Fieldset
Afghanistan: "Patient numbers have increased tremendously"

An MSF medic working in Lashkar Gah shares the impact on healthcare they have witnessed amid the recent conflict and transfer of power

Amid the rapid transfer of power in Afghanistan, Médecins Sans Frontières / Doctors Without Borders (MSF) continues to run medical activities in five provinces across the country.

In Lashkar Gah, the situation is now calm, but there remains some anxiety and uncertainty. People who delayed getting medical help while there was active fighting are now coming to the MSF-supported Boost provincial hospital in southern Afghanistan.

As a result, over the past few days, the emergency room has been full, with many people suffering from respiratory and gastrointestinal problems, and trauma-related injuries as a result of the fighting and also road traffic accidents.

Between 15 and 21 August, over 3,600 patients received consultations in the emergency room and 415 were admitted to hospital.

Here, a medic working at Boost hospital shares their experience.

All photos in this article were taken before the recent events in Afghanistan. The image at the top of the page shows patients waiting for operations at Boost hospital in June 2016.


On 1 August I came to the Boost provincial hospital in Lashkar Gah and spent 13 days working there. The medical needs were very high; we received a lot of patients wounded in the fighting.

But most of our regular patients (sick children, pregnant women, patients in need of more routine surgical care), which previously numbered around 500 a day, stayed away because access to the hospital was at times made impossible by the fighting.

Our staff had little rest; when patients came in we would wake up and run to the emergency room. We stayed in the hospital to treat our patients. It was very dangerous outside.

After the fighting ended on 13 August, we stopped hearing the heavy sounds of airstrikes, rockets and mortars.

Some patients are coming in critical conditions because they waited until the fighting had stopped

The roads in the city and in the surrounding districts are open and people are, once again, coming to the hospital. Patient numbers have increased tremendously.

Over the last week or so, we are receiving over 700 patients a day in our emergency room, sometimes more than 800.

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.

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An MSF surgeon prepares for surgery to remove a kidney stone from a 63-year-old man in the operating theatre of Boost hospital, May 2021
An MSF surgeon prepares for surgery to remove a kidney stone from a 63-year-old man in the operating theatre of Boost hospital, May 2021

One reason we are seeing this huge number of patients at our hospital is, I think, because other local clinics are not able to meet the needs of the people.

We send around 200 less critical patients (known as green cases) to these clinics each day, but many come back reporting that the clinics don’t have the drugs they need or that they are closed due to a shortage of staff.

Our hospital is now full in terms of the number of patients we can admit. We have more than 300 patients already being treated in the hospital.

We already have more patients in our hospital than we have beds, so the more patients we receive in the emergency room, the greater the problem is finding space for them inside the hospital.

They are waiting a long time in the emergency room, while we try to find space. We have two patients to a bed in the paediatric ward, but we are still struggling to find room for everyone.

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Imran, suffering from a chest infection, is held by his mother in the female observation ward at Boost hospital, October 2020
Imran, suffering from a chest infection, is held by his mother in the female observation ward at Boost hospital, October 2020

So we assess the severity of each patient’s condition because the more severe things are the more they need admitting.

Each day, between 80 and 100 of the people we assess have severe enough conditions that they must be treated as inpatients in the hospital.

This forces us to discharge other patients to make room for them. This is one of the big challenges at the moment.

I don’t know how we can solve it in the long term, but for now we are decreasing the length of stay and discharge them with the medicine they need, unless they are in a very critical state.

Our intensive care unit is also full. All the districts are now open so that’s another reason we are receiving so many patients, as they are coming from outside the city.

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