KUNDUZ/KABUL—Heavy fighting between Afghan forces and armed opposition groups in the northeastern province of Kunduz is increasingly isolating people living in districts outside the provincial capital, where the Doctors Without Borders/Médecins Sans Frontières (MSF) trauma center has been receiving wounded patients.
Kunduz had been considered one of the more stable provinces in the ongoing conflict in Afghanistan, but fighting in the area increased significantly last year and now the so-called “spring offensive” has brought with it intense combat. In a recent three-week period, MSF medical staff in at the Kunduz trauma center treated 204 war-wounded patients, the vast majority of them injured by gunshots or bomb blasts. Of these patients, 51 of them were women and children.
"The proportion of war-wounded patients in the center has more than doubled compared to the same period last year, from 6 percent to 14 percent," says Laurent Gabriel, MSF coordinator at the trauma center. "The surgeons are dealing with severe abdominal and chest injuries, with many patients requiring a series of complex surgical interventions."
The situation is volatile and the flow of wounded arriving to the emergency room is sporadic, ranging from five in one day to as many as 35 on another. This is a reflection of the unpredictability of the conflict, as well as the difficulties that people in outlying districts have in accessing the hospital in the city.
"It is difficult to have a clear view of what is happening in the districts outside the city, where fighting is ongoing," says Gabriel. "We are very concerned that people living in these areas are not able to make it to the trauma center for treatment in time, due to the continued fighting, and the fact that they have to face numerous checkpoints to get into the city. Our patients tell us that some roads to Kunduz city are mined, forcing them to take long deviations to reach the town. Given the severity of the injuries, this delay can be fatal."
In the busy wards of the trauma center, some patients who have finished treatment are refusing to be discharged from the hospital because they fear going back home to the districts. Throughout the province, Kunduz residents restrict their movements to the minimum and prefer to stay indoors. As a result, the number of traffic accident victims arriving to MSF’s trauma center has decreased significantly—from 109 patients the first week of April to 60 in the first week of May. The emergency rooms remain busy, however, with the medical teams treating 1,470 patients over the past three weeks
"For more than a year, Kunduz province has been shaken by military operations. It’s become a chronic conflict zone where the opposition and the government are clashing constantly, with the shifting support of local militias on both sides,” says Guilhem Molinie, MSF country representative. “Local residents, who have no choice but to go on with their lives, risk being shot or killed while playing in their courtyard, harvesting their field, or going to the bazaar."
MSF started working in Afghanistan in 1980. In Kunduz, just like in the rest of Afghanistan, both national and international 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, Dasht-e-Barchi maternity in western Kabul, and 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.