Starvation, disease, death, war, and migration had devastating effects on Afghanistan's health infrastructure in the 1990s. According to the World Health Organization, medication was scarce. Infectious diseases accounted for more than half of all hospital admissions (mostly malaria and typhoid) in 1994. Even before the war disrupted medical services, health conditions in Afghanistan were inadequate by western standards. A national medical school was established in 1931 and, in the following year, the first tuberculosis hospital was built. In 1990, for every 100,000 people, 278 were stricken with tuberculosis.
Efforts to take medical services to war-ravaged areas of Afghanistan and to areas left without public health programs due to the termination of services were waged by volunteer medical programs from France, Sweden, the US, and other countries.
In 1991, there were 2,233 doctors, 510 pharmacists, 267 dentists, 1,451 nurses, and 338 midwives. Between 1985-1995 only 29% of the population had access to health services. During those same years, few of the population had access to safe water (10%) and adequate sanitation (8%). For children under one the immunization rates were as follows: tuberculosis (44%), diphtheria, pertussus, and tetanus (18%), polio (18%), and measles (40%) between 1990–94.
In 2002, estimated life expectancy was 46.6 years—one of the lowest in the world—and infant mortality was estimated at 145 per 1,000 live births, which makes the country have the world's fourth highest mortality rate for children under age 5. The maternal mortality rate in 2002 was one of the highest in the Central Asia region with 1,600 maternal deaths per 100,000 live births. The death rate in 2002 was 17 per 1,000 people. Cholera reached epidemic proportions with 19,903 cases reported in 1995. In 2002, 80,000 children a year were dying of diarrheal disease. From 1978 to 1991, there were over 1,500,000 war-related deaths. It is estimated that 3767 civilians died because of US bombs in Afghanistan between October 7 and December 7 of 2001. Approximately 300–400 civilians were killed betweeen October 2001 and July 2002.
As of 2002, Afghanistan had an average of four hospital beds for every 10,000 people. Most of the country's facilities are in Kabul, and those needing treatment must traverse the countryside to get there. Health care is being provided by the international community primarily. Some military field hospitals were set up as a result of the US-led coalition war. There are some medical facilities supported by the Red Cross operating in the country. In 24 of 31 provinces there are no hospitals or medical staff. For every 10,000 people in the country, there is an average of 1.8 physicians. Primary care physicians are most needed for pediatrics, women's health, internal medicine, and ob-gyn. Afghan physicians need training and retraining to upgrade their skills and knowledge base.