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PublicationsInternational Activity Report 2011AfghanistanDecades of conflict in Afghanistan have taken a huge toll on the quality of medical services available, and Afghans’ ability to access them. Many people face long and dangerous journeys to reach hospitals. Private clinics are often the only option, but they are expensive, unaffordable for much of the population, and the quality of care is not guaranteed. In 2011, Doctors Without Borders/Médecins Sans Frontières (MSF) significantly expanded its activities. A new hospital opened in Kunduz, providing lifesaving surgical care to the people of northern Afghanistan, and a new maternity hospital in Khost is due to open in early 2012.  Ahmad Shah Baba, KabulThe number of people living in Kabul has tripled over the past decade, with tens of thousands of displaced people fleeing more insecure areas of the country, and refugees returning from Pakistan. This has put a severe strain on health services. Ahmad Shah Baba, in eastern Kabul, has a growing population of between 200,000 and 300,000 inhabitants. MSF started working in Ahmad Shah Baba district hospital in 2009. MSF staff work in all departments of the hospital. Their focus has been to improve the quality of, and access to, free medical care, with a particular emphasis on maternity and emergency services. MSF donates medicines and equipment to the hospital. In 2011, new women’s and pediatric outpatient departments were built. Some 550 babies are now born at the hospital every month, compared with 330 in 2010, while the outpatient department sees an average of 9,000 patients per month. An Afghan family in Boost hospital, LashkargahAll names have been changed to protect patients' identities. Reda:"I live with my sons, their wives and children. We all live together in the same house. All morning we could hear bullets flying past really close to the house. Suddenly the shooting stopped and there was complete silence. The women stayed inside, and the men and children started to move outside." Abdul:"I was sitting on the windowsill outside, and my father was lying down. My little nephew, Zabiullah, was sitting next to me. I only saw an aeroplane flying over and then suddenly, this thing—they call it hawan here—exploded in our garden in front of us. I remember seeing a piece of shell fly into Zabi’s head. He died instantly." Reda:"Three of my grandchildren were killed: two boys, five and six years old, and one girl, Haifa, who was 11. The mothers were safe because they stayed inside. Nine other members of the family were wounded." Abdul:"We heard that our house wasn’t totally destroyed, but we haven’t been back yet. Every day people tell us there’s shooting, more trouble in our village. We can’t go back but we can’t stay here in Boost hospital forever either." Ali:"Landmines and fighting control our lives. My brother wasn’t able to take his son to the doctor that day because of landmines; they had to come back home. Then they were both killed at home." HelmandHelmand continues to be one of Afghanistan’s most volatile provinces, and its one million inhabitants are among those most affected by conflict. MSF started working in Boost hospital, in Helmand’s capital Lashkargah, in 2009. It is one of only two functioning referral hospitals in southern Afghanistan. The team at Boost has improved the provision of medical care across the various departments, including maternity, pediatrics, internal medicine, surgery and emergencies. By the end of 2011, the hospital was equipped with 180 beds and admitted an average of 1,500 patients per month – ten times the monthly figure of 120–160 in 2009. In 2011, MSF opened a new outpatient service, which now sees over 6,000 patients every month, many of whom have travelled from areas far outside Lashkargah. An extension to the hospital, allowing for more beds in the pediatric department, was also completed during the year. Malnutrition continues to be a chronic problem in Helmand, in particular among children, and MSF has set up a therapeutic feeding center to provide specialized care. KunduzIn August, MSF opened a new surgical hospital in the northern province of Kunduz. This is the only hospital of its kind in northern Afghanistan. The staff provide surgical care for victims of conflict as well as patients with injuries from other causes. Before the hospital opened, the main option for treatment was a long, expensive journey across the border. The hospital has 58 beds, which will be increased to 70 during 2012. It is equipped with an emergency department, two operating theaters and an intensive care unit, as well as X-ray and laboratory facilities. There are separate surgical wards for male and female patients. A full-time physiotherapist follows up patients and helps with their rehabilitation after surgery. Staff at the hospital are trained and equipped to respond quickly to serious incidents involving several severely injured patients. Since it opened, an average of 350 patients have come to Kunduz hospital every month. Most are from Kunduz, but as word has spread, MSF has also seen patients from neighbouring provinces, even from close to the Iranian border. KhostThe conflict’s impact on the country’s healthcare services has given rise to some of the highest maternal and child mortality rates in the world. The availability of decent and free maternal healthcare is very limited, and most women still give birth without assistance in unhealthy and dangerous conditions. In March 2012, MSF will open a maternity hospital in Khost province, eastern Afghanistan. The 56-bed hospital will provide quality ante- and postnatal care to women in the region, and will be equipped with an operating theater for surgery during complicated births. At the end of 2011, MSF had 496 staff in Afghanistan. MSF first worked in the country in 1980. |
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