Heavy clashes between Afghan security forces and armed opposition groups in Afghanistan's northeastern Kunduz Province resulted in a surge in wounded patients arriving at the Doctors Without Borders/Médecins Sans Frontières (MSF) trauma center in Kunduz city. From June 20 to 23, MSF medical teams treated 77 patients directly wounded in the fighting, one-third of whom were women or children.
The majority of wounded patients admitted to the trauma center came from Chardara District, around six miles from Kunduz city, which has been engulfed in fighting since June 20. The bulk of patients had sustained bomb blast or gunshot wounds, with MSF surgeons treating severe abdominal, limb, and head injuries. Active fighting has decreased since Wednesday, but the situation remains tense.
Caught in the Crossfire
“Civilians have been caught up in the four days of intense fighting, with shells hitting homes,” says Heman Nagarathnam, MSF’s head of programs in northern Afghanistan. “On Monday, three women and three children from a village in Chardara District were admitted to MSF’s trauma center suffering injuries after their home was hit overnight.”
Kunduz province has seen a significant increase in fighting since last year. This week’s influx of wounded follows another wave of violence in May, when MSF teams treated 204 war wounded patients in three weeks.
Ongoing insecurity makes it is extremely difficult for people to reach Kunduz city from Chardara District, particularly at night when there is a risk of being caught in crossfire, hitting landmines, or being delayed at multiple checkpoints.
“Our team is able to assist patients who can make it to the center, but we are very concerned for the people who cannot reach the city in time,” says Nagarathnam. “MSF’s center is the only facility in the whole northeastern region of Afghanistan able to provide life- and limb-saving trauma care, so people have no choice but to risk the dangerous journey to reach us.”
On Monday night, ten children and adolescents between 8 and 18 years of age were brought to the trauma center with injuries sustained when a shell hit the mosque where they were studying. The community members who brought the wounded to the center told MSF’s staff that approximately 30 young people were in the mosque when the mortar hit, but, given how difficult it is to reach Kunduz city, they decided to bring only the ten most severely injured.
“What would normally be a 30 minute journey took them two hours,” says Nagarathnam. “After driving part of the way, they were afraid to hit landmines on the road, so [they] decided instead to walk by a different route, carrying the children. They then took a boat along the Kunduz River and were fired on when they were mistaken for combatants. Once they finally reached Kunduz city, they flagged down vehicles to take them the remainder of the way to the trauma center.”
Given the enormous difficulties people in Chardara District face in reaching Kunduz city, MSF is taking steps to help improve their access to medical care. On June 23, MSF opened a stabilization post in Chardara District, where nurses will provide immediate care to trauma patients before they can be transported to Kunduz city.
MSF started working in Afghanistan in 1980. In Kunduz, as in the rest of Afghanistan, both national and international MSF staff work together to ensure the best quality of treatment. MSF supports the Ministry of Public Health in Ahmad Shah Baba hospital in eastern Kabul, providing maternity services in Dasht-e-Barchi in western Kabul, and managing Boost hospital in Lashkar Gah, Helmand province. In Khost, in the east of the country, MSF operates a maternity hospital.
MSF relies only on private funding for its work in Afghanistan and does not accept money from any government.