Some people traveled for days across the harsh terrain of northern Afghanistan to reach the orthopedic center only to find its gates closed. Staff and security guards had tried to spread the word that the center was suspending operations after a Spanish physical therapist was gunned down in September, but some never received the devastating news. They stood there in tears, say local staff.
The center reopened Tuesday, but the International Committee of the Red Cross is hoping to turn it over to the Afghan government or a local nongovernmental organization — part of a major scaledown in northern Afghanistan.
The international group has operated continuously in the country for 30 years. Some of its aid workers have been abducted and killed over that span of time, but the intensity of attacks has stepped up. In the past 11 months, Red Cross workers were targeted three times. Two of the incidents took place while staff members were traveling on the country's dangerous roads. Then came the attack in September that set a new precedent.
The incident did not happen on roads where the Red Cross must rely on security guarantees from armed groups. It happened in an orthopedic center, a place where the country's war victims came for 26 years to receive physical therapy, prosthetic limbs and medical treatment along with people with polio, spinal injuries and other issues.
On Sept. 11, just days after the release of two abducted staff, a Spanish physiotherapist was treating children with cerebral palsy when a longtime polio patient took out a concealed gun from his wheelchair. The day after the death of Lorena Enebral Perez, the orthopedic center in Mazar-i-Sharif closed for more than a month.
"Immediately from the headquarters in Geneva, we began a discussion and the decision was done," says Andrea Catta Preta, the Red Cross head of communications in Afghanistan. Together with the Afghanistan team, the ICRC chose to scale back operations in the north. That decision means fewer services for 700,000 residents — and has rattled other aid groups working in the region.
"We were hit in what is most probably one of the safest places in Afghanistan. Nobody would dare touch them until this fatal day," says Thomas Glass, former head of the Red Cross' Afghanistan communications.
Two offices — one in Kunduz and another in Maimana — have closed for the foreseeable future. A larger office in Mazar-i-Sharif, known as the nerve center for Red Cross operations in the north, is being significantly downsized over the next few months.
Important programs including food distribution to the displaced and the installation of hand pumps for water have ceased. The transport of war victims to health facilities for initial treatment through the Red Cross' driver system has also been suspended. The planned structural repairs at the 150-bed Sheberghan Hospital will be completed, but the Red Cross will no longer provide medical supplies or training staff.
Security is tightening at all of the Red Cross' seven orthopedic centers in Afghanistan. There will be more unarmed security guards, metal detectors and a separate area for pat-downs of all visitors. They're covering the inside windows with plastic sheeting so that shards of glass don't go flying in explosions.
"It's a frustrating situation because we know the country; we have all the means to assist the people," says Catta Preta. But "we had no other choice."
The repercussions won't just be felt in the north. "At this time we're limiting our movements so we're not leaving urban areas, we're not going to rural areas," Catta Preta says. All of the trucks delivering food, water, blankets and other provisions to poor communities across the country have stopped.
Afghanistan has long been a dangerous place. ISIS, with the help of former Taliban groups, overran a northern district in June. The government controls less than 60 percent of the country, 6 percent less than the same time last year according to U.S. military estimates. Some 8 million people live in contested areas. And years of conflict have fragmented militant groups. "It's getting more difficult to know who the actors are, where they are, if they have a chain of command. Many of them, they don't," says Catta Preta.
In a country where 101 aid workers were killed last year, it's a feeling that other aid organizations understand. "The series of attacks on ICRC in the north have been of great concern to us," says Najia Hyder, the regional director of Afghanistan and Pakistan for Mercy Corps.
The Portland, Ore.-based organization has operated in Afghanistan for more than 30 years. And they have lost workers too. Fearing the security of their staff, Mercy Corps pulled out a team in Kunduz in September 2015 for a few months until the organization felt the area had stabilized.
In Badakhshan, a province in the north, Mercy Corps is engaged in infrastructure projects, including the construction of schools and a health center with OB-GYN and tuberculosis care. After construction is complete, the community and government take control.
Hyder says there have been no plans to reduce their operations — but that could change at any minute. She says, "For security management, it's a day-to-day decision-making."
The Red Cross will continue to facilitate visits and phone calls between families and their imprisoned relatives. Afghans show up describing how a family member went missing or was detained; then staffers track the person down by contacting detention centers. But people who relied on these services in Kunduz and Maimana will now have to travel up to nine hours to Kabul just to make a 20-minute phone call to an imprisoned family member.
Across the country, ICRC has 1,800 local hires and close to 120 foreign workers. Some 100 local Afghan staff will gradually be laid off, and about 30 of the international staff will leave the country. Catta Preta says the organization is preparing a human resources package for those who lose their job and will help try to place them with other institutions.
"I think we've reached a point where the Afghan population is almost beyond anger," says the Red Cross' Glass of the current situation. "It almost reaches a point where they lose hope."
In the past few weeks, he says, Afghans would come up to him to apologize profusely: "They want us to know that this is not the true Afghanistan. But in a way, there is desperation because it feels like this is what Afghanistan is becoming."
Sasha Ingber is a multimedia journalist who has covered science, culture and foreign affairs for such publications as National Geographic, The Washington Post Magazine and Smithsonian. Contact her @SashaIngber