KABUL: An increase in armed groups and the splintering of insurgent factions is cutting Afghans off from healthcare in ever greater numbers, the Red Cross has warned, days after two medical workers were shot dead in northern Afghanistan by unidentified gunmen.

Roadblocks, roadside bombs, the risk of being caught up in fighting and unprovoked attacks are all stopping civilians from getting to hospitals, and limiting travel of doctors and nurses to remote areas without clinics.

Gherardo Pontrandolfi, head of the International Committee of the Red Cross in Kabul, said: “What we observe in some areas of the country is a proliferation and fragmentation of armed actors that renders the provision of basic services to the population increasingly difficult.

“To have safe access to certain parts of the country we have to multiply contacts at all levels with different armed groups, different command structures. It’s not getting any easier.”

The Red Cross has been in Afghanistan since 1987, outlasting Soviet soldiers, civil war and the Taliban’s austere rule, and has promised to stay beyond the end of the Nato-led mission in 2014. But despite decades of experience operating in violent places, its doctors are increasingly separated from sick Afghans by the intensity of fighting across the country.

“A general lack of security prevents medics and humanitarian aid from reaching the sick and wounded just when they need it most,” Pontrandolfi told a news conference in Kabul, adding that patients were not free to travel either. “Civilians are all too often, unfortunately, caught up in the middle of fighting, they are stopped at roadblocks.”

He was speaking two days after the death of a driver and vaccination worker from the Afghanistan Red Crescent who were gunned down in northern Jowzjan province; a doctor and pharmacist are still recovering from injuries.

The group had been taking a mobile clinic to rural areas, but the drive home was considered safe for health workers, and the group has not suffered an attack like this in Jowzjan before, Walid Akbar, a Red Crescent spokesman, said.

The Red Crescent has halted work in the area as they try to find out who the gunmen were, and understand their motives, in order to avoid future attacks. But until then, the people they had been helping will have to risk dangerous roads themselves to seek help when they fall ill.

“This is not only a particularly shocking event for the people involved and their families,” Pontrandolfi said. “Something not always very visible is the side-effect of those attacks. Entire sections of the country are cut off from medical services and supply as a consequence; these are the hidden victims of such attacks.”

The Red Cross head also warned that Afghans struggles’ to get healthcare would probably increase as western troops begin to head home, taking with them the funding and attention that have contributed to improvements in everything from vaccination rates to the number of mothers surviving childbirth.

Jobs will also go as Nato and US contracts dry up, and some families may struggle to pay doctors’ fees and medical bills just as aid spending falls.

“The decline of the war economy brings also difficulties for ordinary Afghans, those who have been relying in international assistance, job opportunities that were provided by this war economy,” he said.

“The risk and concern is that despite dwindling international attention, the needs of Afghan people will not disappear.”

By arrangement with the Guardian