Afghanistan

Tom Casey/MSF

What we do

MSF focuses on emergency, paediatric, and maternal healthcare in Afghanistan, which has one of the highest maternal mortality rates in the world.

We work in one hospital in Helmand province in collaboration with the Ministry of Public Health. We also run a maternity hospital in rural Khost province, a drug-resistant tuberculosis programme in Kandahar, and a trauma centre in Kunduz. We treat malnourished children, who have been displaced, in Herat province.

Major attacks on MSF hospitals have occurred in recent years; in October 2015, US airstrikes destroyed our trauma centre in Kunduz, killing 42 people. An armed group attacked our maternity wing at Dasht-e-Barchi hospital in Kabul in May 2020, with 16 mothers and an MSF midwife among those killed. In the wake of the attack, we made the difficult decision to withdraw from the hospital in Kabul, leaving women in the area without critically-needed emergency obstetric care.

In August 2021, the Islamic Emirate of Afghanistan (also known as the Taliban) entered the city of Kabul as the government collapsed. MSF teams have stayed in place and continue to provide care.

People struggle to access medical care in Afghanistan, where – even as the government has collapsed and uncertainty has set in – we remain to address people’s needs.

What are we doing in Afghanistan?

Maternal healthcare

By providing free, high quality maternal and neonatal healthcare in two hospitals in Helmand and Khost provinces, we aim to help reduce death and sickness in mothers and their newborns in one of the most dangerous places in the world to give birth. Training medical staff is an integral and important part of our projects. We place an emphasis on training local female staff through our projects in Afghanistan. Almost all the midwives are Afghan women, some of whom have become highly experienced in managing complicated deliveries since we opened our maternity hospital in Khost in 2012.

Tuberculosis treatment

We support the diagnosis and treatment of drug-resistant tuberculosis. In Kandahar province, in the south of the country, we run a laboratory, as well as facilities for hosting patients during their treatment. In December 2019, we introduced a nine-month oral regimen allowing DR-TB patients to change from injectable drugs to pills and reduce their number of consultations at the hospital. The shorter, all-oral treatment produces fewer side effects and improves the patients’ quality of life. We also provide support to Mirwais regional hospital, and organise training for other facilities in Kandahar to improve the detection of TB, including drug-sensitive cases.

Trauma care

We opened a new 30-bed trauma centre in Kunduz in August 2021. The centre treats people with trauma injuries, for example, as a result of road traffic accidents, and people injured in the fighting who have complications.

Treating malnutrition

In both Herat and Helmand provinces, we treat malnourished children in inpatient therapeutic feeding centres; those coming to the centre at the regional hospital in Herat have often travelled some distance to get there.

In 2023

Médecins Sans Frontières (MSF) runs a range of projects in Afghanistan, responding to the immense medical needs caused by decades of conflict and political upheaval, particularly among women and children.

In 2023, Médecins Sans Frontières (MSF) continued to support Afghanistan’s struggling health system by providing specialised healthcare across the country. We also launched an emergency response after earthquakes hit Herat province.

During the year, there was a gradual but stable increase in the number of patients coming to MSF facilities in Afghanistan, largely due to the improved security situation, which made it easier for people to travel. However, many Afghans continue to face huge challenges in accessing care.

In a broken economy, many cannot afford medical assistance. The public health system in Afghanistan has also been under-resourced, under-funded and over-burdened for years, and remains unable to meet people’s needs. In 2023, MSF teams in Afghanistan witnessed very high bed occupancy rates, reaching 130 per cent to 200 per cent in most facilities.

We ran nine projects in eight provinces, maintaining a strong focus on emergency care, surgery, and mother and child health. We also carried out an emergency response in October, after four 6.3 magnitude earthquakes hit Herat province, killing more than 2,000 people and displacing over 250,000. We donated emergency kits and helped treat the wounded at Herat regional hospital, the
main treatment facility for earthquake victims.

The situation for women did not improve in 2023. In late December 2022, following the decision by the Islamic Emirate of Afghanistan, also known
as the Taliban, to ban women from working for NGOs and to limit their access to higher education opportunities, MSF condemned the gradual erasure
of women and girls from public life in the country.

In April, the ban was expanded to women working for the UN. In order for essential services to be available to everyone, there must be no constraints
on who can deliver them. Women must be allowed to work, and to train as medical professionals.

Bamyan

In December 2022, MSF started a community healthcare programme in Bamyan, delivering healthcare services to remote and underserved districts in the province. We initially focused on mother and child healthcare, including obstetric
and gynaecological consultations, support for non-complicated deliveries, and outpatient services for children under five. We also worked to boost the provincial hospital’s capacity for treating measles and COVID-19 patients, a short-term project that has since ended.

In 2023, we saw significant needs for general outpatient services, prompting us to expand our services. We also began administering routine vaccinations to protect children from preventable diseases.

Helmand

MSF supports Boost provincial hospital in Lashkar Gah, offering a wide range of medical services, including emergency, paediatric, neonatal and maternity care, surgery, and internal medicine. Our teams continued to witness the negative impact of poor access to health services in Helmand, with many patients travelling long distances from other provinces to reach the facility, sometimes arriving very late and in a critical condition.

Herat

In Herat province, we work in the paediatric department at the regional hospital, supporting triage, the emergency room, both inpatient and outpatient therapeutic feeding centres, the paediatric intensive care unit, and an intermediate care unit. During 2023, our teams admitted a high number of severely ill children to these units. Our teams also run an outpatient clinic in Kahdestan, in Injeel district, where we offer care for pregnant and lactating women and treatment for children with moderate acute malnutrition, as well as general health services. 

In 2023, we continued to treat patients with measles at Maiwand teaching hospital, but our main focus during the year was malnutrition. Our team increased the feeding centre’s bed capacity from 34 to 47 – the maximum the space would allow. Due to space constraints and a growing demand for inpatient care, MSF ended activities at the hospital on 26 December, with a plan to relocate to another, larger facility in the capital.

We also maintained our assistance to the Afghan Midwives Association’s pilot project by offering funding and technical support for deliveries, ante and postnatal care and, family planning.

Kabul

In 2023, we continued to treat patients with measles at Maiwand teaching hospital, but our main focus during the year was malnutrition. Our team increased the feeding centre’s bed capacity from 34 to 47 – the maximum the space would allow. Due to space constraints and a growing demand for inpatient care, MSF ended activities at the hospital on 26 December, with a plan to relocate to another, larger facility in the capital. We also maintained our assistance to the Afghan Midwives Association’s pilot project by offering funding and technical support for deliveries, ante and postnatal care and, family planning.

OUR ACTIVITIES IN 2023

OUTPATIENT CONSULTATIONS
0
BIRTHS ASSISTED
0
SURGICAL INTERVENTIONS
0
PEOPLE STARTED ON TREATMENT FOR TB
0
EMERGENCY ROOM ADMISSIONS
0
CHILDREN ADMITTED TO IFP
0
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