During this transition period and the eventual drawdown of international forces, ICRC Head of Delegation Reto Stocker reflects on the major humanitarian challenges and the situation for ordinary Afghans caught up in conflict.

How do you see the situation today in Afghanistan?

Many Afghans simply say they want to leave their homeland. And they are questioning what has really improved over the past 10 years of conflict. Of course a lot of things have changed. There have been improvements to infrastructure and communications, to name only two areas. But for the vast majority of the population Afghanistan is still a country at war, and they see little hope of the situation getting better anytime soon. In many parts of the country, and across different social groups, from what we can judge, there is a widespread mood of desperation.

One of the ICRC's main concerns is for the sick and the wounded to have safe access to health care. How does this play out in Afghanistan?

We are increasingly hearing stories of doctors being prevented from doing their work because one or other party to the conflict is not happy if their opponents get medical treatment. This goes to the heart of our mandate and to its commitment to safeguarding the right of everybody who is injured or sick to have safe and timely access to health care.

Part of the ICRC's role is to help the Afghan Ministry of Health and its staff – in hospitals, rural clinics and health posts – continue their work. For example we have made a very large commitment to Mirwais regional hospital in Kandahar, supporting the hospital authorities in all areas of their work for some three and a half million people. And there are the seven ICRC-run physical rehabilitation centres. They have helped more than 100,000 physically disabled adults and children to lead productive lives within society over the past two decades.

Detention issues are one of the ICRC's main priorities. What are your views on the transfer of detainees to Afghan authority?

Rule-of-law issues in Afghanistan are at a critical juncture. With detainee transfers from international forces to Afghan detention under way, those who are responsible for it have an obligation under international humanitarian law to ensure that detainees will continue to have satisfactory conditions and receive correct treatment afterwards. This is why pre- and post-transfer monitoring is so important and it is the transferring authority's responsibility to do this. Detainees are also protected by procedural safeguards and judicial guarantees whilst in detention. This is where the ICRC can have some influence by sharing its findings confidentially with all parties and advising them about their obligations under international humanitarian law in this regard.

Sustainability also comes in here. Sustainability in the sense that there needs to be an Afghan-run penitentiary system that is able to cope with the increasingly large number of detainees who are going to be transferred into the Afghan prison system before the end of 2014.

I am glad to say that we have had an increasingly coherent and positive dialogue over the years both with international and Afghan officials on detention issues. We also have an ongoing dialogue with the armed opposition – including the Taliban, the Haqqani network and Hisb-i-Islami – about the fact that they, too, have obligations under international humanitarian law to treat detainees humanely.

And what about the drawdown of the international forces until 2014?

The ongoing debate about a possible accelerated drawdown of the international troops has consequences for the ICRC in that our dialogue with them on the conduct of hostilities and the protection of civilians has to shift very, very rapidly to the Afghan National Security Forces. The US and other troop-contributing nations support and mentor the Afghan army and police, and also a multitude of civil defence groups, the latest being the Afghan Local Police. This comes with legal obligations under the Geneva Conventions, to ensure that such forces will respect international humanitarian law at all times, including after the departure of most international troops.

In addition, at such time as discussions about an eventual downsizing of the Afghan security forces are finalized, efforts must go into making this complicated process work, including demobilization and reintegration.

Concerning the civilian population, I knew Kabul as a city of 400,000 inhabitants when I first came here 13 years ago. Now it has around five million people, many of them returnees from Pakistan and Iran. Some came back with skills they could use and have prospered, but others have not. They, together with other impoverished communities – rural farmers and the like – manage to survive partly because of Afghanistan's war economy. While having made comparatively few people very rich, it has also trickled down through employment in the security sector or created jobs for day labourers that have made it possible for them to feed their families, for example.

But as this war economy shrinks over the months and years to come, and the interest of the international community wanes, it will affect all sectors of society, including both those who are struggling and those who have got used to a comfortable living. Already, following a massive cut in USAID funding late last year, several big international NGOs have stopped ongoing projects and started to lay off their Afghan staff. And this is just the beginning.

For those aid agencies like the ICRC who will stay for the long term – we've already been here for 25 years – the workload will increase as we try to address the needs of war-affected communities and an increasingly impoverished population. I fear there will still be a lot of work to do well beyond 2014. I wish it were otherwise.

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