A few days ago, Dr. Zanidin Amin sent his seven children and the rest of his family back to their hometown of Marjah, a district outside Lashkar Gah, the capital of southern Afghanistan’s Helmand Province. Their house in the capital had been hit by bullets during heavy fighting between Afghan Government forces and armed opposition groups.
Dr. Amin works in the pediatric ward of the 300-bed Boost Hospital in Lashkar Gah, where Doctors Without Borders/Médecins Sans Frontières (MSF) has supported the Afghan Ministry of Public Health since 2009. In early October, fighting in the Lashkar Gah area intensified and MSF teams in the hospital treated 34 wounded patients. Many people fled the city, including a large number of patients who left the hospital because they feared they would be trapped if fighting reached the city itself.
"I was in the pediatric intensive care unit and suddenly saw many people starting to leave the hospital wards," recalls Dr. Amin. "On a single day we went from almost 300 patients to around a hundred. I would say that at least half of those who left from the pediatric ward still needed critical care, including some who were receiving oxygen. Although it was against medical advice, people left because they were scared."
Fewer people came to the hospitals thereafter. Figures show that the number of daily emergency cases has dropped by around 30 percent on average, from 33 at the beginning of October to just 23 three weeks later.
"We were in Lashkar Gah for the wedding of my husband’s brother, but then my baby became sick so we brought him to the hospital," explained the mother of a young patient. "My husband says the city may be attacked and it is not safe, so we will leave as soon as possible."
People come from all over conflict-battered Helmand Province to receive treatment at Boost Hospital. The facility is the only public hospital in Lashkar Gah that provides specialized pediatric medical services.
"Some private clinics are available in the city, but they are expensive, so people usually prefer to come to our hospital because it is free,” Dr. Amin explains. “Besides, during the heavy fighting many clinics and health centers closed and their staff left."
While the situation in Lashkar Gah has calmed somewhat since mid-October, fighting continues in several parts of Helmand, making it very difficult for patients to reach Boost Hospital. "Many patients, especially those in far away districts, have difficulty reaching us because many roads are closed due to fighting or improvised explosives. Journeys that in normal conditions take half an hour can now take three, four, and even six hours," says Dr. Amin.
"It took us seven hours to come here by car, three times longer than usual," recalls the mother of a young patient at the hospital. "The fighting forced us to stop many times on the way, although we were in a hurry to come to the hospital with our sick child. We could not wait for more passengers, so we had to rent the whole car and that cost us 10,000 Afghani (about $150). We had to borrow that money and it will take us a long time to pay that back."
During the heaviest fighting, Dr. Amin stayed at the hospital day and night. Now he can go home when his shift is over, but he sleeps alone in the house in Lashkar Gah, which used to be home to 30 members of his family. "I left my clinic in Marjah two years ago because clashes were increasing there and I moved with my whole family to Lashkar Gah," he says. "So it’s not the first time we’ve had to run away from the war. Sometimes I want to leave Lashkar Gah and go with my family, but my job is here and I want to help."
MSF started working in Afghanistan in 1980. Since 2009, MSF has run various departments of Boost Hospital in partnership with the Ministry of Public Health. In 2015, MSF teams performed almost 80,000 outpatient consultations, admitted more than 33,000 patients, and assisted more than 12,000 deliveries.
MSF also supports the local authorities in Ahmad Shah Baba Hospital in eastern Kabul and Dasht-e-Barchi Maternity in western Kabul. In Khost, in the east of the country, MSF operates a maternity hospital.
MSF is also preparing to open a multidrug-resistant tuberculosis diagnosis and treatment facility in Kandahar. MSF relies only on private funding for its work in Afghanistan and does not accept money from any government.