Crisis in Afghanistan
Our medical teams have continued to provide care to the people of Afghanistan throughout the current crisis.
Since May 2021, fierce clashes between Afghan forces and the Islamic Emirate of Afghanistan (IEA, also known as the Taliban) took place in and around provincial capitals claiming thousands of lives.
Hospitals and medical facilities were caught in the crossfire, cutting off healthcare and emergency treatment for people wounded by bullets and explosions. At the same time, hundreds of thousands of people were forcibly displaced from their homes in the space of three months.
Now, as the clashes stop, there are mounting concerns about the availability of medical supplies and other humanitarian assistance for a healthcare system that has been on the brink of collapse for years.
Throughout the crisis, Médecins Sans Frontières / Doctors Without Borders (MSF) has continued to provide life-saving medical care to people caught in the chaos.
In five locations across Afghanistan, our teams are treating emergency trauma cases, supporting people with chronic conditions and welcoming new life into uncertain times.
“On 21 August we treated 862 people in our emergency room, which I think is the most we’ve ever received. Some patients are coming in critical conditions because they waited until the fighting had stopped.”
In four of the areas where MSF teams were already working before this surge in violence, the consequences of the conflict have been acute.
This includes the provincial capitals of Lashkar Gah and Kandahar, both in the south, Herat in the west and Kunduz in the north. MSF also runs another project in Khost, in the southeast.
The situation on the ground is extremely fast-moving. The information about our response, below, is correct as of 22 September 2021 and is likely to change.
Our emergency response across Afghanistan
The situation in Lashkar Gah, where MSF supports Boost Hospital, became extremely tense during the fighting. At one point a rocket exploded inside the hospital compound. Fortunately, there were no casualties.
During the violence, our team were living in the basement of the hospital so that they could continue to provide emergency care. They worked amid the chaos to treat patients injured by shelling, mortar and rocket attacks, with airstrikes taking place extremely close by.
Between 3 May and 6 August, we treated 652 war-wounded people – around a quarter of whom were aged under 18 – with many patients arriving in surges between the clashes.
The situation in Lashkar Gah is now calm, and many people who held off seeking treatment during the fighting have been arriving at the hospital. The emergency room has been extremely busy with patients suffering from respiratory conditions, injured in road traffic accidents or with wounds related to the conflict.
We are currently treating a large number of patients due to other healthcare facilities not fully functioning, while many people are now also reaching the hospital from outside of the city. At points recently we have seen over 800 patients a day in our emergency room, with all 300 inpatient beds full.
Between 6 and 12 September:
- 5,387 patients received consultations in our emergency room (around 770 per day)
- An average of 77 malnourished children a day receive treatment in our therapeutic feeding centre
Fighting surged around the city of Kunduz with airstrikes, rocket-propelled grenades and mortars hitting densely populated areas.
When clashes first intensified in July, the MSF office space was transformed into an emergency 25-bed trauma unit to care for injured people. The “Kunduz Emergency Trauma Unit” also included an operating theatre and pharmacy. Between 1 and 9 August, the team here treated 127 people for bullet and blast injuries, including 27 children aged under 16.
During the initial fighting, we also opened a temporary clinic for displaced people in the Sar Dawra area of the city, while MSF teams supported the regional hospital and two advanced health posts with supplies, surgery, wound care and stabilisation of trauma patients.
The situation in Kunduz is now stable, with the city itself emptier than before. On 16 August, all patients from the emergency unit were transferred to the newly opened Kunduz Trauma Centre which had been under construction.
Our teams are now mostly treating people either with complications from war wounds, or those injured in road traffic accidents – many of whom have head trauma injuries. We would usually refer these patients to the limited neurosurgery services in the area, but these are no longer available and the needs are as acute as ever.
The health system in Kunduz continues to be strained as experienced medical staff continue to leave the province, including senior health administration officials. The staff who remain have not been paid for several months.
Between 6 and 12 September:
- 153 patients triaged in the trauma centre
- 102 patients treated in the inpatient department
- 34 surgical procedures
Clashes took place around Kandahar, where MSF runs a project treating patients for drug-resistant tuberculosis (DR-TB).
Our teams were able to continue providing care, delivering remote consultations and providing buffer stocks of vital medication to avoid patients needing to cross the frontlines.
The initial fighting displaced thousands in the province, causing many people to seek shelter inside the city itself.
In response, MSF set up a temporary clinic in Haji Camp, where we treated 179 children under the age of five and worked to provide clean water and sanitation to the estimated 5,000 people living there.
The camp has now largely emptied, and we’ve closed the clinic. Before this, the main conditions treated were diarrhoea, respiratory conditions, anaemia and skin and eye infections.
TB care is continuing today and we have a small number of inpatients in our DR-TB centre. At Mirwais Regional Hospital, MSF is screening patients for TB.
In early September the team started running a mobile clinic for people living in informal settlements near the border with Pakistan, in the town of Spin Boldak.
In the last two weeks, the teams have provided 540 consultations, nearly half for children under five. The majority of people are presenting with respiratory infections, diarrhoea, and gastrointestinal problems. On 14 September, water trucking and water chlorination started as well, to help provide clean water.
Between 6 and 12 September:
- 33 DR-TB outpatient consultations for follow up and contact tracing: 4 DR-TB inpatients receiving treatment in our TB centre.
- 131 patients screened for TB at Mirwais Regional Hospital.
- 540 consultations through mobile clinics on Pakistan border at Spin Boldak
In early August, intense clashes took place in the outskirts of Herat, putting MSF community outreach activities on standby.
Our feeding centre in Herat Regional Hospital is facing a critical situation. We have twice the number of patients to beds with around 90-100 children admitted. This is most likely due to the lack of functioning health services in the area, the economic downturn, inflationary pressures in the marketplace and persistent drought conditions.
However, the third wave of COVID-19 appears to be on a downward trend and fewer patients have been referred to our centre for oxygen treatment.
At the Kahdestan clinic – where we provide care for non-communicable diseases and sexual and reproductive health services – we are now seeing the number of patients reducing as other healthcare providers are returning and reopening in the area.
Between 23 and 29 August:
- More than 1,900 outpatient consultations at our Kahdestan clinic (25 percent of cases were children under five).
- More than 60 new admissions to our inpatient feeding centre for the third week in a row
- 695 suspected COVID-19 cases triaged at the Herat Regional Hospital
Khost is home to MSF’s busiest maternity hospital worldwide.
Throughout the recent chaotic events, medical activities have been able to continue here, as well as at eight MSF-supported comprehensive healthcare centres in the area.
In July alone, there were 1,450 deliveries at Khost and 871 more at the healthcare centres.
Despite the conflict coming to an end, increasing numbers of people in the region are facing challenges in accessing healthcare, while local transport systems and private clinics are not fully functioning. Some women have given birth at home as they were unsure if facilities were open.
Khost 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.
Between 22 and 28 August:
- 440 pregnant women admitted
- 373 births assisted
- 45 babies admitted to our neonatal ward
Page last updated: 22 September 2021