When 4-month-old Umar* contracted measles, his eyes were shut for five days from crying so much. He then developed pneumonia, and the private hospital treating him couldn’t help him. He eventually made it to a hospital supported by Doctors Without Borders/Médecins Sans Frontières (MSF) in Mazar-i-Sharif, Afghanistan, where he was able to access care.
"By the time we brought him here, his skin had turned blue, and he couldn’t breathe," says his mother, Farzana. "He was almost dead. He had stopped breathing, and the doctors immediately put him on oxygen. His chest was rising and falling heavily. He was in such a bad state that I thought he wouldn’t survive.”
“I didn’t know what to do,” she recalls. “When I looked at him, I thought he wouldn’t recover. Both my husband and I were in a very bad emotional state. We had no hope because two hospitals had already turned us away.”
In northern Afghanistan’s Balkh province, millions of people like Farzana struggle to access quality medical care. Despite the critical need for robust health care systems, many communities and families face severe barriers in accessing essential services at all levels—from primary care to specialized treatment—which can have far-reaching consequences for people’s health. For example, a shortage of skilled birth attendants and neonatal intensive care units (NICUs) in the region has led to higher rates of neonatal mortality, often due to preventable causes like birth asphyxia, premature births, and infections.
Umar, however, was able to recover under the care of MSF. "Now, he is doing better,” Farzana says. “His color has returned, and he can drink milk from his mouth, something he couldn’t do before ... I am very grateful to the doctors and nurses. They really worked hard to save him."
Infrastructure and economic challenges impede access to care
Throughout the region, many health care facilities are either under-resourced, understaffed, or geographically inaccessible to communities, particularly those living in remote areas. In Balkh, the few functioning medical centers are overwhelmed with patients, resulting in overcrowded wards, long waiting times, and overburdened staff.
MSF teams are witnessing the urgent need for comprehensive support—ranging from improved health care infrastructure to better-trained medical professionals—to reduce preventable deaths and enhance people’s overall health. At the same time, the socio-economic and cultural barriers that restrict families’ access to care must be addressed.
The situation is particularly dire for people coming from rural districts surrounding Mazar-i-Sharif, where health services have been suspended or stopped due to funding cuts. At the same time, families have to travel long distances on poorly maintained roads to reach functioning health care centers, paying transportation fees they can barely afford.
This burden disproportionately affects women in labor, patients with chronic conditions, and children with acute illnesses. These groups often require timely and specialized care, but the lack of an efficient referral system complicates their access to higher levels of treatment. In Balkh, however, referral systems are often dysfunctional. Many health care providers lack the resources or knowledge to properly refer patients to secondary and tertiary care centers.
These gaps in the health care system increase the risk of preventable illness and death. High infant and child mortality rates, driven by preventable diseases like pneumonia, diarrhea, and malnutrition, underscore the need for better health care access.
Caring for patients and caregivers alike
Children’s conditions can deteriorate rapidly if they arrive at a health facility late, or if their family can’t afford treatment elsewhere. Many of our young patients come to us in critical condition, with measles, pneumonia, or severe malnutrition. In October alone, our team admitted a total of 1,211 patients to the pediatric and neonatal intensive care units, and 95 patients to the measles isolation unit.
When children are admitted, their family members—most often their mothers—stay with them in the hospital to provide care and emotional support. MSF teams actively engage with caregivers through regular health education activities, including both individual and group sessions. This helps families better understand their child’s condition, treatment process, and key practices for maintaining hygiene and preventing infections.
MSF also provides psychosocial and mental health support to families, recognizing the emotional strain and anxiety that often accompany a child’s hospitalization. Dedicated counselors and mental health staff offer sessions to help families cope with stress and build resilience during their stay.
The team is also responsible for implementing infection prevention and control measures across the hospital to ensure a safe and hygienic environment. As part of these efforts, MSF constructed a fully equipped laundry facility at Abu Ali Sina Hospital to strengthen infection prevention and control practices and reduce the risk of hospital-acquired infections.
Increased investment in the health care sector is necessary
In recent months, the combined effects of reduced funding and a growing influx of patients have put a strain on remaining health services. MSF is not directly impacted by the funding cuts, thanks to our independent funding model, and our teams remain committed to delivering lifesaving care and advocating for sustained funding and support to ensure that patients receive the treatment they need.
Continued investment by humanitarian organizations and international institutions is essential to maintain service quality, protect health care workers from burnout, and safeguard the health of children.
About our work in Mazar-i-Sharif
MSF began supporting the Abu Ali Sina Hospital in Mazar-i-Sharif in 2023, in collaboration with the Ministry of Health, working to strengthen the hospital’s capacity to deliver critical and emergency care for young patients and ultimately reduce child and newborn mortality in the region.
Since 2023, MSF teams have triaged 366,002 patients and provided care for more than 8,477 pediatric patients aged 14 and below, 17,853 neonates in the intensive care units, 6,417 patients in the measles isolation room, and consulted 122,143 cases in the emergency room.
* Names have been changed
