Afghanistan: Medical needs urgent as ever after Taliban takeover

Kunduz Emergency Trauma Unit

Afghanistan 2021 © Evangeline Cua/MSF

Doctors Without Borders/Médecins Sans Frontières (MSF) teams in Afghanistan are continuing to provide medical care across all five of our projects in Herat, Helmand, Kandahar, Khost, and Kunduz provinces. Despite intense fighting in recent weeks, our teams did not stop providing vital medical care. Sustaining these health services under extreme pressures is a testament to the dedication of the some 2,300 MSF staff members working in the country.

On Sunday, August 15, after months of intense fighting, the Islamic Emirate of Afghanistan (IEA, also known as the Taliban) entered the city of Kabul as the government collapsed. The IEA has declared that the war is over and assumed control over the country. 

While many individuals and organizations have fled Afghanistan, our teams are staying put to provide essential medical care to people across the country. Given the current instability, the displacement of large numbers of people, and acute health needs, we are concerned about the ongoing humanitarian crisis. 
Since the end of the fighting we have seen a change in the needs that people present within our projects, and many of our facilities are now full. We are seeing people who were injured in the fighting and require follow up-care, as well as patients with a variety of health conditions who now find it safer to travel to access medical care.

MSF runs a wide range of medical programs in Afghanistan, including an intensive therapeutic feeding center for sick and malnourished children and a COVID-19 treatment center in Herat, support for Boost hospital in Lashkar Gah, a maternity hospital in Khost, a trauma center in Kunduz, and a drug-resistant tuberculosis project in Kandahar.

During the fighting, MSF also treated large numbers of war-wounded people in our projects in Lashkar Gah and Kunduz. We provided health care to displaced people in Kandahar and Kunduz, setting up new activities in response to the increased needs. Now that fighting has ceased in the provinces, the number of patients seeking care in our projects has actually increased as people are able to move about more easily.

Many local health facilities are under enormous pressure with staff and equipment shortages, meaning that some people cannot access the care they need.

    MSF operations in Afghanistan

    Increase of patients in Herat clinic

    In Herat, in western Afghanistan, the MSF team has seen a slight reduction in the number of patients arriving at our COVID-19 treatment center and inpatient therapeutic feeding center (ITFC). However, at our clinic in Kahdestan—on the outskirts of Herat, where we provide outpatient care, treatment for noncommunicable diseases, and sexual and reproductive services—we have seen an increase in patients after other clinics in the area suspended their activities.

    Key figures:

    • On August 15 and 16, we provided 200 patient consultations at the Covid-19 treatment center—44 patients were admitted in severe and critical condition
    • Between August 9 and 15 August, 47 children were admitted to the inpatient therapeutic feeding center; 20 percent were younger than six-months-old
    • Between August 9 and 16, we provided 555 consultations at our Kahdestan clinic

    Displaced people in Kandahar

    During the fighting, MSF was able to continue its care for patients living with drug-resistant tuberculosis (DR-TB) by offering remote consultations and providing buffer stocks of medication so that they could avoid crossing frontlines to access care. 

    The Haji camp for internally displaced people—where 5,000 people were staying—is now largely empty. MSF is looking to relocate its temporary clinic to a location closer to our TB center so that we can continue providing health care to children under five years old. The main health issues we saw in Haji camp were diarrhea, upper respiratory tract infections, anemia, and eye and skin infections.

    Key figures:

    • We treated 179 patients at our temporary clinic in Haji camp
    • Between August 10 and 16, our TB center admitted three new patients and carried out 28 outpatient consultations

    Accessing maternity care in Khost

    MSF has continued providing care to pregnant women and newborns in our maternity hospital and in the eight comprehensive health centers (CHCs) we support in Khost. In July, we helped to deliver 1,450 babies in the maternity hospital and more than 870 in the CHCs.

    Recent instability in Khost has made it difficult for people to access health facilities, so MSF expanded its admission criteria beyond complicated obstetrics to ensure access to safe maternal and neonatal care for the community. We saw a reduction in patients during that period, but the number of admissions is now returning to normal.

    Key figures:

    • Between August 15 and 17 August MSF admitted 100 pregnant women and assisted 77 deliveries

    Trauma care in Kunduz

    The situation in Kunduz is now calm. On August 16, we moved all patients from the Kunduz Emergency Trauma Unit (KETU) to the new Kunduz Trauma Center (KTC), which has been under construction since 2018. The KTC will initially have 30 beds and one operating theater. We are treating people injured in accidents as well as people wounded in the fighting.

    Key figures:

    • Between August 9 and 14 we treated 63 patients, the majority for wound care

    Addressing a spectrum of needs in Lashkar Gah

    The situation in Lashkar Gah has also stabilized, and people who delayed seeking medical care during active fighting are now coming for care. Over the past few days, the emergency room has been full—many people have respiratory problems, gastrointestinal problems, and trauma-related injuries related to the fighting or road traffic accidents.

    Key figures:

    • Between August 12 and 16 we assisted 215 deliveries (we’re currently assisting around 50 deliveries each day), provided 105 surgical procedures, and treated 65 war-wounded people
    • On August 17 we provided 815 consultations in our emergency room and are currently providing care to 300 people in our inpatient department

    MSF is a medical humanitarian organization operating under the principles of independence, impartiality, and neutrality. Since the 1980s, MSF has provided medical care throughout Afghanistan in areas under the control of a variety of political and armed factions. In Afghanistan, MSF relies solely on private funding and does not accept funds from any government for its work.