Working to improve paediatric care in Boost hospital, Helmand province, Afghanistan

Over the last months, the breadth of medical care given to the nearly 300 new patients seen weekly across departments, including maternity, surgery and pediatrics, has been improving, and quality drugs are now available for free. “Pediatrics is one of the most important components of the hospital’s services,” said Dr. Dorian Job, MSF medical coordinator .

“In Afghanistan, we often talk about the high levels of maternal mortality, when in fact child mortality can be up to ten times higher.” The pediatric department admits nearly half of the hospital’s patients, five to ten percent of which are newborns requiring special attention. “We’re seeing around 20 new children a day,” said Dr. Sergio Cabral, MSF’s pediatric doctor. “With only 16 beds in two wards, we’re stretched to capacity, so we put nine extra beds in the corridors. Clearly, this situation is far from ideal, which is why we are hoping to expand the pediatric ward soon.” As such, Dr. Cabral’s main goal over the past months has been to train pediatric staff in proper diagnosis and treatment. “Even simple coaching can help to change the way patients are managed here. We’re saving children who otherwise might be misdiagnosed and given the wrong treatment.”

Fourteen-month old Guhl*, was admitted two days ago with severe dehydration, malnutrition and infection. Her mother Jamila, 30, describes a pattern common among desperate parents here in Helmand. “My daughter has had diarrhea for the last four months,” she said. “We tried many private clinics that prescribed lots of different medicines which were very expensive, but nothing worked. When she became unconscious, they told me to bring her here.” On arrival, Guhl was immediately put on a drip containing a mixture of salts, lactate and glucose, along with oral rehydration salts and special milk.

“It’s a really simple treatment, but with a child as fragile as Guhl, it has to be given and monitored properly,” stressed Dr. Cabral. “We advise staff here that simply giving antibiotics for diarrhea can be potentially fatal if they are prescribed incorrectly, whereas careful rehydration and feeding can be very effective. Guhl is awake and stable now, with children, small changes can mean big improvements.” Since January 2010, over 1,500 children have received care in Boost hospital’s pediatric department.

* Names have been changed to protect the anonymity of the patients.

MSF chooses to rely solely on private donations for its work in Afghanistan, and does not accept funding from any government. In addition to its support to Boost hospital in Lashkargah, MSF currently supports Ahmed Shah Baba hospital in eastern Kabul. In both locations, MSF aims to provide life-saving and free medical care using effective drugs, working in all areas including maternity, pediatrics, surgery and emergency rooms. MSF will be extending its support to hospitals and rural health centres in other provinces in Afghanistan towards the end of 2010.