Emergency room of the Doctors Without Borders Kunduz Emergency Trauma Unit, a medic treats a patient who has suffered a complicated fracture of their upper and lower leg due to a bomb blast. © Stig Walravens/MSF
Doctors Without Borders continues to provide care in the trauma unit but has started to transfer outpatient services to the new Kunduz Trauma Centre (KTC), which has been under construction since 2018. Doctors Without Borders is also continuing to support the district advanced post in Chahar Dara, a stabilization unit in a district outside Kunduz city, which saw 126 war-wounded patients between 1 and 8 August.
In a country with a poorly functioning health system, violence is severely exacerbating people’s access to care. In areas with heavy fighting it is too dangerous for people to leave their homes for medical treatment, or they delay until they are very sick. We see that the number of patients in our emergency rooms, COVID-19 treatment centre, or outpatient clinics decreases as the violence increases. In Kandahar where Doctors Without Borders runs a project for patients with drug-resistant tuberculosis (DR-TB), they are being provided with remote consultations and buffer stocks of medication to avoid having to cross frontlines. And in Lashkar Gah a couple of days ago, the number of pregnant women seeking care increased when the situation was calmer. Medical emergencies, births and chronic conditions do not stop during times of war.
We only had one pregnant woman in the hospital, but the next day, after the fighting died down for a bit, 10 pregnant women managed to reach us, so we know the needs are out there. We’re really worried that women are having to give birth at home with no medical help available if they have complications.Sarah Leahy, Project Coordinator
The clashes between the warring parties have also forced hundreds of thousands of people from their homes. Some have sought safety in urban areas and are living in informal settlements with little access to basics such as food, shelter and medical care. In July in Kunduz, MSF opened a small clinic providing outpatient consultations for displaced women and children in Sar Dawra and began providing safe drinking water to internally displaced people.
On 6 July MSF set up a temporary clinic for people displaced by heavy fighting around Kunduz city. The clinic team carried out over 3,400 consultations during the first 12 days. The project is run by a nine-person team, including doctors, nurses and a health promoter. © Prue Coakley/MSF
The clinic team carried out over 3,400 consultations during the first 12 days. The project is run by a nine-person team, including doctors, nurses and a health promoter. © Prue Coakley/MSF
In June, heavy fighting around Kunduz city forced thousands of people from their homes. 400 families sought shelter at an informal settlement where MSF teams began providing 12,000 litres of clean drinking water a day. © Prue Coakley/MSF
The clinic treated around 300 patients a day and in early August Doctors Without Borders handed over the activities to another organisation to allow teams to focus on trauma care. In Kandahar city, Doctors Without Borders has set up a temporary clinic providing medical care to children under five in Haji camp, an informal settlement where 500 displaced people are currently living. We have also been rehabilitating water points and ensuring access to toilets and showers. As of last week, since 28 July over 170 children had been treated, the majority for respiratory illnesses, diarrhoea and anaemia.
The conflict remains very dynamic with violence flaring in different areas of the country, and Doctors Without Borders is adapting its projects as much as possible to address the changing needs. But medical staff around Afghanistan are faced with fighting taking place in the streets around medical facilities, and with little rest or respite; constantly worried about the families they have left at home. As fighting enters cities, hospitals continue to function but the threat of being in the wrong place is ever-present, as we saw yesterday in Lashkar Gah. All working medical facilities must be respected.
