The U.S. military’s days in Afghanistan may be numbered, but for many humanitarian workers—including Anne E. Goldfeld, associate professor of medicine at Harvard Medical School (HMS)—the work is just beginning.

Goldfeld, along with two researchers from the non-profit American Refugee Committee (ARC), returned from a two-week mission to Afghanistan to treat tuberculosis among Afghani refugees last month.

“The situation is urgent,” says Goldfeld, who besides being a board member of ARC is also an infectious disease specialist at the Brigham and Women’s Hospital.

Facing disease, drought and poor nutrition, thousands of refugees have flocked to Afghanistan-Pakistan border. Most, newly arrived and seeking shelter from the U.S. war campaign, are in desperate need of medical attention.

Goldfeld visited three refugee camps in northwest Afghanistan, in addition to meeting with newly installed officials in Kabul who endorsed ARC’s efforts.

In Dire Need

Afghanistan currently has one of the worst tuberculosis problems in the world. It is estimated that 60,000 to 70,000 new cases of tuberculosis are diagnosed each year in Afghanistan and that 15,000 people die of the disease, according to the most conservative estimates.

As of now, half of those with the disease will die in five to nine months unless they get help—and the war-torn country is hardly equipped to deal with this epidemic.

“The health system is completely decimated,” says Joe Bock, interim executive director of the ARC. “The World Health Organization estimated millions of dollars to rebuild Afghanistan’s health system.”

While tuberculosis was a serious problem long before the words Taliban and al-Qaeda were part of the American vocabulary, the recent war in Afghanistan has only made matters worse.

“Crowding, cold, and lack of supplies in the refugee camps foster the spread of the contagious, airborne disease,” Goldfeld says.

“In addition, this is the fourth year of drought in Afghanistan and the economic situation there is quite dismal,” she says.

Women—whose oppression under the Taliban gained international attention—have also disproportionately fallen victim to tuberculosis.

Eighty percent of tuberculosis deaths and 70 percent of new cases are among women.

“Women spend a lot of time sequestered indoors. They are married very young, have many children and their nutrition is much worse,” Goldfeld says.