VZCZCXRO4731
OO RUEHDBU RUEHPW
DE RUEHBUL #0525/01 0690510
ZNR UUUUU ZZH
O 100510Z MAR 09
FM AMEMBASSY KABUL
TO RUEHC/SECSTATE WASHDC IMMEDIATE 7652
INFO RUCNAFG/AFGHANISTAN COLLECTIVE PRIORITY

UNCLAS SECTION 01 OF 02 KABUL 000525 
 
SIPDIS 
 
DEPARTMENT FOR SCA/FO, SCA/A, EUR/RPM 
STATE PASS USAID FOR ASIA/SCAA 
NSC FOR WOOD 
OSD FOR WILKES 
CG CJTF-101 POLAD 
 
E.O. 12958: N/A 
TAGS: PGOV PREL KDEM EAID AF
SUBJECT: PAKTIKA PROVINCE: SECURITY CHALLENGES HINDER 
HEALTH CARE, EDUCATION AND EMPLOYMENT 
 
Summary 
------- 
 
¶1.  (SBU) Declining security in the second half of 2008 in 
Afghanistan's Paktika province affected residents, access to 
health care, education and employment opportunities in large 
parts of the province.  Exceedingly low levels of education, 
combined with limited means of information and communication, 
restricted public awareness and civic engagement.  Despite 
growing markets in the largest population centers, lack of 
employment opportunities continued to drive young men abroad, 
and economic activity was oriented toward Pakistan, 
especially in the border districts. 
 
Medical Services Available to Many, but Limited 
--------------------------------------------- -- 
 
¶2.  (U) Basic health services are available to many, but not 
all, residents of Paktika.  In November a new PRT-built 
hospital opened in Orgun, Paktika's largest town.  A number 
of clinics in the province continued to provide basic health 
services such as vaccinations, family planning, maternal 
health care, and tuberculosis treatment.  The PRT plans to 
establish in 2009 a women's health and training center in 
Sharana that will expand services for women and provide a 
setting for local training of midwives.  This service is 
badly needed, as Paktika has no female doctors and midwife 
positions are understaffed around the province. 
 
¶3.  (SBU) Security problems hampered some health projects in 
¶2008.  For example, USAID cancelled plans to construct 
twenty-bed hospitals in Bermel and Waza Khwa districts 
because poor road security prevented the contractor from 
beginning construction.  USAID has recently agreed, however, 
to build a similar-sized hospital in Khair Kot, provided 
security conditions in that district do not deteriorate. 
NGOs operating clinics in Paktika reported difficulty 
delivering supplies and equipment to their clinics because of 
road security.  In September, the entire medical staff of 
Sharana hospital submitted a joint resignation letter, 
complaining that they would quit their jobs unless security 
improved on the Sharana-Ghazni road.  This action followed 
attacks on three members of the medical staff on this road 
earlier in the month.  Following discussion of the problem 
between the PRT and then-Governor Khpalwak, the medical staff 
withdrew its resignation threat; provincial officials say 
security of the road has improved since this episode. 
 
Many Schools Closed for Security Reasons 
---------------------------------------- 
 
¶4.  (SBU) According to Provincial Education Director 
Hafizullah, schools were closed during the second half of 
2008 in Naka, Dila, and Khushamond districts because of 
insecurity, and Gomal district was considering closing its 
schools.  A limited number of schools were functioning in 
Terwa and Wor Mamay districts because of Taliban threats, 
with teachers warned of consequences if they did not limit 
themselves to teaching only the Quran.  Insurgents in these 
two districts have also posed as teachers in order to collect 
salaries from GIRoA.  In September the Taliban attacked the 
girls' school in Sar Hawza, resulting in its closure; and 
school supplies were burned at another school in Sar Hawza 
built by the PRT.  In Ziruk district, four out of 10 schools 
were operating.  Bermel district leaders told PRT in October 
that only four of 28 schools were open; and the Bermel 
education director was kidnapped and decapitated by the 
Taliban in September. 
 
¶5.  (U) Schools around the province faced a lack of qualified 
teachers because of a combination of poor security conditions 
and the overall low educational level of the province.  The 
provincial department of education had adequate books for 
Paktika's schools for grades one through six, but the lack of 
transportation assets and insecurity prevented their delivery 
to some areas.  Adequate books for higher grades were not 
supplied by the Ministry of Education.  Despite these 
challenges, numerous schools constructed or supported by the 
PRT were functioning, and the Provincial Governor and 
Provincial Development Council continued to request 
additional schools.  A teachers training college built by the 
PRT in Orgun opened in early 2008 and was functioning in the 
second half of the year. 
 
Lack of Media Complicates Public Communications 
--------------------------------------------- -- 
 
KABUL 00000525  002 OF 002 
 
 
 
¶6.  (U) Government officials' means for conveying their 
messages through the media remained limited.  Paktika has no 
television coverage, and no newspapers are printed or 
distributed in the province.  The only print media is the 
"Ghatul" ("Tulip") magazine, which published only two issues 
in 2008 because of lack of printing facilities.  There was no 
cell phone coverage outside the largest population centers 
and part of the corridor connecting them, and no internet 
cafes or other means of internet access.  The chief means of 
outside communication for most residents outside the main 
population centers was telephone call shops in some district 
bazaars.  The main source of public information remained 
radio: two FM stations in Sharana and "radio in a box" 
stations provided by CF in several districts.  While still in 
office, Governor Khpalwak (who was replaced as governor in 
February 2009) used the existing local media, as well as 
national and international media, to convey strong pro-CF 
messages in response to events. 
 
While Major Bazaars Grow, Poverty and Unemployment Fuel 
Instability 
------------------------------------- 
 
¶7.  (U) Growth of the bazaars in Sharana and Orgun continued 
in the second half of 2008.  However, economic isolation 
stemming from lack of infrastructure as well as insecurity 
continued to drive Paktika's economic alignment toward 
Pakistan, particularly in the five border districts.  Many 
goods for sale in Paktika's bazaars came from Pakistan.  In 
much of Paktika, Pakistani rupees and U.S. dollars were more 
widely used than Afghanis.  The absence of banks in Paktika 
also continued to contribute to the use of rupees, as no 
formal structure existed for the distribution of the national 
currency to the province.  The possibility of cell-phone 
banking services could fill a much needed financial services 
void for residents of Paktika's population centers where cell 
phone coverage exists. 
 
¶8.  (SBU) Then-Deputy Governor Mohammad Malik Tanai told PRT 
in October that at least half of Paktika's security problems 
stem from unemployment, with insecurity, poverty, and 
unemployment acting in a self-reinforcing cycle.  Provincial 
Council Chairman Nawab Waziri estimated that 95 percent of 
Paktika's families have at least one member working outside 
Afghanistan, typically in Pakistan, Iran, UAE, or India. 
These young men working abroad can be vulnerable to radical 
religious influences and enemy recruitment.  Provincial 
leaders believe that providing employment opportunities for 
young men would reduce labor-related emigration, increase 
community involvement in development, and foster trust of 
GIRoA among the people.  Ongoing construction trades training 
workshops carried out on FOB Sharana by Task Force Castle are 
helping to develop a skilled workforce, but more such efforts 
are needed. 
 
¶9. (SBU) Comment:  Paktika exemplifies the vicious cycle that 
now pertains in many provinces )- today,s level of 
insecurity makes it difficult to address the lack of basic 
government services, ignorance and employment opportunities 
that are at the base of a good measure of the insurgency. 
DELL