos in Gadchiroli District, in which Maoists used an Under-Barrel Grenade Launcher (UBGL). At peak, five such incidents were recorded in 2005.
The Maoist influence and their impact are on a decline in Gadchiroli, one of their crucial strongholds in the past, a strategic confluence zone connecting Chhattisgarh, Madhya Pradesh, and Telangana. Sustained and aggressive consolidation against the Maoists by SFs and outreach by the civilian administration can ensure that the residual movement is eventually eradicated.
Weekly Fatalities: Major Conflicts in South Asia
June 24-30, 2024
