With porous borders, creaking hospitals and large illiterate populations, Afghanistan and Pakistan face a potentially devastating health crisis after the new coronavirus erupted in neighbouring Iran.

Islamabad has closed official border crossings while Kabul has suspended all travel to the Islamic republic, which has reported 19 deaths and a total of 139 infections -- making it one of the hardest hit countries outside the virus epicentre China.

Afghanistan has one confirmed case of coronavirus -- a patient who had recently been in Iran where millions of Afghans live
Afghanistan has one confirmed case of coronavirus -- a patient who had recently been in Iran where millions of Afghans live AFP / WAKIL KOHSAR

But experts fear the measures could prove ineffective with thousands of people -- refugees fleeing violence, Shiite pilgrims, smugglers and migrants looking for work -- likely crossing the long, poorly patrolled frontiers every day.

The virus has spread to more than 30 countries, killing over 2,700 and infecting 80,000, mostly in China. But new outbreaks in Europe, the Middle East and in Asia have fanned fears of the contagion taking hold in poor nations which lack the healthcare infrastructure to cope.

Pakistan announced Wednesday its first two cases of the virus. Officials said one of the infected individuals was a 22-year-old Karachi male who had acquired the virus in Iran. While they did not confirm where the second case was reported, local media placed it in Islamabad.

Afghanistan's healthcare system is in tatters after more than four decades of war and there are fears it would not cope with an outbreak of the new coronavirus
Afghanistan's healthcare system is in tatters after more than four decades of war and there are fears it would not cope with an outbreak of the new coronavirus AFP / WAKIL KOHSAR

Afghanistan meanwhile announced Monday its first virus infection involving a patient who had recently been in Iran where millions of Afghans live.

Afghan television and radio broadcasts have begun advising people on how to prevent transmission of the virus, while residents have rushed to buy face masks -- straining supplies and sparking a tenfold increase in the cost of a single mask at some pharmacies in the capital Kabul.

There are growing fears over how Pakistan would deal with an outbreak of the coronavirus given its history of failing to contain infectious diseases
There are growing fears over how Pakistan would deal with an outbreak of the coronavirus given its history of failing to contain infectious diseases AFP / Banaras KHAN

"We are worried, we don't have a proper functioning health system and the borders are open. All we can do is take some preventive measures and pray to God to help us," said Ihsanul Haq, a government employee.

Afghanistan's healthcare system is in tatters after more than four decades of war, with the few available hospitals focused mainly on basic care and trauma. They lack the expertise to deal with infectious diseases.

"It could be a disaster if the virus really spreads all over the country. There aren't that many health centres," said Wali, a Kabul-based physician, who specialises in viral infectious diseases.

Pakistan has sealed off its frontier with virus-hit Iran in southwestern Balochistan province in a bid to prevent an outbreak in the impoverished region
Pakistan has sealed off its frontier with virus-hit Iran in southwestern Balochistan province in a bid to prevent an outbreak in the impoverished region AFP / Banaras KHAN

"The government is doing what they can to contain the spread of the virus. But it is very difficult."

Adding to the challenge of limiting the spread of the virus is the Afghan tradition of greeting family and friends with handshakes, hugs and kisses.

A doctor checks the temperature of a man on February 25 as he returns from Iran to Pakistan, where two cases of novel coronavirus have been confirmed
A doctor checks the temperature of a man on February 25 as he returns from Iran to Pakistan, where two cases of novel coronavirus have been confirmed AFP / Banaras KHAN

A largely illiterate population also makes it difficult to educate people about ways to stop the transmission.

"People are illiterate, you can't get the message through to them," Wali said.

Iran security forces
Security forces stand on alert and trucks wait after the closure of the border between Pakistan and Iran as fears grow over a jump in new coronavirus infections. The country reported new deaths and confirmed infections on Wednesday as thousands of prisoners are set for temporary release from prison. AFPTV / Syed ALI

Across the border in Pakistan there are growing fears over how the country would deal with a potential outbreak.

Islamabad has a history of failing to contain infectious diseases such as polio, tuberculosis and hepatitis.

Adding to the challenge, hundreds of thousands of quack doctors are thought to be working across the country and scandals involving the use of dirty needles in healthcare settings have eroded public trust in the system.

Some Pakistani students trapped in the Chinese city of Wuhan -- where the virus was first detected in December -- told AFP recently they were nervous about returning to their country if authorities were to evacuate them.

"We are worried about how the authorities are going to treat us when we go back to Pakistan -- some students who went back told us the officials treated them very badly," Ruqia Shaikh said.

While Pakistan has closed land borders with Iran, it has maintained air travel to and from China -- increasingly a source of trade and commerce for the country.

"There is a limited concept of prevention unfortunately. I fear it's not well prepared at all for any health emergency," Pakistani public health expert Arshad Altaf told AFP.

Pakistan this week moved quickly to quarantine at least 270 people near the Iranian border after a group of pilgrims returned and briefly mixed with other residents.

That came hours after Pakistan sealed off its frontier with Iran in southwestern Balochistan province, which remains vulnerable to a public health emergency.

Decades of fighting a separatist insurgency and militant violence, along with neglect from the central government, have left the impoverished area with little infrastructure.

At the Taftan border crossing long queues of trucks waited in hope of being allowed into Iran, as residents and officials donned surgical masks.

"There is no information sharing whatsoever," said resident Khuda Baksh, chiding officials for failing to keep locals informed about the situation.

"There is fear and panic among the public, our business and lives are at risk."