In 2015, the Doctors Without Borders/Médecins Sans Frontières (MSF) hospital in Kunduz, Afghanistan, was destroyed by US airstrikes. Forty-two people were killed, including patients, MSF staff, and caretakers. For the last few years, we have been working to rebuild a new trauma center in the city, even amid escalating conflict between the Islamic Emirate of Afghanistan (also known as the Taliban) and Afghan government forces.
During the intense clashes last month, MSF transformed its Kunduz office space into a temporary trauma unit to care for wounded people. On August 16, these patients were transferred to the nearly-finished Kunduz Trauma Center. This facility will employ 300 Afghans when it is fully operational, including staff members who survived the initial US attack six years ago. Many local people still need significant trauma care. Here, a medic on MSF’s Kunduz team describes his experience during the recent fighting and the work that is taking place now.
Today it is busy but calm. We’re recruiting new staff, and the final steps of the construction process are taking place all around us.
The first evening we opened, there was continuous bombardment and shooting. We had to rush to the bunker, and we stayed there all night, without any sleep. Patients were not able to reach the trauma unit at that stage, on account of the non-stop fighting in the streets.
The following morning, we got news of multiple victims arriving in the unit, but we could not get there because there was fighting in the street between where I was staying and the unit. Our colleagues were asking for our help very urgently, because they had a patient who had gunshot wounds in his chest and stomach that required immediate surgery.
A moment came when the guns were finally quieter, and it was possible to move. Three of us ran to the other side of the road to the operating theater. The patient had just lost his pulse, so we started chest compressions while the anesthesiologist looked for an airway.
I cut two holes in the chest to make sure blood could drain out and to allow the lungs to expand. Meanwhile, another colleague was trying to stop the bleeding below the sternum. We could tell pretty quickly that the bullet had probably hit part of the heart, and it rapidly became clear that there was no way that we could save him.
Hard days
That was the start of our day of hell. And the first moment of our team being completely overwhelmed. There were a lot of other victims who came in and had to go to surgery: many had gunshot wounds, others were injured by bomb blasts or were caught in the crossfire.
Much of our staff could not reach the trauma unit. The night-shift staff worked through the day. Some would take naps and sleep while others worked so we could keep staff going from morning and into the night.
At about 6:30 a.m. the next morning, an ER doctor called me on the radio, saying “I need your help now.” As the fighting receded, I ran with the surgeon across the road. The hospital unit was crammed.
Four patients urgently needed emergency surgery, all at the same time. We started doing lifesaving surgery on two patients while also doing everything possible to keep the other two alive. We eventually proceeded to operate on them too. In the end, one patient died, but three survived, which is quite remarkable—they all had very severe gunshot wounds and bomb blast injuries. While waiting for space to open up in the operating theater, and trying to keep the other two alive in the emergency room, we still needed to assist other patients who had come in and needed care.
