KABUL (Reuters) - An ambitious U.S.-funded project to build hospitals in Afghanistan has run into the ground, with the largest hospital ever planned in the country unlikely to open in full, U.S. and Afghan officials said.
The $60 million (35 million pounds) project by the U.S. Agency for International Development (USAID) started in 2008 and aimed to meet the medical needs of over two million Afghans by 2009.
Five years on, not one of the healthcare centres built under the project is open. The biggest, 100-bed hospital in eastern Paktia province is unfinished and may never open, according to Reuters interviews with U.S. and Afghan officials.
Paktia public health director Baz Mohammad Shirzad said even if completed, the new facility is far too big for the local authorities to handle because there were not enough doctors and other staff to operate such a big hospital.
"With current possibilities, we are only able to run 30 beds," he said.
The USAID project may be small, but it portrays the wastefulness that has plagued many such programmes drawn up without examining the capabilities of local communities.
"A health centre that exists is not the same as one that is used or that actually functions," Doctors Without Borders said in a report last week.
The aid group said access to healthcare remains as dire as before the arrival in 2001 of U.S.-led forces that ousted the extremist Taliban from power.
"The story about healthcare risks being skewed by the persistent efforts of donors, the international community and the government to show peace dividends," it said.
USAID confirmed none of the healthcare facilities was in use, but said many other structures in education, healthcare and government had been completed on time.
"USAID is proud to have delivered hundreds of new public service structures to the Afghan people," said a USAID spokesman, adding that the hospital would be ready in June.
Western powers have poured billions of aid dollars into Afghanistan as a way to win the hearts and minds of ordinary Afghans and are keen to project an image of success as foreign troops withdraw from the country this year.
Development projects are subject to accusations of wastefulness and inefficiency the world over, but in Afghanistan the problem is particularly acute as people prepare for an uncertain future after troops withdraw and the security situation worsens.
Official narratives of success jar with the reality on the ground, according to Doctors Without Borders, adding that the number of people in need of access to healthcare was likely to rise to 5.4 million in 2014 from the current 3.3 million.
The study found as many as one in four Afghans in some areas had lost a close friend or relative over the past year due to poor access to healthcare across Afghanistan.
U.S. auditors, known as the Special Inspector General for Afghanistan Reconstruction, said the biggest hospital built by USAID may not open at all.
"The new hospital's annual operation and maintenance costs could exceed five times the annual operating costs for the hospital it will replace," it said in an October report.
A second, smaller hospital in neighbouring Paktika province is also unfinished and may be unsustainable, it said.
(Additional reporting by Samihullah Paiwand in Gardez; Writing by Jessica Donati; Editing by Maria Golovnina and Ron Popeski)