In the wake of intense fighting and the rapid transfer of power to the Islamic Emirate of Afghanistan (also known as the Taliban), people are facing widespread instability, mass displacement, and the disruption of basic services, including health care. Despite the challenges, Doctors Without Borders/Médecins Sans Frontières (MSF) teams continue to provide essential medical care across all five of our projects in Afghanistan—in Herat, Helmand, Kandahar, Khost, and Kunduz provinces. Here, two medical staff members working in Lashkar Gah (Helmand province) and Khost city describe the recent changes they have witnessed, and how they have affected patients and health care providers alike.
Names withheld to protect anonymity.
Lashkar Gah: “We are receiving over 700 patients a day in our emergency room”
Relative calm has returned to Lashkar Gah, Helmand province, but anxiety and uncertainty linger. Many people who delayed seeking medical care during the fighting are now coming to the Boost provincial hospital, which is supported by MSF. Over the past few days, the emergency room has been full.
Many patients are suffering from respiratory illnesses, gastrointestinal problems, and trauma-related injuries sustained in the fighting and road traffic accidents. From August 15 to 21, more than 3,600 people were treated in the emergency room, and 415 were admitted to the hospital. Here, a medic working at Boost hospital shares their experience.
“On August 1, I came to Boost provincial hospital in Lashkar Gah and spent thirteen days working there. The medical needs were very high. We received a lot of patients wounded in the fighting. But most of our regular patients ... stayed away because access to the hospital was at times made impossible by the conflict. [Before the fighting, the hospital saw around 500 people a day, including sick children, pregnant women, and patients in need of routine surgical care.]
Our staff had little rest. When patients came in, we would wake up and run to the emergency room. We stayed in the hospital to treat our patients. It was very dangerous outside.
After the fighting ended on August 13, we stopped hearing the heavy sounds of airstrikes, rockets, and mortars. The roads in the city and in the surrounding districts are open, and people are once again coming to the hospital. Patient numbers have increased tremendously.
For the last week or so, we are receiving over 700 patients a day in our emergency room, sometimes more than 800. On August 21, we treated 862 people, which I think is the most we’ve ever received. Some patients are coming in critical condition because they waited until the fighting had stopped.
One reason we are seeing this huge number of patients at our hospital is, I think, because other local clinics are not able to meet the needs of the people. We send around 200 less-critical patients to these clinics each day, but many come back reporting that the clinics don’t have the drugs they need or that they are closed due to a shortage of staff.
Our hospital is now full in terms of the number of patients we can admit. We have more than 300 patients already being treated in the hospital. We already have more patients in our hospital than we have beds, so the more patients we receive in the emergency room, the greater the problem is to find space for them inside the hospital.
They are waiting a long time in the emergency room while we try to find space. We have two patients to a bed in the pediatric ward, but we are still struggling to find room for everyone. So we assess the severity of each patient’s condition, because the more severe things are the more they need admitting.
Each day, between 80 and 100 of the people we assess have severe enough conditions that they must be treated as inpatients in the hospital. This forces us to discharge other patients to make room for them. This is one of the big challenges at the moment.
I don’t know how we can solve it in the long term, but for now we are decreasing the length of stay and discharging [people] with the medicine they need unless they are in a very critical state. Our intensive care unit is also full. All the districts are now open, so that’s another reason we are receiving so many patients, as they are coming from outside the city.”
