HERAT: Dozens of Afghan patients held in isolation, including at least one confirmed to have the coronavirus, escaped from a quarantine facility in western Afghanistan on Monday after breaking windows and attacking hospital staff, officials said.

Dr Abdul Hakim Tamana, head of the health department of Herat province, said the 38 people who escaped had all recently returned from Iran.

The border province of Herat is the frontline of Afghanistan’s efforts to contain the virus, as thousands of people cross the border there from Iran — one of the world’s worst-affected countries — every day.

Afghanistan has so far confirmed 21 cases of the coronavirus, mostly in Herat.

Wahid Mayar, spokesman for the country’s Ministry of Public Health, said that the patients had escaped with the help of relatives, after beating up health workers and breaking the hospital’s windows.

The incident is likely to compound concerns by experts and health officials over the vulnerability of Afghanistan’s health infrastructure, devastated by decades of war and a lack of funds, and likely to be hard pressed to mount any sort of concerted action against a coronavirus epidemic.

Nearly 70,000 Afghans have returned from virus-hit Iran in the past 20 days, an official said on Monday, overwhelming health workers at border crossings and raising fears of a major outbreak in the impoverished country.

They were allowed back in after Kabul reopened land crossings for Afghans wanting to return home — despite having earlier suspended air and ground links over fears of the virus spreading from Iran, one of the world’s worst-hit countries.

More health workers and better testing facilities were needed to cope with the increasing number of returnees and avoid a health disaster, warned Jawed Nadim, head of the refugees repatriation department in the western province of Herat, which borders Iran.

Health workers “only ask (returnees) some questions and test their temperature”, Nadim said, adding: “This is not enough.” Iran has recorded 853 deaths from the new coronavirus since February 19, officials said, appealing for people to stop travelling.

Afghanistan has 21 confirmed infections so far, most of them in Herat.

But the official number likely understates the scale of the problem due to inadequate testing measures and shoddy health infrastructure in the war-ravaged country.Many Afghans who had gone to Iran to look for work are returning home as the contagion cripples Iran’s economy, which was already devastated by US sanctions.

Afghanistan’s spring harvest is also drawing workers home, said the International Organi­sation for Migration.

The number of returnees jumped by 106 percent at two border crossings in the first week of March from the previous week, its figures show.

Ninety percent of those returnees came home voluntarily, while the remaining 10 percent were deported, it added.

Herat’s governor Abdul Qayum Rahimi last week said Afghanistan needed to act quickly to avoid a spiralling crisis.

“With the number of people coming in from Iran (and) entering Afghanistan from several entry points if we don’t take any measures now and don’t work together... we will witness an even worse situation than Iran,” Rahimi said.

“I am afraid... (that) a day will come that we won’t be able to count the dead bodies,” he said.

Returnees said they were tested for coronavirus symptoms — mainly fever — at the border crossing.

“The doctors at the border use thermometers to test (for) fever and... are advising us how to protect ourselves from coronavirus”, said Malik, a 46-year-old labourer.

Public Health Minister Ferozuddin Feroz annou­nced the government would build a 300-bed facility in Herat to tackle the outbreak.

“With that, the capacity of the health facilities in Herat will increase to 1,000 beds,” he said.

Published in Dawn, March 17th, 2020