Médecins Sans Frontières
afghanistan Conflict in Afghanistan continues to limit access to quality healthcare services.
People in need of healthcare must often travel long distances, across insecure areas, to reach public medical facilities. A lack of trained medical staff, particularly female doctors and nurses, further restricts access for many. Médecins Sans Frontières (MSF) is expanding its work at several hospitals, aiming to meet some of the most urgent needs. (For more on access to healthcare in Afghanistan, and the challenges to delivery, see pages 16 – 17.) Trauma care in Kunduz The trauma centre run by MSF in Kunduz is unique in northern Afghanistan, providing free, high-quality surgical care to victims of general trauma such as those resulting from traffic accidents, as well as people with conflict-related injuries. Before the hospital opened, most people with life-threatening injuries had to travel to the capital, Kabul, or to Pakistan for treatment. MSF developed the trauma centre in 2012 with a new emergency room, including more beds for resuscitation and observation. The centre now has a new, larger outpatient clinic, better physiotherapy services and improved infection control and sterilisation procedures, in preparation for the introduction of internal fixation in orthopaedic procedures. Staff in the intensive care unit also implemented new protocols.
Kunduz
Lashkargah
Kabul khost
Cities, towns or villages with MSF activities
Key medical figures: • 332,300 outpatient consultations • 16,580 births assisted • 7,240 surgical procedures
When multiple patients arrive at a health facility at the same time, emergency medical staff use triage so that those with the most critical needs get immediate attention. This type of ‘mass casualty response’ is a significant part of MSF’s work in Afghanistan, and took place on average once per month in 2012 in Kunduz, sometimes involving large numbers of people with life-threatening injuries. During civil unrest in February, 50 patients were brought to the hospital: more than 15 were severe, urgent cases. In August, 20 people were seriously injured in an explosion in the north of the province, and in September staff tended
to 33 casualties from a bus collision. Over the year, 10,000 patients were treated in the emergency department and surgeons carried out 1,500 operations. Ahmad Shah Baba hospital, Kabul The population of Kabul has swelled to more than three million as people migrate or are displaced due to conflict, and refugees return from Pakistan. MSF began working in Ahmad Shah Baba clinic in eastern Kabul in 2009, upgrading it to a district hospital with an emergency department, operating theatre, outpatient clinic, maternity ward and tuberculosis
Abdullah * 40 years old, Helmand province
© Francois Dumont/MSF
Our houses are destroyed. Our children are hurt. Even our wounded are helpless. One is putting bombs under our feet. The other is dropping them on our heads. Where can we go?
Mohammad, 70, was sitting in front of his shop in Lashkargah when a bomb exploded. He has various wounds and is still in shock.
26 afghanistan
Vaccination is needed everywhere, but there is a war in Afghanistan. There is no peace. Sometimes it’s quiet, but then the fighting starts again. What we need is a proper clinic in a safe place. We had to leave our homes. It’s been one year since we’ve been to our village. Two months ago we arrived in this new place. Still there is fighting. This is our reality – still there is war. The patient’s name has been changed.
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