Survey shows death toll of Covid-19 is higher than official figure in Kabul
Though the official figure about death toll caused by the Covid-19 shows a decline in the country, a new poll jointly conducted by Kabul Now and the daily Etilaatroz suggests otherwise in the capital Kabul. The poll has found that there is a huge difference between the official death toll (195) and what has been cited as deaths from the Covid-19 by the survey participants (1,629) in Kabul.
As the number of corona patients in Kabul exceeded from Herat, the government extended an already declared lockdown in the capital. But the lockdown strategy did not work well as majority of the families in the capital—which is home to an estimated six million population—depend on daily wages. The government took an initiative to support poor families and distributed breads, wheat, and cooking oils. This opinion poll shows that the majority of families haven’t received any aids. Most breadwinners of the poor families, under financial pressure, broke the lockdown and got out of their homes to work, earn, and feed their families.
As many as 384 participants, residing in 19 different districts of Kabul, participated in this survey which is formulated in kokaran formula. The finding of this survey shows a totally different result which defies the official figures issued by the country’s Ministry of Public Health (MoPH). According to the ministry, a total of 195 people infected by the coronavirus have died as of Wednesday, July 01. But the number of likely deaths reported by the participants is 1,629. A vast majority of the participants (74.5%), reported receiving no aid from the government, complaining that the aid are peculated by authorities and strongmen.
The survey is made of 11 quantitative questions. The answers for these questions are based on personal knowledge, experience, and observations.
Vast majority reports receiving “no aid” from the government
The vast majority of the participants (74.5%), said that they received “no aid” and the city’s lockdown made them to suffer more for they were running out of food and money. Many of the participants complained that the state aid aimed to be distributed for the needy people were peculated by local authorities, strongmen, those who had connections in the government, and even by the bakery owners. 19.3 percent of participants said that they received breads while expressing dissatisfaction with the quality and size of the breads. 3.6 percent of the participants said that they received 4.5-6 kg of wheat and only a small number of participants claimed that they have got one full package of wheat which is 40kg. One of the participants said in a mocking way that when he received 5kg of wheat he was confused whether it’s for his family or he should give it to his chickens. Out of 384 participants, only one person replied that he received 6,000 afghanis as governmental aid which made everyone else who was listening to him to wonder. The remaining 2.3 percent said that they did not need the state aid. Meanwhile, a number of participants also chose to not answer this question because they were very upset on the government. As one of the participants said that his name was listed five times but he hasn’t got anything so far. He was of opinion that even the media doesn’t have the power to bring the change, arguing that the poor people’s voice is reflected every night by the media but in vein. “Where’s the government to see us, hear us, and help us out?” he asked.
Deaths caused by Covid-19
This survey has also asked about suspicious deaths caused by the Covid-19 and has found a dramatic difference between the official figure and the number reported by the participants. A broad majority of the participants (83.8%) said that they know of someone who passed away for having coronavirus. Collecting the number of suspicious deaths cited by the participants, the total death toll likely caused by the coronavirus becomes 1,629.This suggests a huge difference (1,434 more deaths) than the official figure (195) updated on Wednesday, July 01, in Kabul. Some of the reasons for this huge difference might be that many people neither go to hospital, nor they tell others that their patients have passed away due to the coronavirus. On June 07, at a news conference, Mohammad Yaqub Haidari, governor of Kabul said that there were a significant increase in suspicious deaths in Kabul. “We have suspicious deaths that we didn’t have before. We bury the bodies in the night time, which didn’t happen in the past,” said the governor. He added that many people infected by the coronavirus haven’t visited the hospitals, and that many people suspected of having coronavirus have not been tested due to limited health facilities and medical equipment.
In this opinion poll, the respondents were also asked to provide an estimated number of the people they know were infected by the coronavirus. Responding to the question, 27.6 percent of the participants said that they know “more than 10 people” who were infected by coronavirus. Nearly all these participants are the ones who said that they try their best to follow health instructions. 16.1 percent of the participants said that the number of corona patients they know is between “5-10 people”. Whereas 25.3 percent of the participants reported that they know “less than five people” infected by the virus. 26.3 percent of the participants said that they “don’t know” anyone infected by the virus. The rest 4.7 percent of the participants decided not to answer the question.
According to Kabul governor, Haidari, the number of corona patients in Kabul may exceed one million. Earlier on April 04, the MoPH announced that 80 percent of Afghans might be infected by the coronavirus. “According to estimations, as many as 80 percent of the country’s population is likely to be infected by the coronavirus,” said Wahiduallah Mayar, former spokesman for MoPH. He added that, “if we mobilize and take actions, we can prevent the number of people who may die as the result of coronavirus.”
A social stigma
The health officials have repeatedly acknowledged that the infection rate is much higher than the confirmed cases. At a news conference on June 06, Ahmad Jawid Osmani, head of the health ministry said that the test capacity of coronavirus samples is limited in the country, and that the samples taken from suspected cases for testing are ten times larger than the testing capacity of the government. Therefore, it takes a long time for the health officials to go through the tests and check out their results. In the meantime, many people do not visit the hospitals and try to hide their illnesses. For instance, when the interviewees were asked the question of whether they know anyone who hide their coronavirus, 25.3 percent replied “yes”. One of the reasons shared by majority of the participants (63.6%) was that having the Covid-19 illness is “stigmatized” and many people have the fear of losing their connections and social status. As a result, they would hide it. One of the participants in particular said that his neighbor passed away as a result of being infected by the virus, but his family hid the fact and only after completing his funeral ceremony disclosed his illness. According to his family, they had the fear that no one would show up for his funeral ceremony.
Meanwhile, 27.1 percent of the participants reported that their friends and relatives are “not hiding” their infection, adding that there is no reason to hide the disease. 14.8 percent of the participants said that only a “limited number of people” hide their illness and that’s either because of having the fear or not knowing that they are infected by the virus. The remained 32.8 percent decided not to answer this question.
Public attitude towards Covid-19 hospitals
As many as 20.8 percent of the participants reported that none of the Covid-19 patients they know were admitted to hospitals. They say some Covid-19 patients are unwilling to be admitted to a Covid-19 hospital either they cannot afford the amount of money or fear that they might be killed by the doctors. There have been many rumors about doctors killing patients by intentionally prescribing them wrong medicine or injecting them so that they would die. The MoPH has also confirmed that many doctors at both state-run and private hospitals cannot differentiate the Covid-19 and alike diseases due to lack of experience and knowledge. As a result, the patients are prescribed the wrong medicines. When these participants were asked about the reason for killing these patients, they replied that the more people die, the more foreign aid will be poured into the country. 21.9 percent of the participants said that only a “limited number” of patients go to hospital and that’s when their situation get out of control. 17.7 percent of the participants said that “majority” of the patients they know have admitted to Covid-19 hospital. The remained 31.8 percent of the participants decided to not answer the question.
A vast majority of interviewees (70.3%) who visited the Covid-19 hospitals said that they were “less satisfied” with the health services of the hospitals. According to these participants, they were faced with lack of health services, mismanagement, and rude behaviors of the doctors as they visited the hospital. One of the male participants said that his young son passed away due to lack of health services at a hospital. Another participant said that while carrying the dead body of his young daughter, a doctor approached him and offered him 300,000 afghanis if he would give his daughter’s body to him. When he was asked why the doctor had to offer the amount for getting his daughter’s body, the participant said that he didn’t ask the doctor and it wasn’t the time to make deals with the doctor over his daughter’s body. Only 7.14 percent of the participants said that they are “very satisfied” with the health services of the hospitals which are mostly private. Although by then the private hospitals were not allowed to accept corona patients, 10 out of 15 interviewees said that when they realized that they have the symptoms of coronavirus, they visited the private hospitals and the doctors without taking the test, prescribed them some medicines which made them feel better.
40 percent of the participants didn’t go to hospitals because of lack of health services and not having enough money to visit the private hospitals. However, these participants preferred to stay at home and take care of their health using herbal medicines, ginger, garlic, onions, and opium. As one of the participants said, when he realized that he is infected by the coronavirus, he took little bit of opium and that made him feel better so he offered using opium which he considered as a “fine medicine” to his neighbors and family members who were infected by the virus. 45 percent of the participants chose not to go to hospitals due to lack of trust and the number of rumors they heard about doctors and health centers. 2.5 percent of the participants said that due to their location of residing place, they don’t have access to a proper health center, where they can go and check their health conditions. Whereas, 3.75 percent of the participants chose “others” option and gave explanation of mostly due to their poor economic condition, they couldn’t go to hospital. The rest 8.75 percent decided to not reply this question.
Public awarenes and source of information
With the outbreak of coronavirus in China, Iran, and Afghanistan, many people started doubting on whether or not the virus really exist. Unfortunately, majority of people still consider it as a lie which make anti-corona campaign a more difficult job.
When asked about existence of the coronavirus, as many as 86.5 percent of the participants replied “yes”. 10.2 percent of the participants replied that there’s no coronavirus and it’s a lie made by the government to receive aid and make poor suffer more. In particular, eight of the participants said that when the poor people get sick and are taken to hospital, they are given the wrong medicine including injection which immediately make them feel worse and some of them even pass away. Two of the participants who were upset about the mess situation created by the government said that one of their neighbors and close relatives, who felt little sick, went to hospital and after 2-3 hours of visiting a state-run hospital, their dead body were brought back to their families. Additionally, the remained 3.4 percent of the participants replied that they don’t know whether it’s true that the virus has spread in the country or not. According to some of the participants, they heard of people dying from the virus, but they have never witnessed or experienced it.
76 percent of the participants said that they get most of their updated information from media, especially through Facebook and different TV channels. Whereas 15.4 percent of other participants said that they get the information from society and mostly people. Majority of the participants who get their information from the society are vendors and fruit sellers who spend most of their life on the street. Many of these vendors claimed that they even were infected by the virus which they believe were transferred from their customers. Only a few number of participants, 2.3 percent, said that they got the information from mosque and via the awareness campaigns. By seeing the option for awareness campaigns, one of the participants in particular noted that, “people of higher authorities think of Afghanistan as other countries. Specifically when they raise awareness about coronavirus, we are asked to stay at home as if they would deliver food to us.”
24.7 percent of the participants said that they “absolutely” follow the instructions and wear masks and gloves. Meanwhile, 53.4 percent of the participants who were mostly vendors and daily wage workers said that they “sometimes” follow the instructions. Additionally, 17.4 percent of the participants said that they don’t follow the instructions “at all” because they think that these instructions are just another lie made by the government. As many as 10 participants said that, they are unable to follow such instructions because they need to earn money and feed their children. “Such instructions of avoiding social interactions and following social distance are not for poor people,” one of the participants said. The remained 4.4 percent decided not to answer the question.
In this opinion poll, reporters of Kabul Now and the daily Etilaatroz distributed the survey questionnaire for the participants and collected their opinions. The reporters have orally asked the questions and filled in responses given by the illiterate participants. For completing this survey, 21 different areas in Kabul were chosen to be polled which include Sarai e Shamali, Khair Khana, Lise Maryam, Taimani, Karte Parwan, Dasht e Barchi, Company, Char Rahi Qambar, Park Zar Negar, Shah e Do Shamshira, Cinema e Pamir, Kote Sangi, Pole Sorkh, Darul Aman, Markaz Shahr, Macroyan, Pole Charkhi, Arzan Qeymat, Bagrami, Karte Naw, and Shahre Naw. The participants who participated in the survey resided in 19 different districts of Kabul. 76.6 percent of the participants were male while the rest, 23.4 percent, were female. Out of this, 68.5 percent were young (aged between15-35), 19 percent were middle aged (35-45), and 12.2 percent were old aged (45 +). Additionally, as many as 73.7 percent of the participants were educated (67.2 percent holding bachelor and 6.5 percent others having masters degree), while the rest 26 percent were illiterate. 43.8 percent of the participants were daily wage workers like vendors, rivers, and shopkeepers. 26.6 percent others were jobless. 10.9 percent of the participants claimed to have governmental jobs and 18.8 percent others claimed to be the staff members of private companies. We are grateful to Abdul Wahid Haidari from Etilaat Roz, Nangialai Nangial and Mohammad Ghani Khaleqyar who helped us with distributing the survey questionnaire and gathering the participants’ opinions in some areas.