Reinforcing emergency healthcare in Helmand, Afghanistan

Dr Khalid Rahman sutures a farmer from outskirts of Lashkargar, attacked and beated earlier that day. Helmand’s one million inhabitants continue to suffer from the effects of the ongoing conflict between coalition and Afghan government forces and various opposition groups. In Lashkargah, the capital of Helmand province, where MSF has been supporting activities in Boost Hospital since November, 2009, the need for emergency medical assistance remains acute.

Kate Ribet/MSF

“The emergency room was only open for four hours in the morning, after which patients had to go to the inpatient department in the main hospital. There was also a huge shortage of medicines and functional equipment” explained Volker Lankow, MSF’s Field Coordinator in Helmand.

The recently upgraded emergency room, is now seeing a rise in the number of war-related injuries. Dr. Khalid Rahman, who has worked as a surgeon in Boost for the last four years, currently spends two days a week on rotation in the emergency room. This morning, together with two nurse assistants, Dr. Khalid has seen 31 patients in the last two hours alone.

“We get around four to five war-wounded a day, sometimes more, not to mention serious injuries from traffic accidents or domestic incidents,” he said. “Lashkargah is a dangerous place but we don’t allow weapons in the hospital.” Aasif*, 40, brought his wife and ten-month old daughter from Marjah province. As he watches Dr Khalid remove his crying daughter’s stitches, Aasif explained, “My wife and child were travelling near Marjah province when their car came under fire. My wife was shot in the leg, and my daughter was hit by a bullet in the leg and waist. They’ve been in Boost hospital for a month now, and my daughter’s getting her stitches removed today. We’re finally going home. It’s difficult to see my child still in this much pain.”

We’re finally going home. It’s difficult to see my child still in this much pain. Aasif

Boost is one of only two remaining public referral hospitals in south Afghanistan. This means that those who need urgent medical care often have to travel at great risk and expense to receive it. “I have had to spend a lot of money on transport,” confirmed Aasif, “so it was a relief to be able to get my family treated for free.” In another bed lies Nair*, 40, a farmer from the outskirts of Lashkargah. He is barely conscious after he was attacked by a group of men, leaving him with deep wounds in the head. After Dr. Khalid sutured his gashes, he was given a fresh change of clothing and dispatched to the hospital’s inpatient department for a few nights of observation. Especially in a conflict area, emergency response is a crucial part of a hospital’s services.

“It is a 24 hour frontline that can stabilize patients and give them immediate care, after which they can then be referred to other departments for monitoring or specialized treatment,” said Lankow, MSF’s Field Coordinator. Over 4,000 patients have been seen in the emergency room since May 2010.

* 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.