Crisis in Afghanistan
Our medical teams have continued to provide care to the people of Afghanistan throughout the current crisis.
Hospitals and medical facilities across the country are under extreme pressure with staff and equipment shortages due to a severe lack of funding.
For months, our teams have seen high numbers of malnourished children in our inpatient feeding centres in Helmand and Herat. This is likely due to: persistent drought, food scarcity, an improved security situation, an economic crisis and a health system in a state of disarray.
Since the change in power, Médecins Sans Frontières / Doctors Without Borders (MSF) has continued to provide life-saving medical care to people caught in the chaos.
"Our main concern now is that we’re running out of beds. At the moment, it’s two families – one mother and one child – to every large bed."
In five locations across Afghanistan, our teams are treating emergency trauma cases, supporting people with chronic conditions and welcoming new life into uncertain times.
MSF is working in Lashkar Gah and Kandahar, both in the south, Herat in the west and Kunduz in the north. MSF also runs a maternity hospital in Khost, in the east.
The information about our response, below, is correct as of 16 December 2021 and is likely to change.
Our emergency response across Afghanistan
As the only fully functional public hospital in the province, Boost hospital in Lashkar Gah is very busy. Other public health facilities both within Lashkar Gah city as well as in nearby rural provinces continue to struggle to deliver services.
The inpatient feeding centre continued to see a high number of patients in November, but slightly fewer than October (155 percent bed occupancy rate in November compared to 167 percent in October). One explanation may be that a feeding centre run by another organisation is now running at full capacity, which gives people more options.
We have seen an increased number of measles cases in November, 425 compared to 270 in October. The majority of cases are children under five, and those with severe measles and complications are admitted in the isolation ward.
In November, the maternity staff assisted 1,912 deliveries. This is the third consecutive month that MSF has assisted over 1,900 deliveries in Boost.
Our emergency room continues to be extremely busy. We are supporting the Ministry of Public Health’s Fatima Bayat hospital in Lashkar Gah with medical supplies and medication so that they can treat the less serious cases that we refer to them.
From 1 – 30 November:
- 18,353 patients were triaged and treated in the emergency room, of which over 2,500 were admitted
- More than 1,900 deliveries assisted
- 240 children admitted to the inpatient feeding centre
The health system in Kunduz continues to be strained, as many staff have not been paid for months and often come to work for only a few hours a day.
Medical and logistical supplies continue to be lacking in the public health system, and the main regional referral hospital continues to rely on donations.
The MSF trauma centre continues to treat people injured in road traffic accidents and those suffering from other trauma injuries.
Following an explosion in a mosque on 8 October, the trauma centre received over 100 major casualties with 20 dead on arrival.
MSF admitted 74 patients within two hours of the bombing. All patients bar one have now been discharged, most received treatment for burns.
From 1 – 30 November:
- 921 patients triaged in the trauma centre
- 113 patients treated in the inpatient department
- 278 surgical procedures
Tuberculosis (TB) care is continuing in Kandahar and we have a total of 54 patients enrolled in our DR-TB programme.
In September, MSF restarted screening patients for TB at Mirwais regional hospital and Sarpoza prison, having put this on hold during the peak of the fighting in Kandahar in August.
To respond to high levels of severe and acute malnutrition in the area, on 15 December MSF opened an outpatient feeding centre in Kandahar, next door to the MSF TB clinic.
The first phase of this activity will see us providing malnutrition treatment for patients aged between six months and five years who have been discharged from the nearby inpatient feeding centre at Mirwais regional hospital.
From 1 – 30 November:
- 54 DR-TB inpatients receiving treatment with the oral short-course regimen.
- 20,071 patients screened for TB, leading to diagnosis and starting treatment of 69 drug-sensitive TB cases
- Due to insecurity in 2021, two patients of the drug-resistant TB cohort were lost to follow up (0 patients were lost to follow up in 2020).
Our inpatient feeding clinic at Herat Regional Hospital has been very busy this year. The facility was initially set up with 40 beds, but to cope with the increase in malnutrition cases this was increased to 74 beds in October.
Over the course of the year, our teams have seen significantly higher numbers of patients arriving at the feeding centre.
Malnutrition is a seasonal phenomenon in Afghanistan and last year numbers decreased significantly in September, at the end of the seasonal peak.
The number of new admissions has started to decrease this year as well, from 65 per week in September to 50 per week in October and then 38 per week in November, but this is happening later and more gradually than previously.
Significant numbers of patients continue to travel from faraway districts and provinces; in November, Badghis province accounted for 15 percent of feeding centre admissions despite being around 150 km away.
On 8 December, MSF started supporting the paediatric department of Herat Regional Hospital. The first phase sees our teams working in the emergency room and the intensive care unit.
On the outskirts of Herat, MSF continues to provide outpatient care, treatment for non-communicable diseases, and sexual and reproductive health services at the Kahdestan clinic.
In November we triaged around 100 suspected COVID-19 cases per day in MSF’s triage area of the Herat Regional Hospital. Only a small proportion of them were critical or severe COVID-19 patients needing referral to COVID-19 treatment centres, including the nearby MSF COVID-19 treatment facility.
From 1-30 November:
- The Kahdestan clinic carried out over 1,700 outpatient consultations, including 625 for antenatal care
- 150 new admissions to the inpatient feeding centre in November, an average of 38 per week
- 2,800 suspected COVID-19 cases triaged at the Herat Regional Hospital, an average of over 100 per day. We referred an average of four severe or critical patients per day to COVID-19 treatment centres.
Khost is home to MSF’s busiest maternity hospital worldwide.
The hospital usually focuses on treating patients with complicated conditions, however, it was decided to expand the admission criteria to ensure that more mothers and newborns could reach safe maternal and neonatal care.
We are seeing an increase in patients and deliveries, and MSF helped to deliver 1,800 babies in October and 2,000 in November.
Private clinics in the area are seeing significantly fewer patients as the deteriorating economic situation means that people aren’t able to afford to pay for treatment.
The neonatal unit in the Khost maternity has been extremely busy over the last few months. The unit was designed for 28 beds but at times we have had between 30 and 45 babies admitted.
We also continue to support the eight comprehensive health centres (CHCs) and Khost Provincial Hospital with food, fuel and medical items.
These facilities along with others had their funding suspended by the World Bank in August, but despite that staff continued to work and in some cases, communities pooled money to pay for fuel, medicine and other supplies to keep the centres running.
Once CHCs across Khost are functioning well again and communities return to them, MSF’s Khost maternity will revert to its original admission criteria to focus on complicated cases.
From 1 – 30 November:
- Over 2,400 admissions to Khost maternity hospital
- Over 2,000 deliveries
- Over 170 babies admitted to our neonatal ward
Timeline: MSF in Afghanistan
Page last updated: 17 December 2021